+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: Changing Pressure and Medicare (/Thread-Changing-Pressure-and-Medicare)
Changing Pressure and Medicare - GTOdude - 12-13-2015
Im on Medicare and have to send the data card every month to my DME. I changed my pressures on my APAP today upon recommendations from other knowledgeable people about to improve my therapy.
How does that impact the info sent to the DME and/or Medicare pertaining to being paid for my machine rental, versus the Dr's prescription pressures?
Thanks all.
Mark
RE: Changing Pressure and Medicare - justMongo - 12-13-2015
Medicare only cares about compliance. Days and hours used.
Most DMEs don't look beyond that. And, since they wish to be paid, any fuss will not stop you from getting the machine paid for.
RE: Changing Pressure and Medicare - OpalRose - 12-13-2015
Medicare is most likely looking at compliance, not your pressure settings. If I remember correctly, Medicare requires that you are using the machine no less than 4 hours a night for 30 consecutive days within the first 3 months rental period.
Some DME's or Doctors may get their feathers ruffled a bit about you taking charge of your therapy, but again they may not. I think their main concern is that you are compliant, because if not, Medicare will stop paying them rent. I wouldn't worry about it, you have to do what's best for you.
RE: Changing Pressure and Medicare - GTOdude - 12-13-2015
(12-13-2015, 10:58 PM)justMongo Wrote: Medicare only cares about compliance. Days and hours used.Thank you, Mongo!
Most DMEs don't look beyond that. And, since they wish to be paid, any fuss will not stop you from getting the machine paid for.
I read in another post elsewhere that you were an Airman? Can I assume you were USAF? I am retired Air Force MSgt.
Mark
(12-13-2015, 11:02 PM)OpalRose Wrote: Medicare is most likely looking at compliance, not your pressure settings. If I remember correctly, Medicare requires that you are using the machine no less than 4 hours a night for 30 consecutive days within the first 3 months rental period.OpalRose, My Dr is a pretty decent guy. The DME I have dealt with before, but back before I turned 65 and was on an HMO and Military medical, trying to make an old BiPAP machine work for me (without success).
Some DME's or Doctors may get their feathers ruffled a bit about you taking charge of your therapy, but again they may not. I think their main concern is that you are compliant, because if not, Medicare will stop paying them rent. I wouldn't worry about it, you have to do what's best for you.
Thanks!
Mark
RE: Changing Pressure and Medicare - Ghost1958 - 12-13-2015
Medicare does not give a rats patooti what your pressure is or who set it as long as you were diagnosed by home study or sleep lab, have a prescription, do the two face to face dr meets and are compliant.
RE: Changing Pressure and Medicare - justMongo - 12-14-2015
(12-13-2015, 11:18 PM)GTOdude Wrote: I read in another post elsewhere that you were an Airman? Can I assume you were USAF? I am retired Air Force MSgt.
Mark
USAF NKP Thailand and Da Nang RVN.
RE: Changing Pressure and Medicare - GTOdude - 12-14-2015
(12-14-2015, 12:27 AM)justMongo Wrote:And I thank you wholeheartedly for your service during a bad time in history.(12-13-2015, 11:18 PM)GTOdude Wrote: I read in another post elsewhere that you were an Airman? Can I assume you were USAF? I am retired Air Force MSgt.
Mark
USAF NKP Thailand and Da Nang RVN.
I spent 4 years in Korea during peacetime. Did 20.5 years.
Mark