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+--- Thread: [CPAP] Online purchase - how is data transmitted to Medicare? (/Thread-CPAP-Online-purchase-how-is-data-transmitted-to-Medicare)
Online purchase - how is data transmitted to Medicare? - CR Mc - 09-27-2019
I have several years use of a Resmed S9 Autoset. Prior to signing up for Medicare this year, I obtained the S9 machine through the DME selected by my internist. Following a recent sleep study prescribed by my sleep doctor, he wants me to obtain a new Resmed Airsense 10 machine. Previously the DME collected compliance and therapy data through an external added cell phone. I am considering making the purchase of the new machine from an online DME provider because the price is about $600 less than from the outfit recommended by my sleep doctor. I know that the Airsense-10 has a built in cell phone. When a device is ordered online, how is the cell phone set up to transmit compliance data to Medicare, my insurance provider and the sleep doctor? Is it worth the trouble to order online or should I just go with the provider selected by my doctor?
Thanks, Craig McClure
RE: Online purchase - how is data transmitted to Medicare? - Nightynite - 09-27-2019
That’s a good question. I know the Myair app uses the serial number on the back of the machine . So theoretically it transmits the same type of info.
RE: Online purchase - how is data transmitted to Medicare? - Sleeprider - 09-27-2019
First, Medicare has specific rules on Medicare Approved Suppliers, and if you have a separate Advantage Plan that supplements your Medicare coverage, they may have a separate list of in-network providers. Be sure that wherever you get your machine, it is approved by Medicare or in-network to your provider. Your doctor's preference is a secondary non-binding recommendation that does not ensure coverage. https://www.medicareinteractive.org/get-answers/medicare-covered-services/durable-medical-equipment-dme/dme-costs-when-you-are-not-affected-by-competitive-bidding
With regard to compliance and other records, you will be required to have a followup with your doctor to discuss your therapy. It's a simple determination that you are using your CPAP and benefiting from the therapy. In most cases your DME will coordinate looking at your compliance record, which is automatically tracked in MyAir and transmitted to the DME, and the physician follow-up. When you pick up the machine, just ask if they will be tracking your therapy for Medicare compliance purposes. If you have an Advantage Plan, the information may go through your insurer.
RE: Online purchase - how is data transmitted to Medicare? - Mosquitobait - 10-10-2019
If you want Medicare to cover it, you need to go to a Medicare approved provider. Most people are part of the bid process, so who is approved today may change next year. I know the provider that my sleep doctor uses is NOT APPROVED!
If you have an Advantage plan, contact your Advantage care number and talk to them about your options. Otherwise, go to this Medicare link to find out what provider options you have: https://www.medicare.gov/supplierdirectory/search.html
If you have a high deductible, it may actually be cheaper for you to pay out of pocket and buy from an online provider. Then there is zero compliance needed unless you are a pilot or a truck driver. I think my machine (Resmed Airsense for Her) cost about $250 from Medicare (my Cost Plan insurance didn't cover anything) which was 80% of cost to Medicare. I'm due for a new machine next year, and apparently my Advantage plan covers more of the cost. My brother's Cadillac plan covered his bipap machine 100%.