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[CPAP] Sleep MD won't give script for CPAP Setup - Printable Version

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Sleep MD won't give script for CPAP Setup - mpiperlcpc - 02-17-2020

Greetings! My first post. Had in lab sleep study last week. Preliminary result recommedation is CPAP. I have high deductible insurance. They want to run an in lab titration. I will have $500. ded. to pay for that. Asked to just get a Prescription from MD for a CPAP and they are pushing back and refusing to give me a script unless I go thru titration study and use a vender they want to pick.
I have found good online prices for APAPs and CPAPs who will provide the machine but must have a prescription. 
Any ideas about what my consumer/patient rights are in this situation?
Thanks for any assistance you could give me. 
Marcus P.

RE: Sleep MD won't give script for CPAP Setup - slowriter - 02-17-2020

I don't know the legal issues here, but something sure seems pretty dicey. How can they possibly "insist" on what vendor (DME) you use, much less that you must have a titration study (which you probably don't need) for them to give you a prescription?

Possible to take your study results to another sleep doc, or even GP, to get the prescription?

RE: Sleep MD won't give script for CPAP Setup - Gideon - 02-17-2020

Is your doc looking for a yacht payment?

Red Flag- and use a vender they want to pick.
It is likely that someone there "owns" or get a kickback for referred patients to that facility. That means their interest is likely profit, money in their pocket, not your health.

IMHO the first sleep study is needed to diagnose sleep apnea.
It is not uncommon to set a patient up with an APAP (AutoSet) to titrate workable settings.

Get a FULL copy of the sleep study that was performed. This means the charts and tables.

You do have a choic of running with them or changing doctors that are more in tune with you.

RE: Sleep MD won't give script for CPAP Setup - harrywr2 - 02-17-2020

Supplier #2 offered to help me with a prescription..my Doctors office relented before I found out the details of what the help entailed.
(I don't know if there was a fee involved.)

RE: Sleep MD won't give script for CPAP Setup - Sleeprider - 02-17-2020

You have a right to a copy of your sleep study results and recommendations under HIPAA. This is enforceable by federal law. With that study, many vendors will dispense an Auto CPAP. Some may charge you a nominal prescription cost to review the sleep study ($36 to $99 is typical), and others won't ask. Supplier #30 actually advertises this service. You could also use your primary doctor, physician's assistant, nurse or dentist to write a prescription from the results of the study. You don't need a sleep doctor and you don't need a titration. This guy is unethical and you need to part ways. Do try to get a Resmed Airsense 10 Autoset.

Take a look at Facebook Marketplace, Offerup and Craigslist for machines that really won't require a prescription, and you should save at least half the cost.

RE: Sleep MD won't give script for CPAP Setup - mpiperlcpc - 02-17-2020

Thanks   I'm going to get a copy oft the study.

Does anyone know if its diffucult to find another Sleep MD to review the results and write an prescription for a CPAP?

RE: Sleep MD won't give script for CPAP Setup - mpiperlcpc - 02-17-2020

I have spoken to vendor #30. They did offer to have an MD write the prescription, however I found another online vendor that can get me set up for about a $300 savings. I am asking them if they have alternatives if the MD who reviews my study won't write the script. 
MDs don't seem to care for informed conumers.

RE: Sleep MD won't give script for CPAP Setup - Sleeprider - 02-17-2020

Supplier #30 advertises a free prescription service with the study or a questionnaire. I'm sure you can tell them where you found a better price, and they will make a competitive offer. Supplier #2 also has very competitive prices. I would also call them and see what they can do with your sleep study and recommendation. Even though it is not a prescription, it may be enough if the report recommends CPAP therapy or a CPAP titration study.

Your situation is especially frustrating. It is unethical for your doctor to hold you hostage to more studies or the purchase of a machine from a sale where he has a clear conflict of interest. Many of us were issued auto-CPAP and instructions to self-titrate. A study rarely offers any benefit, and your financial situation should be considered by your doctor. Talk to your insurance company representative and explain your situation to them. Complain that you want an auto CPAP and to self-titrate in order to minimuze costs. It is likely your insurance company will act on your behalf to leverage payment for your diagnostic study for release of your prescription. Even though you have a high deductible, your insurance company may have a lower negotiated rate for you sleep study, and they can advocate on your behalf to stop this unethical behavior by your doctor. You should not make direct payments to the doctor...go through insurance, even if you get a bill for whatever they allow for the service.

RE: Sleep MD won't give script for CPAP Setup - SarcasticDave94 - 02-17-2020

Sounds like the duck wants replaced. None of the docs I deal with do the "I'll send it to the DME I the doc choose". Easier to get kickbacks for patient referrals I suppose. No doc I choose the DME, gimme the script or you're fired.

RE: Sleep MD won't give script for CPAP Setup - Geer1 - 02-17-2020

Your prescription does not need to be written by the doctor who did the study. Your general doctor that referred you to the sleep doctor/testing should have got a copy of the report and its recommendations for CPAP (or whatever they were). I would try asking him for a prescription if you haven't already.

Depending on what your sleep study indicated it might be worthwhile to do the titration study. If your apnea is severe or includes central apneas then the titration study would help identify if a basic APAP unit will suffice or if you might need bilevel etc. Just something to consider.