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+--- Thread: Medicare FACE-TO-FACE "Compliance" visit? (/Thread-Medicare-FACE-TO-FACE-Compliance-visit)
Medicare FACE-TO-FACE "Compliance" visit? - Night Train - 07-21-2021
Does Medicare REQUIRE an in-face compliance visit of any type at about the 2-3 month point after placement of new CPAP equipment?
My sleep-study practice/DME equipment provider combo outfit tells me that they do, and set me up with a Zoom-like meeting with their NP. However, it was not Zoom-based, it was some phone-app based video conference system. First off, as previously asked, does Medicare require this visit to be in person, or at least face to face through some video conferencing platform? Since they told me that the meeting's purpose is solely to determine compliance, why am I even troubled with this? Isn't that compliance info available to them via 4G in real time, anytime they want to retrieve it? For the DME company to get paid by Medicare for the equipment do I have to do this meeting? Or is this something that their revenue enhancement officer identified as a source of additional revenue above the equipment rental revenue and that is the real reason they are requiring me to do this? And if it is indeed required by Medicare, is it Medicare's requirement to be face-to-face? Couldn't this be done by phone?
I have some problems with the whole process. First, why must I INSTALL AN APP in my phone to do the meeting, with all the Big Brother overreach that we know these apps contain? (And require me to agree to binding arbitration in their home county, half way across the country) Second, why must I put my credit card information on file with the company in order to be able to successfully install the phone app? I have Medicare and Aetna supp. I am old school: mail me a bill and if I think I owe you money (after Medicare and Aetna pays) I will write a check and lick a stamp. I don't want you to bill my credit card summarily, without my review. I want to be the gatekeeper of my healthcare provider's access to my pocketbook. Having my credit card info on file removes me from the management of my healthcare AND THE CONTROL OF ITS COSTS. I become simply a cog in the healthcare revenue-generating mission statement, not the focus of and reason for healthcare in the first place. That dog don't hunt: I uninstalled the half-installed app and told them NO MEETING until I have a chance to educate myself about this process. I know when I am being "handled".
So please reply and get me up to speed as far as Medicare's requirements on this: Do they only want the compliance info and no meeting is needed? Is my supplier playing loose with the facts and the meeting is superfluous and just another way to enhance their revenue? (Seems like if I had chosen to deal with a internet-based CPAP company I wouldn't be troubled with this.)
I'd like to know the facts before I speak with them again. They surely could have done more to make this whole process less cumbersome in my opinion. They do not hide their profit motive well, nor make much of an effort to do so.
RE: Medicare FACE-TO-FACE "Compliance" visit? - OpalRose - 07-21-2021
Yes, this is a compliance requirement by Medicare.
Compliance:
Medicare requires that a patient use CPAP for more than 4 hours per night on 70% of nights (21 nights) during a 30-day consecutive period any time in the first three months of use.
Patient must also have a face to face appointment with their doctor any time after the first 30 days, but before the 90 days expires.
As far as a face-to-face appointment, due to the pandemic, they may be waiving the "in person" visit and allow remote visits.
I quess that is up to your doctor and insurance.
I don't know anything about the app or having to leave your credit card information with anyone. I would be hesitant of that too.
RE: Medicare FACE-TO-FACE "Compliance" visit? - Big Guy - 07-21-2021
I have to see my sleep doctor every six months. Is that considered a compliance meeting?
Other than that, I've never had Medicare call me and I've never had any kind of contact with them.
Is compliance only enforced during the first 90 days of use?
RE: Medicare FACE-TO-FACE "Compliance" visit? - OpalRose - 07-21-2021
Yes, the compliance is enforced during the first 90 days.
Also, in order for insurance/Medicare to reimburse the DME for supplies, a yearly Dr. visit is usually required.
It's just a "game" you have to play to get Medicare to pay.
RE: Medicare FACE-TO-FACE "Compliance" visit? - Big Guy - 07-21-2021
(07-21-2021, 12:21 PM)OpalRose Wrote: Yes, the compliance is enforced during the first 90 days.
Also, in order for insurance/Medicare to reimburse the DME for supplies, a yearly Dr. visit is usually required.
It's just a "game" you have to play to get Medicare to pay.
Thank-you for the confirmation. The first 90 days of compliance was a breeze for me. Even thru-out the first 18 months, no compliance issues at all.
Here I am, now approaching three years (Sept.), and I have to admit, I'm struggling to keep up using my machine.
RE: Medicare FACE-TO-FACE "Compliance" visit? - Homerec130 - 07-21-2021
My doc has me come in every 6 months for Medicare compliance, not a problem. My DME requires a new script for supplies every 12 months. I asked Medicare and they said the 12 month script for supplies is a recommendation. No problem, I just have it in my chart they send a script every time I see him.
RE: Medicare FACE-TO-FACE "Compliance" visit? - factor - 07-21-2021
http://www.apneaboard.com/wiki/index.php/Dealing_with_insurance_%26_Medicare
RE: Medicare FACE-TO-FACE "Compliance" visit? - Night Train - 07-21-2021
Okay, so face-to-face meeting it will be. Thanks for lining me out. I have no problem in going in for the meeting, in person rather than a telemeeting. I just couldn't understand why they were pushing the concept of a telemeeting so much. Now I know: credit card access. The in person works better for me: My wife is undergoing chemo less than 200 yards from this place. Takes 4-5 hours. I can be at their disposal for that time. I am COMPLETELY happy with the equipment they set me up with and its calibration, much better than the thirteen year old IntelliPap I was previously using. From a 69.7 AHI unassisted, now I have attained a sub 1.0 AHI and I sleep like a rock. World Class sleep now. If sleep were an Olympic event I would be carrying the American flag, in my pajamas. Picture that. Or don't. Now, if they could just do something about the dreams I am having. Last night Spiro Agnew sat and looked on approvingly as I paddled a poodle with a green spatula.
Interpret that one Joseph!