am going to have to return my CPAP machine back in because I was told I am not compliant with Medicare rules. Medicare doesn't realize that a person diagnosed with insomnia will not sleep at normal times or lengths.
So my hubby who is very dear to me let me almost max out a paid off CC so I coulf get a working CPAP machine.
I was wondering if any one else has had or is having this problem]
Medicare and Non Compliance
- Severeena
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Medicare and Non Compliance
Last edited by Severeena on Wed Feb 10, 2010 4:20 am, edited 1 time in total.
Sharon
Trust in the Lord with all thine heart and lean not until thine own understanding ..... Proverbs 3:5-
Not all Masks work for everyone. Each Person is Different.
Trust in the Lord with all thine heart and lean not until thine own understanding ..... Proverbs 3:5-
Not all Masks work for everyone. Each Person is Different.
- JohnBFisher
- Posts: 3821
- Joined: Wed Oct 14, 2009 6:33 am
Re: Medicare and Non Compliance
My respiratory therapist mentioned that he's had a few cases where someone was in the hospital and could not use their machine enough to be complaint. So, he lost his CPAP. Medicare would not pay for another CPAP. But they would pay for a BiPAP. You got to love a bureaucracy!
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Additional Comments: User of xPAP therapy for over 20 yrs. Resmed & Respironics ASV units with EEP=9cm-14cm H2O; PSmin=4cm H2O; PSmax=15cm H2O; Max=25cm H2O |
"I get up. I walk. I fall down. Meanwhile, I keep dancing” from Rabbi Hillel
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"I wish to paint in such a manner as if I were photographing dreams." from Zdzisław Beksiński
Re: Medicare and Non Compliance
under medicare you have 90 days to become compliant. Within that 90 days you must show 30days with machine being used more than 4 hours 70 % of the time. Your DME can opt to continue trying to get you compliant after the initial 90 days but they won't be paid until you become compliant.
Re: Medicare and Non Compliance
When did you receive your cpap??
If it is over 90 days, here are your options:
1) Have a face to face eval with the doc, and ask for a bipap rx. You will have another 90 day trial period.
2) have a repeat split night study and go back to cpap (why Medicare will pay for another sleep study, I don't understand!)
3) pay cash for a cpap
If its less than 90 days, the DME should not be removing the cpap.
If it is over 90 days, here are your options:
1) Have a face to face eval with the doc, and ask for a bipap rx. You will have another 90 day trial period.
2) have a repeat split night study and go back to cpap (why Medicare will pay for another sleep study, I don't understand!)
3) pay cash for a cpap
If its less than 90 days, the DME should not be removing the cpap.