insurance won't pay for titration

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SewTired
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Re: insurance won't pay for titration

Post by SewTired » Sat Jun 06, 2015 8:03 am

avi123 wrote:Image

How would you find out in a home- test about the sleep architecture (REMs for example)?
What's the name of the insurer that would not pay for titration?
The Airsence for Her and the Resprionics series 60 will both show RERAs. I'd stick with either of those machines.

I know you said your doc has no clue. People here can help you interpret your husband's results. If your data is confusing or concerning, or you just would feel more comfortable, consult with a pulmonologist. They at least know something about this stuff. I found it really helpful to have 2 weeks of data.

As an aside, the Sleep Center does a lot of home studies, but because I had a prior brain injury, a lab study was more appropriate.

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Ingjv
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Re: insurance won't pay for titration

Post by Ingjv » Sat Jun 06, 2015 6:46 pm

Hubs got his machine today, and I am SO jealous! It is not fair that he gets such a cool machine out of the gate. I can not believe what this machine can do.. Technology is amazing! I feel like he got a new Mercedes and I'm driving a Pinto.
He got a Resmed Airsense 10 Autoset. The tech said I could buy one for around $950.00 from him.
The tech told me "you don't need to download any software because you can get your results by signing up at Resmed. I signed hubs up, but I'm still going to download the sleepyhead.
When we went for the original study, we had to demand copies of the results be mailed to us, why wouldn't they just automatically send your results to you? Wouldn't everyone want them? Who wouldn't want their results? We received a crappy photocopy but it was better than nothing.
I don't know what the most important numbers are, but his original in home study showed:
68.3 AHI
70.1 RI
60.3 ODI
513 desaturations- his lowest saturation was 52 (it was down there pretty often according to the chart), accordingly his pulse went up to 96 then drop to 47 when his O2 dropped so low.
270 apneas, 264 of them were obstructive.
I can't wait to see the difference this machine makes. I've been pushing him for years to get tested, he always refused until I found out there was a home test the insurance would pay for.

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palerider
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Re: insurance won't pay for titration

Post by palerider » Sat Jun 06, 2015 7:32 pm

Ingjv wrote:He got a Resmed Airsense 10 Autoset. The tech said I could buy one for around $950.00 from him.
or, you could save 300$ and buy one from stlmark: viewtopic/t106015/For-Sale-New-AirCurve ... t-650.html

sleepyhead gives you TONS and TONS more info than what you can get on the resmed site, (which is basically just what you can see on the screen of the machine. the tech is full of high grade fertilizer

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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Krelvin
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Re: insurance won't pay for titration

Post by Krelvin » Sat Jun 06, 2015 7:35 pm

Ingjv wrote:The tech told me "you don't need to download any software because you can get your results by signing up at Resmed.
His idea of results is basically compliance and a general overview of what happened for the night.

But if you need to find out why the numbers are what they are, and how you did during the night, sleepyhead will give you a much better picture.

Glad your hubby got his machine and that is is data capable.
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Ingjv
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Re: insurance won't pay for titration

Post by Ingjv » Sun Jun 07, 2015 5:40 am

I don't know how we're going to learn anything from his machine from last night, when I woke up he was snoring away with his mouth wide open I woke him up and told him to close him mouth, he did, now he's breathing in through his nose and out his mouth. But he's breathing!!! YaY!

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palerider
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Re: insurance won't pay for titration

Post by palerider » Sun Jun 07, 2015 10:28 am

Ingjv wrote:I don't know how we're going to learn anything from his machine from last night, when I woke up he was snoring away with his mouth wide open I woke him up and told him to close him mouth, he did, now he's breathing in through his nose and out his mouth. But he's breathing!!! YaY!
you might be surprised... and you'll never know till you look at the data

might pick up a roll of duct tape at the store today though

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Ingjv
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Re: insurance won't pay for titration

Post by Ingjv » Tue Jun 09, 2015 5:44 pm

Image
my first try at posting his info from sleepyhead.
First night on nasal mask, was mouth breathing all night.
Went back to center, got face mask, they made him GIVE BACK the used nasal mask. He had received an email from Resmed telling him he should probably change masks since they could tell that he was mouth breathing with the nasal mask.
Please don't tell me this place is re-using these masks? I can't Believe the insurance company insists that they return the mask, which is what the tech told us.
I smell a rat.

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palerider
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Re: insurance won't pay for titration

Post by palerider » Tue Jun 09, 2015 5:47 pm

Ingjv wrote: my first try at posting his info from sleepyhead.
you got the screenshotting and posting part almost perfect... but, do pick "large thumbnail" and "linked bbcode" from imgur.

now, read this so you can show the right info:

https://sleep.tnet.com/resources/sleepyhead/shorganize

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Last edited by palerider on Tue Jun 09, 2015 5:50 pm, edited 1 time in total.
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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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palerider
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Re: insurance won't pay for titration

Post by palerider » Tue Jun 09, 2015 5:49 pm

Ingjv wrote:Please don't tell me this place is re-using these masks? I can't Believe the insurance company insists that they return the mask, which is what the tech told us.
I smell a rat.
there's instructions in the back of most every mask on what to do to sanitize it between patients.

it's no big deal.

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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ChicagoGranny
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Re: insurance won't pay for titration

Post by ChicagoGranny » Wed Jun 10, 2015 7:07 am

Ingjv wrote:I can't Believe the insurance company insists that they return the mask, which is what the tech told us.
I smell a rat.
You misunderstand. With credit or exchange of returned goods in any business it is good audit procedure. A party, who did not accept the return, should physically check in the returned items.

This helps prevent fraud. For example, if a company does not use this procedure, the employee responsible for making exchanges can easily say he sent out a mask for exchange. He actually did not, but instead took a new one home for his wife to sell on Ebay. The patient does not know anything about the transaction and is still using the original mask.

In your case, how would the insurance company know it was the victim of fraud if it did not require the return of the mask?

Fraud in medicine is huge, especially in Medicare. Be supportive of attempts to reduce it.

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Ingjv
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Re: insurance won't pay for titration

Post by Ingjv » Thu Jun 18, 2015 5:44 pm

I think I got it now. I notice his "my air" account info doesn't even show his pressure.
He's having a lot of trouble with leaks but he's doing great on compliance...
Image

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Ingjv
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Re: insurance won't pay for titration

Post by Ingjv » Thu Jun 18, 2015 5:49 pm

Ooops, showed the wrong day.
Here's last night.....
Image

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tedburnsIII
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Re: insurance won't pay for titration

Post by tedburnsIII » Thu Jun 18, 2015 6:02 pm

Don't know whether a home titration provides patient with important oxygen sat/desats. If it doesn't, good luck- you can always purchase a recording overnight pulse oximeter- not to be ignored.

Sorry, just noticed your 6/6 post. His sats are really bad.
Last edited by tedburnsIII on Thu Jun 18, 2015 6:06 pm, edited 1 time in total.
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Ingjv
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Re: insurance won't pay for titration

Post by Ingjv » Thu Jun 18, 2015 6:04 pm

his machine has a port for one but I don't know how much it costs.

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tedburnsIII
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Re: insurance won't pay for titration

Post by tedburnsIII » Thu Jun 18, 2015 6:07 pm

Wish that mine had such a port! But it's really not that big of a deal without one.

The pulse oximeter I purchased was well worth it. I've used mine overnight on many occasions.

CMS-50D Plus. http://www.coopermedical.com/overnight- ... meter.html

OXIMETRY REPORT:

ImageImage
Machine - https://www.cpap.com/productpage/resmart ... ducts.html
Setting: APAP, 10.5-14cm
Software: Proprietary
Mask- PR Wisp nasal (large); ResMed FX Nasal (wide);
Oximeter: CMS50D+