Cpap insurance compliance issues

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Jerseyguy
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Cpap insurance compliance issues

Post by Jerseyguy » Fri Dec 01, 2017 12:34 am

Ok so I got this machine on October 10th. I had a lot of issues starting it and then more mask issues afterwards. Now I'm not sure I can satisfy my insurances usage compliance. Question is will they extend it if they see that I am now using it faithfully. Will they let me show compliance while I rent it myself for 3 months and then start paying for it?. Should I switch my insurance before open enrollment closes on Obamacare? Will that reset the clock? Should I be calling them and let them know I had problems but I'm good now??

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palerider
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Re: Cpap insurance compliance issues

Post by palerider » Fri Dec 01, 2017 12:47 am

Jerseyguy wrote:Ok so I got this machine on October 10th. I had a lot of issues starting it and then more mask issues afterwards. Now I'm not sure I can satisfy my insurances usage compliance. Question is will they extend it if they see that I am now using it faithfully. Will they let me show compliance while I rent it myself for 3 months and then start paying for it?. Should I switch my insurance before open enrollment closes on Obamacare? Will that reset the clock? Should I be calling them and let them know I had problems but I'm good now??
Honestly, we couldn't even begin to guess what YOUR specific insurance will do...

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Re: Cpap insurance compliance issues

Post by USMCVet » Fri Dec 01, 2017 12:55 am

I can tell you what a stranger's insurance did and i have no idea who insures them.
The guy was at 60% compliance and his insurance requires 70%.
He was told to come back in a few more weeks after using it more to meet the compliance requirement before they could order more supplies.

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SewTired
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Re: Cpap insurance compliance issues

Post by SewTired » Fri Dec 01, 2017 4:26 pm

You have to check with your insurance company. Medicare will do a second 90 day compliance and even a third if the doctor sends in an exception report. I don't know what other insurance companies will require.

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Jerseyguy
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Re: Cpap insurance compliance issues

Post by Jerseyguy » Sat Dec 02, 2017 11:12 am

SewTired wrote:You have to check with your insurance company. Medicare will do a second 90 day compliance and even a third if the doctor sends in an exception report. I don't know what other insurance companies will require.
Any suggestions on the department to call..just customer service or claims?

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greatunclebill
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Re: Cpap insurance compliance issues

Post by greatunclebill » Sat Dec 02, 2017 11:53 am

if medicare is the primary insurance. they approve or disapprove it first and should know what your secondary will do or can find out.

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