What your insurer and DME know

I saw the AWAKE session that was held yesterday (08-May-2018), and I had one pick-up in particular. It was at the tail end of the session where one of the hosts said that CPAP, unlike almost any other medical treatment would be taken away if not used "enough."

Think of what this would mean for a pill! They would know if and when you opened the pill box, if and when you swallowed it, and (provided you "comply") how well the condition is controlled!

Get a life...

Julie wrote: ↑

Wed May 09, 2018 5:14 pm

Get a life...

Not a Chance. Jim

What everybody already knows when D.H. "discovers" it!

Goofproof wrote: ↑

Wed May 09, 2018 5:36 pm

Julie wrote: ↑

Wed May 09, 2018 5:14 pm

Get a life...

Not a Chance. Jim

I'd just be happy if DH would get a brain.

And D.H. continues to do his thing... ignores everyone.

chunkyfrog wrote: ↑

Wed May 09, 2018 7:42 pm

What everybody already knows when D.H. "discovers" it!

At least they are learning unlike Palerider who just tends to criticize without providing useful “correct” information.

Learning is to be commended. Just being critical should be minimized.

Thanks. While this analogy if fairly obvious, I don't think that too many of us considered what comparable "surveillance" would mean for a pill.

Try telling anybody who is not familiar with CPAP that the proveder know all this, and pretend it's a "pill." Most would be shocked!

D.H. wrote: ↑

Thu May 10, 2018 7:35 am

Thanks. While this analogy if fairly obvious, I don't think that too many of us considered what comparable "surveillance" would mean for a pill.

Try telling anybody who is not familiar with CPAP that the proveder know all this, and pretend it's a "pill." Most would be shocked!

A better comparison would be durable equipment such as wheelchairs & walkers.

Whenever I go to the Dr. office they record weight, BP, ask what is going on in my life. peer into orifices and remove body fluids. Sometimes they even do anal probes not to mention genital groping. Hell, I would think I have been abducted by aliens or something to do with UFOs. Then they record all this and report it my insurance CO, and since my insurance is government paid, they, by extension, report all of my health data to "the government". Pills too! Why the pharmacist even has to council me before I get pills. Who do you suppose he reports that conversation to? And that nasty insurance company that is actually paying for the equipment, oh the horrors that they keep track of my use of the equipment as a condition of paying for it, rather than me being able to get xPAp and sell it on the street. Where will the horrors end? ANAL PROBING! OMG

OH yeah forgot to add, the surveillance by the insurer ends after compliance has been demonstrated, after that they don't give an ants fart.

TASmart wrote: ↑

Thu May 10, 2018 8:40 am

OH yeah forgot to add, the surveillance by the insurer ends after compliance has been demonstrated, after that they don't give an ants fart.

Are you sure they do not continue monitoring to insure you need your CPAP supplies?

Not certain, but I don't think they do here in Oregon. Maybe varies by State? I think they leave that up to the DME, since in the scheme of things we have to be under the care of a respiratory therapist at the DME, and thats one way they justify the outrageous prices the DME get to charge the Insurers for the equipment and "care". Although in my experience, there has been very little actual detailed knowledge needed for what the RT at the DME actually does. After all how much expertise is needed to say "the pressure is et by the Dr, you should not be changing it".

TASmart wrote: ↑

Thu May 10, 2018 8:53 am

Not certain, but I don't think they do here in Oregon. Maybe varies by State? I think they leave that up to the DME, since in the scheme of things we have to be under the care of a respiratory therapist at the DME, and thats one way they justify the outrageous prices the DME get to charge the Insurers for the equipment and "care". Although in my experience, there has been very little actual detailed knowledge needed for what the RT at the DME actually does. After all how much expertise is needed to say "the pressure is et by the Dr, you should not be changing it".

My sleep doctor insists I see them every year. In fact, this year I changed DMEs.

My Dr is the same, he will not write a prescription for more than 1 year. Every time I see him or his NP they fax a new prescription over to the DME, and give me a new one for my records. I wonder if it is a Oregon restriction that prescriptions can be only written for a year, of is it considered good medical practice by the physician or his malpractice insurer, or just keeping the appointment book full? Since they run several months in arears for appointments, I do not see it as a greed factor, they appear to have all the business they want or can handle.

I see my sleep doc (or his PA) once a year.
They download efficacy data off my card, and report whatever is necessary to Medicare.
I have nothing to hide.
[[[I swear!]]]