What do you do when...

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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MissAmethyst2U
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What do you do when...

Post by MissAmethyst2U » Mon Oct 03, 2005 11:48 am

Ok, as most of you know I use and LOVE my comfortcurve...the problem I have is through my insurance company and the kind of insurance I have I don't have a choice of home health care companies as I only have one I can go through. My home health care company does not and has not been able to get the comfortcurve in for whatvever reason. I LOVE this company and they have been great! I am allowed 4 masks a yr and have only gotten one the Swift as my comfortcurve doesn't count cause I got that through my Sleep docs office to borrow but my home health company is supposed to give them a new one in place of that one when they get them in. They dont know when they are going to get them. As much as I love the comforcurve it does seem kinda cheaply made or something and doesnt seem to hold up but for so long. I can still use mine but I have had it since May and it seems to be wearing out the silicone and all seems to be stretched as well as the headgear I have the old style headgear. I don't want to go just purchase a CC from somewhere cause my insurance pays 100% for all my medical supplies and whatnot and I just don't have the money to put out to get one. I liek to plan ahead and I know this mask is gonna be worn out by the end of this yr I am sure and I soooo want to get one...any suggestions on this?


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wading thru the muck!
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Post by wading thru the muck! » Mon Oct 03, 2005 12:05 pm

The reason your provider "can't get" a comfort curve is because they don't want to pay for it. Your insurance company most likely has a contract with them for a fixed reimbursement amount for masks. They want to give you the cheap masks and not the "premium" interfaces like the Comfort curve. This is a very common situation. You could try to work out a deal with them to pay the difference or have them bill your insurance for the four cheap masks and give you only two good masks, but in both cases this would be insurance fraud. Your best bet is to insist that you are unable to make the cheap masks to work for you. Your insurance is required to provide care, if available, that is effective for you. You may need to be "the squeaky wheel" to get it.

Sincerely,
wading thru the muck of the sleep study/DME/Insurance money pit!

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MissAmethyst2U
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Post by MissAmethyst2U » Mon Oct 03, 2005 2:13 pm

Hmmmm I don't understand that as them not wanting to pay for it as I mean I have a Swift they paid for I thought that was a really good mask but it doesnt work for me Both my doc and my HHC company know the CC is the only one that works for me I have tried a few others from my Sleep docs office. My dad has way better insurance than me and is being told the same thing but then again its through the same HHC company Grrr I am frustrated with them. Maybe I can call my sleep docs office and see if I can get another one through them in another month or so they had a few of them and nobody liked them the sleep techs dont like it either. Well it works for me and I am determined I am NOT paying a dime out of pocket when I have insurance that will pay for it. I guess I will wait and talk to my sleep doc when I go there the end of this month and see what she thinks...


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yawn
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Post by yawn » Mon Oct 03, 2005 4:02 pm

Why don't you call the company that makes the Comfort Curve and ask them if they have ever done business with your HHC. Tell them what the problem is and maybe they can help somehow. Maybe they can contact your HHC and tell them they can supply the Comfort Curve. There's something "fishy" with your HHC...it doesn't make sense that they "can't" get the Comfort Curve...sounds more like the don't "want" to get it. I would be much more "persistent" about this. Don't accept "no" or "can't" from your HHC...show them how to get the CC or offer to get it sent to them and then they can give it to you. Be assertive!
Amy