Scared

I just had the titration portion of my sleep study last night and I'm a bit nervous. I'm on MassHealth and had to beg and plead for a sleep study in the first place. In the early 2000s I had a sleep study and was diagnosed with sleep apnea and got a CPAP and just kinda stopped using the machine, got pregnant, had a baby, etc. etc. etc. The combination of sleep deprivation of having a child and sleep apnea has caused me to push for having another sleep study and wanting to get back on the machine again.

So anyway, I went in for my study FINALLY, after MONTHS of begging my PCP to prescribe it. I went in and the tech was surprised that she didn't ask for both a study and titration in the same night. Oh well. Then, after night 1, I got a call from the lab to come back. I called my MD's office to get the results, which were, "You need a CPAP." I went in last night and it was pretty miserable. The leads kept falling off my head. I had used nasal pillows the first time around and asked for them specifically. In the morning I was told that someone would be in touch with me and will deliver my CPAP machine and headgear to me at some point, which indicates to me that I won't have much of a choice about it.

I'm feeling a little frustrated. The tech couldn't tell me how many interruptions I had the first time around. I'm going to call my doctor tomorrow, but if there is anyone out there with experience with Medicaid, especially in Massachusetts, I'd appreciate the wisdom.

-Kirsten

kirstenl wrote:I just had the titration portion of my sleep study last night and I'm a bit nervous. I'm on MassHealth and had to beg and plead for a sleep study in the first place. In the early 2000s I had a sleep study and was diagnosed with sleep apnea and got a CPAP and just kinda stopped using the machine, got pregnant, had a baby, etc. etc. etc. The combination of sleep deprivation of having a child and sleep apnea has caused me to push for having another sleep study and wanting to get back on the machine again.

So anyway, I went in for my study FINALLY, after MONTHS of begging my PCP to prescribe it. I went in and the tech was surprised that she didn't ask for both a study and titration in the same night. Oh well. Then, after night 1, I got a call from the lab to come back. I called my MD's office to get the results, which were, "You need a CPAP." I went in last night and it was pretty miserable. The leads kept falling off my head. I had used nasal pillows the first time around and asked for them specifically. In the morning I was told that someone would be in touch with me and will deliver my CPAP machine and headgear to me at some point, which indicates to me that I won't have much of a choice about it.

I'm feeling a little frustrated. The tech couldn't tell me how many interruptions I had the first time around. I'm going to call my doctor tomorrow, but if there is anyone out there with experience with Medicaid, especially in Massachusetts, I'd appreciate the wisdom.

-Kirsten

I have no experience with Mass. Medicaid, but I still wanted to say good for you for "begging" for the sleep study.

Techs aren't really supposed to tell you much, unfortunately. That's just how it works.

This forum has a lot of helpful people to help you make a go of PAP therapy this time around, though.

Welcome.

Someone please correct me if I'm wrong, but I believe the results of the test (the whole report, not just the summary page) are your right by law and unless Medicaid proves otherwise, you should assert your right with the doctor's office or sleep lab to get the report.

Julie wrote:Someone please correct me if I'm wrong, but I believe the results of the test (the whole report, not just the summary page) are your right by law and unless Medicaid proves otherwise, you should assert your right with the doctor's office or sleep lab to get the report.

That's how I understand it.

I waited until the sleep doc sent the report to my primary doc and then got a copy of it from the primary doc.

Then I'll try to get a copy of that report from my pcp.

As a side note, I hope masshealth is not the model for healthcare reform as one who was once on premium health insurance. In Portland Oregon I went to a 4 star sleep lab in comparison. Live and learn.

Thanks,

Kirsten

kirstenl wrote:I hope masshealth is not the model for healthcare reform as one who was once on premium health insurance.

I'm afraid it is. Most everything in the Federal health reform bill is a repeat of what was done in Massachusetts. I think the biggest difference is that the federal bill wants to put even more people (proportionally) on Medicaid.

That's the problem - the few supporters that the health bill has don't realize that Medicaid will be a a primary factor. People who are expecting first rate health care are in for a big surprise. If only someone had gotten a strong hand in regulating insurance companies and health providers - we might actually have reform.

Sorry that you are having such a hard time getting a CPAP machine. You do have the right to your study report. They know that too.

It's always good to do your own research before you talk to the DME.

I found this site http://www.mass.gov/?pageID=eohhs2termi ... id=Eeohhs2 and you can click on " for charts listing DME. Once you have the chart open, search for CPAP.

I didn't get to spend too much time looking, but it looks to me that they reimburse by HCPC codes and CPAP is E0601. There are some "modifiers" and I didn't get a chance to look up what those were. Do some research.

At the very least, look carefully at that and see what the criteria are. If you deal with a DME from a knowledgeable point of view you may be able to advocate for a data capable machine and the nasal mask of choice.

As a student of counseling, the ethics and professionalism class I took states that you DO have the right to anything in your medical file. It's part of the law that created the Patients Bill of Rights, IIRC.

Hang in there; we are totally rooting for you.

oh Yes !!! Your medical records are yours and you should not need to do anything but ask nicely. If they give you attitude - let them know they are not the only frog in the pond! Both my Dr office and the DME are giving me copies of my sleep study and my RX - I live 45 min away and have other health issues or I would have them in my hands right now but I do know they are there waiting for me to pickup. I have learned so much from good people here and think I am finally on the road to where I need to be headed. Be strong and assertive - not nasty - just do not back down. It really works to state your case - I did it and am working with someone truly nice and decent now. I will let you know more after Tues as I get my new S9 that day - its been a bit rough getting to this point but if I can do this so can you - I believe in you!