Thatgirl wrote:This would fall into the billing for unnecessary services realm of healthcare fraud. If you didn't use the CPAP at all, obviously you didn't need it, thus it was an unneccessary service that your insurance was billed for. Insurance companies have time spans when new equipment is covered, but almost all, if not all, also say that it be medically necessary as well.
It's virtually impossible to be
eligible - as stated in my original post - for a cpap machine if it's medically unnecessary.
To become eligible my insurance company had to receive a recent sleep study, doctors notes and compliance data. Then, they had their doctors review everything and approve it. This took 6 months.
Insurance companies have set resupply schedules which give patients a buffer of extra equipment for safety reasons. Not following these schedules is dangerous and inefficient. I had a machine break once before and if I didn't have a spare I would have been in deep trouble.
Furthermore, it's recommended that machines be replaced as soon as the resupply schedule permits because they lose accuracy over time even if it's not visibly apparent.
Shortly after receiving this machine, regrettably, we found out that my epiglottis is covering 75% of my airway which means I can't use cpap until I have surgery.
Sadly, your post and the posts of others may dissuade someone who can't afford the full retail price of a cpap machine from considering this offer.
I hope this clarifies things.