Online Rx and DME

[fasttimes]

Has anyone used an online telemedicine service to obtain a CPAP Rx to provide to your insurance’s DME provider? How did it work out for you?

My ENT is a real piece of work. He insists on a office visit before referring me to a sleep study, and after as well. Why on earth do I need to see him twice? My primary and pulmonary docs each said they’d order a sleep study and wouldn’t even require a single office visit. I have all but accused him to his face of insurance churning. If I ever see him again, I’m going to correct that oversight.

[ChicagoGranny]

My primary and pulmonary docs each said they’d order a sleep study and wouldn’t even require a single office visit.

Why do you need a new sleep study? Just get your primary doc to send a script to your DME. My primary doc sends a renewed script to my DME each year at my annual wellness visit.

BTW, I see in an earlier post of yours (from 2018) you say your insurance company provides a new CPAP every two years. That's highly unusual. Personally, I have my doubts

[zonker]

My primary and pulmonary docs each said they’d order a sleep study and wouldn’t even require a single office visit.

Why do you need a new sleep study? Just get your primary doc to send a script to your DME. My primary doc sends a renewed script to my DME each year at my annual wellness visit.

came to see this, left satisfied.

[Julie]

Since when is it a crime fcr a primary doc to want to be paid for an office visit - and then a referral?

These days they don't always do that well as we're all using Dr Google, etc...

I mean, they do work hard.

[fstrife]

I have not, but was considering using https://lofta.com/products/rxexpress

It's only $35 right now and says:
"If the physician is unable to issue a renewal prescription to you under this program 100% of the money that you have paid will be promptly refunded."

[fasttimes]

Since when is it a crime fcr a primary doc to want to be paid for an office visit - and then a referral?

These days they don't always do that well as we're all using Dr Google, etc...

I mean, they do work hard.

This is my ENT, not primary. He wants to milk his CPAP patients for an extra visit, for reasons I can only speculate as greed. There is absolutely no justification for a visit prior to ordering a sleep study.

[fasttimes]

My primary and pulmonary docs each said they’d order a sleep study and wouldn’t even require a single office visit.

Why do you need a new sleep study? Just get your primary doc to send a script to your DME. My primary doc sends a renewed script to my DME each year at my annual wellness visit.

BTW, I see in an earlier post of yours (from 2018) you say your insurance company provides a new CPAP every two years. That's highly unusual. Personally, I have my doubts

I’ve since switched insurance. The new insurance is 5 years.

[GrumpyHere]

Has anyone used an online telemedicine service to obtain a CPAP Rx to provide to your insurance’s DME provider? How did it work out for you?

I spent $90 through healthsqyre for a CPAP Rx. Online DMEs accepted the Rx.

The forum sponsor sells a home study for $170 that included a teleconsult for referral, home test, automated results and Rx for APAP and supplies. This is a PAT based test. This version cannot detect CA. You can get a follow-up for additional $100.

I haven't used this.

https://www.cpap.com/home-sleep-apnea-test

Wall of text from the link.

We’ll get you started on a path to better sleep as soon as you place your order! After your order is confirmed, our telemedicine partner will contact you to schedule your virtual doctor consultation. You’ll then receive an email confirming the date and time of your appointment, as well as an intake form to complete before your visit.

During your virtual visit, the doctor will verify whether or not a home sleep test is the best path of care for you. You’ll also be able to discuss any questions regarding the sleep test and possible sleep apnea diagnosis at this time. You’ll only be charged the full cost of $169 if prescribed a home sleep test. If not prescribed a home sleep test, you’ll only be charged the virtual visit cost, $100. Home sleep test devices typically ship within one business day of your visit.

Wirefree and as easy as 1,2, ZzZ! Once your NightOwl® device arrives, you’ll get an email with instructions and an activation code to set up the NightOwl Phone App. The integrated app provides a guided walkthrough of how the home sleep test works and step-by-step setup instructions. To attach the fingertip-sized sensor, you’ll place the device on your pointer finger pad and secure it with the included fabric medical tape.

NightOwl's comprehensive report includes a detailed view of your Pulse Rate, perceived AHI, SpO2, Total Sleep Time, Respiratory Events, and REM Time. After a successful night of testing is complete, your sleep study results will be sent to our telemed partners for interpretation. Occasionally, test results can be inconclusive and may require another night of testing. In this case, you would be notified within the app to use your NightOwl device for another night to ensure an accurate diagnosis.
Once the doctor has reviewed your report, within 1-2 business days you’ll receive an email regarding your results and what your next steps are. If you have questions after viewing your report, you can schedule an additional virtual follow-up visit for $99 to go over your results and any questions you may have.

Depending on your sleep test results, you may be prescribed an APAP machine, require further testing, or get confirmation that your sleep test results were normal with no abnormalities. All CPAP therapy prescriptions using the NightOwl home sleep test device will be for APAP machines. APAP machines do not require a specific pressure setting but rather adapt to your changing needs throughout the night, increasing comfort and improving your nighttime sleep.

[ChicagoGranny]

My primary and pulmonary docs each said they’d order a sleep study and wouldn’t even require a single office visit.

Will they write a script for you?

Why do you think you need a sleep study?

[fasttimes]

My primary and pulmonary docs each said they’d order a sleep study and wouldn’t even require a single office visit.

Will they write a script for you?

Why do you think you need a sleep study?

I’m sure they will. But the insurance company insists on a sleep study. They make it a hassle on purpose.

[ChicagoGranny]

My primary and pulmonary docs each said they’d order a sleep study and wouldn’t even require a single office visit.

Will they write a script for you?

Why do you think you need a sleep study?

I’m sure they will. But the insurance company insists on a sleep study. They make it a hassle on purpose.

Do you not have a study on file? It's unusual for an insurance company to require a second study. Something doesn't sound right.

[Okie bipap]

But the insurance company insists on a sleep study. They make it a hassle on purpose.

Have you verified this through your insurance company, or are you relying on the word of your doctor?

[McSleepy]

My insurance (BCBS) requires a sleep study not older than 10 years before paying for a new CPAP machine. I was at 9.5 years before my last machine and my sleep doctor said that I just caught the last train.

McSleepy

[ChicagoGranny]

My insurance (BCBS) requires a sleep study not older than 10 years before paying for a new CPAP machine. I was at 9.5 years before my last machine and my sleep doctor said that I just caught the last train.

McSleepy

Note that BCBS is made up of 35 independent and locally operated companies. Policy specifics vary across the U.S. https://www.bcbs.com/bcbs-companies-and-licensees

[chunkyfrog]

Contact your insurance company.
Talk to the benefits manager about your specific CURRENT policy.
Terms of coverage can change every year.
Anybody else could just be MAKING UP SHIT.