Encore Software & Reader / Insurance

[omnisleep]

I was getting information from Apria about the Encore Software and if my insurance would cover it. Apria told me that they have never sold it to a patient and why would I want it?
Anyway I talked Respironics and they gave me a HCPC Code for the software & reader (A9279) to give to my insurance provider and they could tell me if that product was covered. My Insurance provider is United Health Care (big company) and that code did not show up on their computer.

Just curious about anyone who has the product if your insurance provider paid for the software & reader.

I know I could probably just call my Dr., but every time I contact them all they want to do is schedule another sleep study.

[Wulfman]

Just curious about anyone who has the product if your insurance provider paid for the software & reader.

Not me. I purchased it. Tried to convince my provider to let me include it in my other purchases but they wouldn't budge.
I've seen one or two people state that their providers paid for it, but that's extremely rare.
The meager price of the reader and software is nothing when compared to further sleep studies and office visits.

Den

[blarg]

The meager price of the reader and software is nothing when compared to further sleep studies and office visits.

Correct, but it's not total dollars we're concerned about, it's total dollars lining our pockets.

My insurance didn't cover the software.

[Boomer]

I purchased my initial setup, here, from cpap.com. This is included the Remstar Auto, heated humidifier, Activa mask, hose, extra filters, chin strap, card reader and software. Submitted the entire invoice, total of ~$1100, to my insurance. They paid 80% (normal, in-network rate) of the entire invoice amount.

I have bought all of my cpap stuff here, since being diagnosed, in May of 2005. I submit the invoice from cpap.com, and they pay 80%, assuming my deductible has already been met.

Boomer

[Guest]

Could not get my insurance to pay, but was able to get my FSA (flexible spending account) to pay. I did have to appeal an initial denial by the FSA, but they ended up paying for both the software and reader (Also, I think the only reason my appeal was successful was I dealt with a person at my FSA who had family members with apnea and understood why I wanted the software).

TM