Frequency of Follow-up Visits

[Shaky]

I received a new CPAP (Auto-set s8) a year ago and have had great results. I did a follow-up visit at six months and all the data was great. I'm still sleeping great and have no problems, but my doctor is basically demanding that I come in for another follow-up visit (a "card" visit, as they put it) just six months after my last visit. Is this the usual protocol? I looked for a protocol for follow-up visit frequency online, but couldn't find anything.

[LSAT]

If you are reviewing your results from your machine and find that they are "great". Plus you are having no problems...
I would say that you have no need to see your doctor. (Maybe he needs the $$$). I saw mine 60 days after I started on CPAP, but not again since then. That has bee over 2 years ago. All he would probably do is review your results and tell you that you are doing great.......How can he "DEMAND" that you come in??

[Slinky]

Have your DME provider download this past week's data and FAX it over to the sleep doctor.

Actually, you just MIGHT have one of those RARE individuals - a sleep doctor actually interested in how you are doing. Maybe you can get the DME provider to give YOU a copy of a download of this past week's data and you can send it to the sleep doctor along w/a thank you card. Be sure to tell him how well you are doing and how rested you are feeling.

[illinigal]

My Dr requires a yearly visit. At that visit he reads my card, does a general review of my overall health and writes a new rx for masks and cpaps.I do not neccessarily need new equipment, but the rx is there if I need it. I ask him why if I was feeling well and my numbers were good why this was neccessary. He said that insurance companies will very often call and ask him to verify that that there has been an average of 4hrs a night usage. Of course he cannot do this unless he has actually read the card and kept a printout. Maybe you are lucky enough to have a Dr. who wants you to do well and be healthy . I have been on cpap for 4 yrs now, the first year was rough, but he gave me an extra card. I always had one in the cpap and one at the drs office or on its way back to me..he would call and discuss the report and talked me through changing pressures etc if it was needed.

[bap40]

I never even saw the sleep doctor who was in another state and did everything remotely. Place went out of business not long afterwards. Back then I was pretty ignorant......not anymore! Thanks to this board.

[Janknitz]

Some doctors actually care about follow-up. If you have one of those, be glad. Make sure that when he's looking at your data, he's looking at efficacy, not just compliance.

Your insurer may require periodic documentation of compliance if you are not on Medicare. You should know about that if that's the case, because if you don't make the appointment, you could lose authorization for continued machine rental if you have it on a rental basis.

[GumbyCT]

I received a new CPAP (Auto-set s8) a year ago and have had great results. I did a follow-up visit at six months and all the data was great. I'm still sleeping great and have no problems, but my doctor is basically demanding that I come in for another follow-up visit (a "card" visit, as they put it) just six months after my last visit. Is this the usual protocol? I looked for a protocol for follow-up visit frequency online, but couldn't find anything.

My experience has been that docs know what each insurance plan will pay for and that determines the frequency of appointments. I seriously doubt that insurance would require scheduled appts. but do contact them to ask. The DME is usually the one obligated to report compliance not the doc regardless what the doc says. I would ask the insurance about that also. That would guide me in deciding if I should find another sleep doc.

If you are feeling good but do not feel like contributing to the docs retirement plan then note in the "Thank You" card that it is the co-pay which is keeping you away.

[rested gal]

Have your DME provider download this past week's data and FAX it over to the sleep doctor.

Actually, you just MIGHT have one of those RARE individuals - a sleep doctor actually interested in how you are doing. Maybe you can get the DME provider to give YOU a copy of a download of this past week's data and you can send it to the sleep doctor along w/a thank you card. Be sure to tell him how well you are doing and how rested you are feeling.

I like Slinky's suggestion.

[GumbyCT]

Have your DME provider download this past week's data and FAX it over to the sleep doctor.

Actually, you just MIGHT have one of those RARE individuals - a sleep doctor actually interested in how you are doing. Maybe you can get the DME provider to give YOU a copy of a download of this past week's data and you can send it to the sleep doctor along w/a thank you card. Be sure to tell him how well you are doing and how rested you are feeling.

I like Slinky's suggestion.

I do too.

I just think IF the doc was honestly concerned about the patient and not the money, s/he would make a phone call instead of insisting she "come in" for a follow-up.

I have had docs call me at home, surprising me at 9:30 + 10 PM to ask questions. And my VA doc who I could email. Now those are RARE docs to me but not insisting you make a co-pay to see them.

JMMO - Just My Meaningless Opinion

[Shaky]

Thank you for the feedback. The six month follow-up seemed a little excessive to me - especially coming after a follow-up visit that was nothing but good news. The whole process seemed very coercive to me . . . I received several phone calls from the doctor's office insisting I come in for a visit and that to refuse would be to "ignore doctor's orders." I wasn't too thrilled with that wording and the escalating nature of the calls (first two were from staff people, third was from the office manager). I then got a letter saying that unless I agreed to come in for a visit, the doctor would assume I was receiving treatment elsewhere and I would no longer be considered a patient (I'm not sure if that's a legal thing or what). Anyway, I wasn't too concerned about it, but was curious as to whether six months was the standard time between follow-up visits.

I'm not very sophisticated about this whole process and don't know how to check my own data. I got the machine from the doctor (insurance paid some, I paid some), so there is no third party to go to. If there is an easy way to do this, that would be great. Otherwise, I plan to find another doctor, have my charts transferred over and do another appointment at the end of this year or early next year (roughly 12-18 months after my previous check-up), which seems like a more appropriate interval for someone whose sleep is going well.

Thanks.

[SnoozyQ]

I've been on CPAP since Sept 2010. I have seen neuro once in Nov 2010, and that wasn't very productive as they couldn't review my data. I told them how my data looked since I viewed it at home. Since then *I* contact *him* via email to update him, whether he wants it or not and work out any medication details. (That's a perk of being employed by the same large hospital--I can find his email address). I will see him next month, and plan to print out the data, and mark it with questions about room for improvement. After that I would guess it will be 6 mths to a year before he wants to see me, unless an issue arises that we can't ponder via email.
I don't see the need for frequent face to face time, in my personal experience. Communuication is important to me, sitting in his clinic for a 5 minute appt saying "keep doing what you're doing", is not.

[GumbyCT]

I'm not very sophisticated about this whole process and don't know how to check my own data. I got the machine from the doctor (insurance paid some, I paid some), so there is no third party to go to.

That is what is known as a "Money Mill". When the sleep doc owns or has an interest in where the patient "buys" their equipment. IMO - these (Money Mills) are to be avoided at all cost.

Otherwise, I plan to find another doctor, have my charts transferred over and do another appointment at the end of this year or early next year (roughly 12-18 months after my previous check-up), which seems like a more appropriate interval for someone whose sleep is going well.

Talk to people locally, search this forum and online for another doc but read and educate yourself for the fight you will have when you try to get your medical records from this "Money Mill".

[avi123]

I received a new CPAP (Auto-set s8) a year ago and have had great results. I did a follow-up visit at six months and all the data was great. I'm still sleeping great and have no problems, but my doctor is basically demanding that I come in for another follow-up visit (a "card" visit, as they put it) just six months after my last visit. Is this the usual protocol? I looked for a protocol for follow-up visit frequency online, but couldn't find anything.

Comments:

1) S8 AutoSet has not the latest technology in it. It lacks some of the output of the S9 AutoSet. So you might want to visit your Doc and ask for an Rx for the newer machine.

2) You have been on CPAP just for a year. So seeing the Doc after 6 mo is more than practiced in my area which is 3 mo, especially if you have a medical "problem". My dentist expects to see me every 6 mo even for cleaning.

3) You posted this:

I'm not very sophisticated about this whole process and don't know how to check my own data. I got the machine from the doctor (insurance paid some, I paid some), so there is no third party to go to. If there is an easy way to do this, that would be great. Otherwise, I plan to find another doctor, have my charts transferred over and do another appointment at the end of this year or early next year (roughly 12-18 months after my previous check-up), which seems like a more appropriate interval for someone whose sleep is going well.

Let me ask: how can you say that your sleep is going well if you don't know how to check the data?

[Tired Linda]

I received several phone calls from the doctor's office insisting I come in for a visit and that to refuse would be to "ignore doctor's orders." I wasn't too thrilled with that wording and the escalating nature of the calls (first two were from staff people, third was from the office manager). I then got a letter saying that unless I agreed to come in for a visit, the doctor would assume I was receiving treatment elsewhere and I would no longer be considered a patient (I'm not sure if that's a legal thing or what). Anyway, I wasn't too concerned about it, but was curious as to whether six months was the standard time between follow-up visits.

Shaky, that's just plain weird, unless there's something going on, like your insurance requires it and they are pressuring the doc big time. I'd check with insurance. But, still, even my DME can figure out how to send a mailer to read my card!

As far as frequency of follow ups go, I'm one of the luckier ones. I saw my sleep doc on an initial consult before he ordered the sleep study. Then, I saw him after the initial study, when he went over the results and suggested we do the titration. I saw him a month after I began therapy (October) and three months after that (last week). He suggested I come back in 6 months (which will be one year since I began therapy) for a follow-up.

[Slinky]

One month, three months and six months seems to be the SOP around here for sleep doctor visits after starting CPAP.