update and question re: modem after compliance is done.

[lorraineg57]

So I've been on estrogen for 'almost two weeks and I'm sleeping better than I have in years, including the last almost 3 months that I've been using cpap. I called the sleep specialist who had suggested an overnight oximetry. He'd wanted to see if my O2 levels were dropping at night to see if perhaps that was why I was still waking multiple times per night, even though my AHI was excellent and all my other numbers looked good. My levels were very good at between 97 and 99 all night. Not quite sure how they could be low when using the cpap but I think he was grasping at straws.

So I called and told him I was sleeping much better. Not waking as often, etc. He said I could do my own "experiment" and go a few weeks without the cpap and see how my sleep goes (OSA is largely positional and pretty much non-existent when I sleep on. my side, which is always). He prefers I keep using it "because you have significant numbers when you sleep on your back". However, I work for an internal medicine doctor and he took one look at my sleep study, laughed and said "you don't need a cpap, just don't sleep on your back.

I do have to say I trust the doc I work for. I see how he cares for his pt's on a daily basis.

So I called Apria to see how this experiment would affect my compliance and they told me I already own my machine, I'm past compliance. I wanted to know just in case I DON'T use it for a couple weeks during the "experiment" and start feeling super tired again. (I am feeling more rested now but don't know if it's due to sleeping better from the estrogen OR the cpap is actually starting to help in addition to the estrogen). I asked if they would pick up the modem and she said that my insurance (UPMC) usually likes to keep the modem on so they can monitor???

If I own it, why do they need to monitor anything????? No one monitored a darn thing when I was waking 3-4 times a night and needed help!

Input anyone?

[archangle]

Compliance is so they don't pay for CPAP for people who don't use it.

[chunkyfrog]

Treating positional apnea by "not sleeping on your back" is not as effective as some may think--even doctors.
Most of us roll over without even knowing about it--repeatedly.
I might try a night or two, but without a Zeo and a dyno strapped to your head, and a pulse-ox, there is no data.
Edit: another thought:
Insurance will not pay for something not medically indicated--in spite of what your INTERNIST boss believes.

[Janknitz]

Crapria is not known for their accuracy or truthfulness (they earn their nickname). Call your insurance and ask THEM if they have any further requirements for monitoring compliance. My guess is that they don't, if you already own the machine. What could they do, anyway, unless your contract with them states that they can repossess the machine if you are not meeting ongoing compliance requirements (highly unlikely)?

Crapria is either stupid OR they want to be able to charge more for "monitoring"--and be aware that YOU may get stuck with the bill if your insurance company doesn't require any further monitoring.

NEVER, NEVER, NEVER, NEVER, NEVER trust what a DME says about your insurance. ALWAYS check the facts yourself.

[lorraineg57]

Compliance is so they don't pay for CPAP for people who don't use it.

Yes, I'm aware of that. I've already fulfilled the requirements for compliance and own the machine. (Although I WILL be calling my insurance co. to verify that.)

[lorraineg57]

Insurance will not pay for something not medically indicated--in spite of what your INTERNIST boss believes.

My INTERNIST didn't say they would, nor did I say he believed they would. I'm not sure where you got that. Insurance has already paid for the cpap.

My question was in regards to why I would have to leave the modem on the machine if I'm out of the compliance period.

[chunkyfrog]

Once you are out of the compliance period, the DME should want the modem back.
If they are through using this, they need to take it back so they can't keep charging rent/whatever,
which insurance will no longer pay for.
You mentioned that your boss, (the internist) didn't think you needed to be on cpap.
This might be useful if you cannot use your machine for a short time,
like a power outage or a trip--just stay off your back when you can't pap.
Doing this full-time may be a bit difficult and hard on your body.
Moving around at night is normal and healthy--as long as it's not an aerobic workout.

[lazer]

I was told with my insurance that compliance will be required to be proven every 90 days until eternity, even after the rental to own is complete so in order to keep on with supplies. No modem here though. They - The DME? - Is to mail me an envelope every 90 days with a new SD card and a return envelope to send the current one back in.

[lorraineg57]

I was told with my insurance that compliance will be required to be proven every 90 days until eternity, even after the rental to own is complete so in order to keep on with supplies. No modem here though. They - The DME? - Is to mail me an envelope every 90 days with a new SD card and a return envelope to send the current one back in.

Are you by chance UPMC insurance?

[lazer]

I was told with my insurance that compliance will be required to be proven every 90 days until eternity, even after the rental to own is complete so in order to keep on with supplies. No modem here though. They - The DME? - Is to mail me an envelope every 90 days with a new SD card and a return envelope to send the current one back in.

Are you by chance UPMC insurance?

Highmark BCBS PPO Blue