Pressure Adjustments and Insurance Coverage

[MaskedSleeper]

I'm just wondering if anyone has had issues with your insurance denying or limiting coverage for your supplies because of making your own changes to pressure settings? I own my machine outright so I'm not worried about them taking that away from me, but I'm concerned they would try and deny me coverage for making "unapproved" changes to the settings.

[Pugsy]

No.

Insurance companies only monitor hours of use. They don't monitor settings or even how effective (or not) the therapy actually is.

[chunkyfrog]

Their only interest is money.
The only measurement they care about is hours of use.
Whether you thrive or perish is a matter of convenience.

[Janknitz]

A DME will tell you that to scare you. They can bill for adjusting your machine when required by a doctor's prescription. So you may taking money out of the DME's pocket. I wouldn't feel too sorry for them.

There is no CPAP police. The only issue is if you don't meet your insurer's compliance requirements, they won't pay for the machine. The only numbers they are concerned with are hours of use. They don't look at your pressure settings, they don't care.