Wading thru the insurance Muck - Update

[Mikesus]

Well, insurance reimbursements have started trickling in. I was told by no less than 4 people that because I purchased the way I did, I would have a $200 deductible. Well, got a check for my mask, and no deductible applied. However, they turned down the machine as they needed the RX, (which they had), a copy of the sleep study, (which they also had) and now asked for compliance data. Thankfully Encore Pro has that report, so I provided all to them.

Suggestion to ALL that purchase with the intention of reimbursement:

GET THE SOFTWARE!! You *might* be required to provide compliance data, and without the software, you probably won't be able to provide that.

If the deductible doesn't apply, then my out of pocket for my Remstar Auto with Cflex with software (not covered) and an Ultra Mirage FF mask will be : $430.60 (have 80/20 coverage)

[Hugh Jass]

I agree the software is great but for those not able to afford it, can they not ask their DME to print the data from their smart card, which can provide the compliance data.

My DME did this for me on several occassions.

[Mikesus]

I agree the software is great but for those not able to afford it, can they not ask their DME to print the data from their smart card, which can provide the compliance data.

My DME did this for me on several occassions.

Ummm, that only works when you have a DME, my point was that if you go the NON-DME route and purchase on your own, then you want to buy the software also... I doubt a DME that you didn't buy from is going to be download friendly...

[Thomas]

When I went to talk to the sleep technicians at the local sleep clinic, they asked me if they could download the info from my machine. I said sure! If DME's don't like doing it, I expect sleep clinic techs would be more than happy to, and will even help you decipher the info.

Tom

[MelMel]

You don't necessarily need the download software. Often times all you have to do is write a letter to the insurance company saying how often you wear the machine and how long each night you wear it. You can also include information on if you are sleeping better, snoring or feeling better during the daytime.

Just a suggestion,
MelMel