Insurance will not cover my ASV

[justbreathe]

Not medically necessary is what they (BCBS of NC) say.

I did not spend enough time on BIPAP. I only used a straight CPAP.

They will only approve it after I spend 30 days on Bipap. My time on CPAP do not count.

Now I am waiting for doctor to write a script for the Bipap. I did a sleep titration with ASV that controlled centrals.

Last Night AHI was 0.0 with centrals controlled by ASV.

[Pugsy]

Bummer. Want me to cuss them out for you?

[JohnBFisher]

The old double bind ... you have to 'fail' using BiLevel ... I hope you can get it worked out. Sometimes a stern letter from a doctor will remove that roadblock. Sometimes you have to play their game. Hope it goes well for you.

[tonycog]

I hope that you can get your insurance to play ball and that this doesn't need to be your long-term solution, but you might check Craigslist for an ASV machine. It may take awhile but they do seem to show up from time-to-time. I found a backup ASV with 1.6 hours on it for myself for $200 last summer.

Tony

[justbreathe]

Bummer. Want me to cuss them out for you?

I don't use language like that myself. But if you write the words I just may read them silently....

[justbreathe]

I do go to the VA for my meds.

If all goes bad with my BCBS I will give them my sleep studies and see if they will issue my necessary equipment.

Then they turn around and bill BCBS anyway......

[justbreathe]

Talked with my Doctor's Nurse today. She said she will HAVE (her words) the doctor call for a peer review with the insurance today. He is in the office and believes they can get it approved.

I will wait and see....

[chunkyfrog]

Yeah!
(fist pump)

[JohnBFisher]

That's great to hear. I know that my doctor had to have words with my insurance company. As he said, "Once I quote the figures from the sleep study (the report of which they obviously did not read), I will make it clear that 'medical necessity' does not mean 'nice to have' !!". My insurance company approved it remarkably quickly after that. So, here's hoping you will get less flack once your doctor 'explains' the situation to them.

[justbreathe]

Doctor's office called today. They will be sending a new prescription to my DME for a Bi-level CPAP. It will be the S9 not sure which one yet.

This is such a fun ride. I guess life is what happens between two nights of good sleep.

[justbreathe]

Picked up my new S9 VPAP Auto.

set pressure 4-20 with Pressure support of 4. I also picked up my Hybrid mask.

I hope that this will prove to be effective treatment. Time will tell.

[SleepingUgly]

Insurance is a PIA.

As an aside, your avatar really freaks me out.

[justbreathe]

As an aside, your avatar really freaks me out.

This is what SLEEP APNEA does to you right after you turn blue....

[GumbyCT]

So to summarize ....

As an aside, your avatar really freaks me out.

This is what SLEEP APNEA does to you right after you turn blue....

Is this one of those "Pot calling the kettle" thingies??

[justbreathe]

Is this one of those "Pot calling the kettle" thingies??

ROTFL