Worried about compliance

[junior49]

The first month of cpap was hell for me. Luckily, around the 30 day mark I had quite a breakthrough. I switched to a nasal mask (resmed mirage fx) after learning to nose breath, although I still used a chinstrap for a while. I had been using the quattro fx and just couldn't beat the leaks (my pressure is 17). I was sleeping 2-3 hours a night with the mask. Then I'd just take it off and get another 3-4 hours.

The first night with the mirage fx I slept 11 hours, in 3 different sessions. It felt great. I'm now consistently getting over 5-6 hours a night. Anyway, I'm just worried about compliance for the 1st month. My doctor has never said anything about it, but I'm wondering if I'm going to get stuck with the bill or something. My first month I had maybe 10 days over 4 hours. I just learned how to use resscan, I printed a report for the first 49 days and 25 > 4 hours, 24 < 4 hours. So what usually happens when you don't meet the compliance numbers, which I've read here is usually around 80%?

[NightMonkey]

So what usually happens when you don't meet the compliance numbers,

We cast lots to see who holds you down and who runs bamboo shoots under your fingernails.

[Pugsy]

I think Medicare wants 70% of the nights being greater than 4 hours of usage. I think they wait 90 days before they want to check.
Did your insurance buy the machine outright or are you doing the monthly rent to own thing?

Different insurance companies might have different compliance requirements. Best thing would be to check with your insurance to know exactly what they require. You are at about 50% right now and if your insurance goes by the 90 day thing then you have time to bring your % of usage up.

[robysue]

I'll also toss out this suggestion:

If there's documented improvement in that usage and the doc is willing to write a letter stating something along the lines that you had some exceptional problems during the first month, but that you are now compliant (in the sense of using the machine > 4 hours every night), the insurance company may be happy to grant you a grace period for establishing that you are both using the machine and benefiting from it.

[ems]

If there's documented improvement in that usage and the doc is willing to write a letter stating something along the lines that you had some exceptional problems during the first month, but that you are now compliant (in the sense of using the machine > 4 hours every night), the insurance company may be happy to grant you a grace period for establishing that you are both using the machine and benefiting from it.

Exactly correct! A letter from the doctor is all it takes. I was in a similar situation b/c the DME and the doctor's office couldn't read the SD card. Once all of that got straightened out, the doctor sent an email and that took care of it.

[apnea2142]

Does this nasal mask work if you have a deviated septum? I have one and the nasal didn't seem to work that well. anyway I think the ramp feature on phillips machines is one of the most important factors in getting sleep

[bayourest]

I agree
get a call into your doctors office and tell him/her what's going on, and ask that it be noted in your record. and perhaps even follow it up with a fax.
then if you do have a problem with insurance you should be able to demonstrate a marked improvement in compliance along with documentation that you had a problem and are trying to address it.

[Kenneth P.]

I was in the same boat.The first 6 month's was ugggg..But,changed to the same nasal mask&wow!!what a difference.Finnally got me a new bed last week&O"H boy don't want to even get up now.lol..But,yes doctor is the las t one to take care of it..

The first month of cpap was hell for me. Luckily, around the 30 day mark I had quite a breakthrough. I switched to a nasal mask (resmed mirage fx) after learning to nose breath, although I still used a chinstrap for a while. I had been using the quattro fx and just couldn't beat the leaks (my pressure is 17). I was sleeping 2-3 hours a night with the mask. Then I'd just take it off and get another 3-4 hours.

The first night with the mirage fx I slept 11 hours, in 3 different sessions. It felt great. I'm now consistently getting over 5-6 hours a night. Anyway, I'm just worried about compliance for the 1st month. My doctor has never said anything about it, but I'm wondering if I'm going to get stuck with the bill or something. My first month I had maybe 10 days over 4 hours. I just learned how to use resscan, I printed a report for the first 49 days and 25 > 4 hours, 24 < 4 hours. So what usually happens when you don't meet the compliance numbers, which I've read here is usually around 80%?

[macewa]

I had terrible problems the first month of using my machine - no help from the sleep doctor in fixing my problems. But I had and still have an exceptional DME person.
She worked with me and knew I really wanted to meet compliance and was aware that my struggles were legit. I changed doctors and he also worked with me on getting an extension of time to meet those requirements. I don't know what kind of DME you have, but here in this town which is on the small side, I have a somewhat personal relationship with mine. I'm sure there were days when they saw me coming through the door they were saying, Oh no, not her again! LOL I would suggest that you start with your DME if you are in jeopardy of losing your machine due to non-compliance. Edit to include: yes, the doctor is the one that writes the letter/email.