Annual Sleep Doc Visit?

[khauser]

How did you get your CPAP? How were you diagnosed and titrated?

My regular doctor, after hearing about my snoring and daytime drowsiness, ordered the sleep lab test. He received the report and wrote the prescription.
At the same time I researched, found here, had the presence of mind to request an apap, and the rest is history. To be honest my treatment was non-problematic and aside from finding the right mask or was pretty boring.

[Grumpy48]

I also never saw a 'sleep doctor'. I had some data from an oximeter ring I was wearing at night that indicated significant drops in O2 during the course of the night that I presented to my primary care doctor. I asked him about a sleep study and he set one up. During the two sleep studies I had I only saw the technician that ran the tests. A sleep doctor did review the tests and I assume wrote the prescript for the CPAP, but I never saw him/her. An RT from the DME company delivered and setup the CPAP machine and gave instructions on use. I had the Medicare required 3 month followup with my primary care doctor which pretty much was a waste of time and if I had questions he wouldn't be able to answer them properly as I had found out.

[chunkyfrog]

DME, or doctor--both lining up with the others to latch onto a faucet squirting free milk.

[jimmy christmas]

Well this was interesting. My "sleep doctor" is a pulmanologist and I see him once a year. He does review the data on the SD card and does send a script to my DME who says that I must have a script to get supplies. mmmm, maybe I should look at other DMEs, but I have no complaints at the moment. Because of other breathing issues I will continue to see this doctor who is also the one that ordered the original sleep study and my first CPAP back in 1995.

[Pugsy]

Well this was interesting. My "sleep doctor" is a pulmanologist and I see him once a year. He does review the data on the SD card and does send a script to my DME who says that I must have a script to get supplies. mmmm, maybe I should look at other DMEs, but I have no complaints at the moment. Because of other breathing issues I will continue to see this doctor who is also the one that ordered the original sleep study and my first CPAP back in 1995.

Actually if I were in your shoes I probably wouldn't be doing anything any different.
There's no guarantee that a new DME wouldn't also have their own in house rules requiring a yearly renewal of the prescription (they get to make their own rules) and you are happy with your doctor and you have other health issues where you would be seeing him anyway.

My sleep doc is a pulmonary specialist as well. Seems like a lot of sleep docs are like that and that's fine.
I just don't have any other lung issues or respiratory issues that makes it necessary for me to go back to see him....so I don't.
Now if I did...I would for sure go and get the annual renewal at that time.
The last time I saw the sleep doc (August 2009)...what I was told was "you seem to have a good grasp on things....if you run into anything you can't handle or have questions...call me".... I haven't run into anything I couldn't handle or understand. That's the way I like to manage my own health care.
But if I had other health issues that needed closer follow up....I would do it.

You know what's funny....I do see my PCP for my arthritis stuff and BP stuff regularly and the little print out they give you showing your list of problems or diagnoses and treatments........no where does it mention sleep apnea. Never has and I am in the same overall medical group. It should be on the computer generated records but it isn't.
And I never discuss cpap use or sleep apnea with my PCP even though he was the one who made the referral to the sleep doc.
It's like a forgotten little blip on my records and I quite honestly am happy to leave it that way. Medicare still pays for what I might want or need when I want it and that's all I really care about. It's not much but it's there if I need or want something.
They can't call me for auto renewal or bug me like that. That's a no-no with Medicare.

[Grumpy48]

You know what's funny....I do see my PCP for my arthritis stuff and BP stuff regularly and the little print out they give you showing your list of problems or diagnoses and treatments........no where does it mention sleep apnea. Never has and I am in the same overall medical group. It should be on the computer generated records but it isn't.
And I never discuss cpap use or sleep apnea with my PCP even though he was the one who made the referral to the sleep doc.
It's like a forgotten little blip on my records and I quite honestly am happy to leave it that way. Medicare still pays for what I might want or need when I want it and that's all I really care about. It's not much but it's there if I need or want something.

My PCP is listed as a doctor for the hospital I use, has his office in same the hospital building, and he has all my records in his computer system which he was mandated to have by the government legislation. However, my PCP is not an employee of the hospital and his practice is independent of the the hospital although affiliated with it. His records system does not tie into the records system of the hospital which has caused some minor issues when the hospital urgent care center needed some information from his office on a weekend. He also uses a form with check boxes to request labwork that I hand carry to the lab as he isn't on the hospitals system to do it electronically.
Perhaps your PCP practices under a similar situation(?) I've found it to be some what common for doctors to be listed for a hospital, yet have an independent practice.
The government mandate for electronic records keeping may not have been a bad idea, but it fell far short of what it shoulda/coulda been to ensure information could be shared not only between hospitals, but the doctors that work in the same facilities.

[Pugsy]

Perhaps your PCP practices under a similar situation(?)

Nope. He's not independent. He's part of the system. When they told him he had to quit taking the competing hospital's insurance or patients...there was a big notice to that fact on his bulletin board. He would be happy to see them but no longer accept their insurance kind of thing.
Plus I have been to other specialists all within the "system" and the little print out thing has never mentioned sleep apnea as far back as I can remember. Most recently was an orthopedic doctor for some arthritis issues in a thumb joint just last month.

My point mainly....medical records can contain errors. Sometimes good errors and sometimes not so good errors.
But my DME (also part of the hospital system with access to all my records) doesn't seem to care that I have nothing in my medical records about my sleep apnea or cpap use...and yet they continue to file with my Medicare and Medicare pays. Are they maybe making something up....dunno...I never see the paperwork until I get a bill for my 20%. Don't really care either. I don't really want to go see another specialist just to get a script for a mask. Waste of my time and money. Now my DME does have a big notice in their lobby about BCBS requiring an annual visit and script thing....but so far they haven't even bothered asking me for anything. So I assume that they and Medicare don't need anything. I am not going to rock that boat.

Now with a recent visit where I took my mom to her wound care doctor it was mentioned "her diabetes is slowing the wound healing" and I had to say and make sure they documented it...."she's never had a diagnosis of diabetes...how did that get in the records".
She has a lot of health issues but diabetes has never been one of them. It's a good thing too because she loves her sweets.
It just popped up all of the sudden out of the blue on her records.