Changing PCP is a nightmare in the US :shock:

So, I have changed Doctor (PCP) - I have great insurance but the Sleep center I have wants my new doctor's approval. She will sign but also wants me to have a new study. All I care about is the equipment and I like what I have but it is leased. So the Doctor must OK, or NOT? I doubt that they will leave me without a machine but I am curious of this scenario. What happens?
I think a year from now I can do a new sleep study (actually it is recommended because I have restless leg syndrome too). By then I'd own the machine.
I am on medication there is no second guessing especially not by a general practitioner, why is this happening with equipment. BTW the new Sleep Center is part of a Hospital and I am sure medically far better than the first, where I never met the doctor. Still, I am little worried about the equipment - I already told them that I accept only Auto machine.

When was last sleep study ? I guess I don't understand where the new PCP is coming from unless maybe it's a very old sleep study on file? I also wonder what your current weight is vs weight at last sleep study. Maybe PCP wants to make sure there is still a need if circumstances have changed?

I think she just wants to have some more data. I gave her the last sleep study which was 60 days ago. The new PCP and her hospital is markedly better than my old setup. Still this can(could) wait one more year when I own my machine. I am pretty sure the insurance will say the same. But still usually this questioning only happens with medical equipment and external stuff like CPAP...

Has the new Dr seen your old study? Is the new test for something not covered in the older study? Will ins. even pay for another one so soon?

andrasnm wrote:I think she just want to have some more data. I gave her the last sleep study which was 60 days ago. The new PCP and her hospital is markedly better than my old setup. Still this can(could) wait one more year when I own my machine. I am pretty sure the insurance will say the same. But still usually this questioning only happens with medical equipment and external stuff like CPAP...

Maybe she saw something in your machines data or maybe the last titrartion. Did you complain about any problem to her? when I had to change Sleep Dr.'s after a year I was presently surprised she ordered a new titration. The new setting they ordered much improved my CPAP results, but I had mentioned and shown here some desaturation issues I was having.

Call insurance directly.
They are the only ones who will tell you the truth about
whether or not an additional study is necessary.
There is always the possibility your doctor is covering his rump.
(Or filling his pockets)

Yeah, I have talked with the Insurance already. I am not going to pay out of pocket I would do a new titration in Jan. I have decided THAT! I already have my own mask I like! It will be very different but I doubt it will happen.

Cardsfan wrote:Has the new Dr seen your old study? Is the new test for something not covered in the older study? Will ins. even pay for another one so soon?

Thats the $64000 question. She has the result the name of the sleep doctor (and tel #) I doubt insurance will opay for new Tiration NOW, maybe later...

andrasnm wrote:new Titration

Give the new doc copies of your Sleepyhead reports showing that your therapy is titrated to the correct pressure and is effective. Then ask her what is the use of a new study.

Something doesn't make sense here. Why would a doctor order another sleep study when one was just done two months ago? Unless you went to a known quack previously, or are complaining about the accuracy of your last study, there would be no reason for such a thing other than enriching the new doc and the hospital they evidently work for.

That's the way I see it anyway.

Keep this in mind..... "The doctors work for YOU".
You and your insurance provider are paying THEM and consequently they are like contracted employees.
Don't let them get or have the "God Complex" when you're dealing with them.

Sounds like you're getting scammed.
And, why would you even think you would have to change equipment? If your insurance provider hasn't changed, your equipment shouldn't either.
ANNNNNND, if you (or your insurance provider) get your equipment paid for before the end of the year, you shouldn't have another deductible to worry about after the first of the year. Get your insurance to pay off your machine BEFORE the end of the year.


Den

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Have you asked the doc the most critical question: "Why do you need a new study when my study is only two months old?" "What is wrong with the original one?" If a doc can't or won't answer your questions candidly, it might be you have the wrong doc for you. Will your insurance cover a second opinion, or are you stuck with a doc 'assigned' to you rather than one 'chosen by' you? Doc:Patient = partnership, not Master:Servant. In the final analysis, it's your health and wellbeing that should be the ultimate interest, not the doc's ego, income, status, etc.