Medicare CPAP User Doctor Questions

Hi Everyone.

I've been using the services of a sleep doc for several years and am not receiving much in the way of service. The only reason I go is to get an annual prescription update, and even that isn't going so well. I've been depending on myself to monitor my sleep results and make adjustments - but that's going pretty well.

I know that some folks are able to use their primary care physicians to get the Medicare paperwork documented for cpap supplies. This puzzles me, probably because I don't fully understand it.

When a primary doc submits an annual confirmation of your usage, how does s/he know that you are in compliance? They probably don't monitor your machine usage. Or...is confirmation of compliance the job of the DME alone?

Is a primary doc able to get Medicare to pay for a new machine every 5 years, and, if so, what does s/he have to do for that?

Much appreciated!

It depends on your PCP.
Some refuse to bother with anything for which you have already had a referral elsewhere.
My PCP no longer does my diabetes stuff--he never did cpap stuff,
and will only push orthopedic issues to PT--it is up to me to request a referral to a specialist--
AFTER making Medicare happy by suffering for an additional month or three.
The bullfrog is alive only because he was very insistent about his cardiac problems--
(The in-office tests were all NEGATIVE--but he had an 80% blockage!) WTF!!!!

During my annual physical I always mention my CPAP..PCP never asks about it. Every year my DME emails my PCP to verify that I am using my CPAP. After the first 90 days there is no compliance issue.

My sleep clinic, cardiologist, and PCP are all part of the same medical network. What one enters into my records, the others see when they open my records during a visit.