Supplies, Medicare/Insurance, & Usage Compliance

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Grumpy48
Posts: 452
Joined: Tue May 12, 2020 7:57 am

Supplies, Medicare/Insurance, & Usage Compliance

Post by Grumpy48 » Mon Jul 04, 2022 6:29 pm

I'm well past needing compliance for CPAP usage to have Medicare and my insurance pay for the machine 'rental' and I 'own' it now, but regarding routine supplies that Medicare and insurance pay for, is the DME obligated to show usage compliance when resupplying me and submitting a bill to Medicare and subsequently insurance? I presume verification of usage could be done though monitoring of the manufacturers host cellular data collection (for my DME's case Resperonics Care Orchestrator). The DME online ordering website does have a checkbox, 'Are you still using your CPAP', but I'm wondering if they do any further checks to ensure I'm continuing to use my CPAP (a DS2). I've started using an alternate CPAP machine (an AS10 Auto) that is not monitored by my DME which means less hours going in on the DS2. I'm using the same mask for both machines which is covered in full between Medicare and insurance and I don't want risk them not paying for the mask and headgear due to what might appear as non or insufficient use of the DS2.

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SleepGeek
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Joined: Mon Feb 09, 2015 2:56 pm

Re: Supplies, Medicare/Insurance, & Usage Compliance

Post by SleepGeek » Mon Jul 04, 2022 9:22 pm

I have ordered and received supplies when I had the modem removed from the cpap before I ever powered it on for the 1st time. Did for years no less.

Oh yes I have Medicare. I think those usage questions are routine for Medicare accounts.

So I think you are safe.
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