Does Medicare care if you go into the Provider menu to enable detailed sleep reports?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
tisket
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Does Medicare care if you go into the Provider menu to enable detailed sleep reports?

Post by tisket » Sun Mar 12, 2023 11:25 am

Hopefully an easy one for those who know. My girlfriend got a bipap from Medicare around 8 months ago. It's still gradually being paid off. She had a three month compliance period where I think the DME was looking at her data through the cellular connection. She hasn't seen a doctor since she got the machine.

I would like to go into the provider menu to enable the option to get the detailed sleep report each morning so she can check her leaks instead of just getting a smiley face. Does anyone know if changing something in the provider menu would cause Medicare to stop paying for the machine? Does it matter if it's just changing a display setting like this? Maybe they react differently if you change the pressure settings?

I have always bought and set everything myself so I have no idea how Medicare (or an insurance company) react to you fiddling with the provider menu or how much they can tell you have changed things in there. It's kind of a weird situation because you have a pressure prescribed, kind of, but unlike a regular prescription you could just change it yourself. Also does this change once you own the machine and it's fully paid off?

Thanks!
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LSAT
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Re: Does Medicare care if you go into the Provider menu to enable detailed sleep reports?

Post by LSAT » Sun Mar 12, 2023 11:33 am

It's her therapy...it's her machine. No one cares if you monitor her therapy or make adjustments to make the therapy work better. The only monitoring , as you mentioned, is for compliance during the first 90 days. No one is monitoring anything unless she would call the DME or doctor with a problem.

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ChicagoGranny
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Re: Does Medicare care if you go into the Provider menu to enable detailed sleep reports?

Post by ChicagoGranny » Sun Mar 12, 2023 11:35 am

Medicare, Medicaid, health insurance companies - none of them have a clue about reports, AHI, leaks, etc.

All they care about is compliance - hours of use.

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Pugsy
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Re: Does Medicare care if you go into the Provider menu to enable detailed sleep reports?

Post by Pugsy » Sun Mar 12, 2023 11:36 am

No...Medicare doesn't care what you do to or with the machine.
Medicare only cares that you use the machine the minimum number of required hours...that's all they care about.

Besides....Medicare doesn't have any way at all to know if someone goes into the clinical menu set up area to change anything unless someone tells them and even then...they just don't care.

Medicare doesn't care if you use software or not...Medicare doesn't care if you change the settings in any way shape or form.

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tisket
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Location: Florida

Re: Does Medicare care if you go into the Provider menu to enable detailed sleep reports?

Post by tisket » Sun Mar 12, 2023 11:37 am

Thanks everyone, that's good news.
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Janknitz
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Re: Does Medicare care if you go into the Provider menu to enable detailed sleep reports?

Post by Janknitz » Wed Mar 15, 2023 3:10 pm

Medicare DOES care about use (compliance).

" It's still gradually being paid off. She had a three month compliance period where I think the DME was looking at her data through the cellular connection. She hasn't seen a doctor since she got the machine"

And this is a violation of Medicare regulations, because Medicare requires a FACE TO FACE meeting with a doctor during the first 90 days to document compliance. Now it may be that the DME captured the data online and reported it to the doctor. And Medicare may now be permitting Zoom or Teledoc appointments for compliance because of the Pandemic. BUT, the requirement for a doctor's check in is still there. Is it possible she did this via phone or Zoom?
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tisket
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Location: Florida

Re: Does Medicare care if you go into the Provider menu to enable detailed sleep reports?

Post by tisket » Wed Mar 15, 2023 5:10 pm

Maybe she did see a doctor, that was a long time ago, my point was no one seems to be paying attention to her data or her settings. But now that you mention it I think she had to go see the primary care physician who ordered the sleep test, and who has no expertise in sleep medicine, to fulfill that requirement. Not sure what that has to do with whether I can change her settings.

Note she had been using bipap for years, this was all a formality to get the machine onto Medicare once she joined.
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james999
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Re: Does Medicare care if you go into the Provider menu to enable detailed sleep reports?

Post by james999 » Wed Mar 15, 2023 8:54 pm

I had the same question about my Resmed AS10. But, I got mine from the VA. After researching it and talking to the VA rep., they told me that the machine is mine to keep and that they just are interested in usage, like what people are saying about medi-cal here. Per their rules, I have to use it 4 hours a day, three times a week, at least. I think that is so that I can be eligible for the free annual supplies that they send me (water tub, 4 masks of my choice, filters and hoses). Don't have to pay for any of it. I don't think that they even care about my AHI's on an ongoing basis, They just need to know at the end of the year have I used it enough in order to get the annual reorder supplies. I have changed settings in it after research myself and the settings just stay the same the way I have changed them. I don't know if they can change a setting through the modem? One good thing I found out on my own is that I can message the VA anytime and request any mask to try out and they will send it. Takes about 11 days for me to get one once I request it. It doesn't affect the annual order either. I have used this benefit to get the right masks and will be ordering two from Fisher Paykel and two from Resmed. Well, maybe all this is TMI, but I don't post that frequently. ☺

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