Compliance rates - All the same?

I am on Medicare and my compliance rate is about 99%. I should be fine. My wife is on Tricare Standard and her compliance rate is about 75%.

Anyone know if there is a "Standardized Compliance" for us within the medical community or does every insurance company have their own?
I am asking because she has lost about 40 pounds and says she is not sure she needs it I tell her to use it anyway because she might have it taken away if they check and her compliance numbers are too low.

BTW, what is your compliance level? I use Encore Pro 1.8.65

Good question! I never worried about it because my Ins Co (Blue Cross Fed) doesn't require proof of compliance.

My compliance is 100% I guess. I never sleep without CPAP, and average 8-9 hrs/night.

I just checked my numbers and for the last 3 months my compliance is 95% (I have fallen asleep a couple times without my mask ) I have Tricare Prime and they do check compliance. My report was mailed into them sometime in April... I think there might be one more time that they check compliance. Right now I pay my copay share of my machine every month...

Has your wife actually checked to see if she is right about not needing CPAP? She shouldn't just presume that because she lost weight, she doesn't need it anymore. Most people just notice a reduction in the needed pressure with weight loss. It doesn't often change to not needing it at all. She should check that before she just stops using it.

If you are on medicare you own the machine after 13 months.

Guest wrote:If you are on medicare you own the machine after 13 months.

Yes, and according to my DME, they check compliance once between the 31st and 90th day. IIRC, compliance has to be 70% for them to continue paying.

I've never had my compliance rate checked by anyone, but I am not on medicare and do not have tricare standard. I am 100% compliant as I always use my machine. Can't get to sleep without it. I have also lost 40 pounds and still have apnea, my pressure requirerments didn't even decrease. So weight loss does not mean your apnea will disappear.

Rosie

Apria called the other week to check up on how I was doing. Obviously my insurance requires them to do it. It was "using the machine?" Yup. "every night?" Yup. "OK thanks".

elader wrote:Apria called the other week to check up on how I was doing. Obviously my insurance requires them to do it. It was "using the machine?" Yup. "every night?" Yup. "OK thanks".

Mine doesn't even have a person call. I get a machine and press 1 for yes.

My DME checks the compliance by mailing me a blank smart card and I return the used one (SMS). My insurance requires 80% compliance. Compliance is deemed as a night with 4 hours of continuous usage.

Good feedback.

The reason my compliance is not 100% is because Encore Pro "dropped out" some days in 2007. I am 100% or I might not be alive.

No one has ever called to see if I am compliant. Maybe they have figured out anyone using the SV machine WILL be compliant.