Requirements for Insurance Compliance

It's my understanding that compliance is 30 continuous days, 4 hours a day, 70% of the time, within the first 90 days of use. I met that in the month of September, 70% exactly. However, my retarded DME says it is a % of ALL 90 days, which I am sure is absolutely wrong.

Is my understand of the general rules of compliance correct?

Only insurance (or Medicare if applicable) will tell you the truth.
Either get it in writing or a conference call with insurance rep and the nincompoop at the DME.

Paralel wrote:It's my understanding that compliance is 30 continuous days, 4 hours a day, 70% of the time, within the first 90 days of use. I met that in the month of September, 70% exactly. However, my retarded DME says it is a % of ALL 90 days, which I am sure is absolutely wrong.

Is my understand of the general rules of compliance correct?

What does your insurance co. say?

Paralel wrote:It's my understanding that compliance is 30 continuous days, 4 hours a day, 70% of the time, within the first 90 days of use. I met that in the month of September, 70% exactly. However, my retarded DME says it is a % of ALL 90 days, which I am sure is absolutely wrong.

Is my understand of the general rules of compliance correct?

It's all about the money. The insurance provider is paying the DME and they're supposed to be making sure you USE the therapy for as long as the insurance provider requires it. Typically, it's a minimum of 4 hours daily for 70% of the time period required.

Your insurance provider can tell you what that time period is.

Under normal circumstances, I can't imagine why a person could NOT comply with that very lenient set of requirements.


Den

.

I was finally able to find the published policy for my insurance company that proves my understanding is indeed correct.

Wouldn't it be nice if people who do something for a living actually knew what they were talking about for once?

I am getting so sick of running into moron after moron who are getting paid to not know their own job.