Invalid Prescription

I was recently diagnosed with OSA. I had a second (titration) study and was prescribed: "Auto CPAP 16-10 mm H2O, Best Fitting mask, ramp mode, heated humidity, compliance card".

My doctor's office referred me to Apria Healthcare (they are the only provider in my town that takes my insurance), and also sent them the prescription. I stopped in their office yesterday, and they said that the machine I'll get is a Respironics 560. They didn't raise any issues at that time.

I contacted Apria today to see if they'd sent a request to my insurance company yet, and they said that they haven't because the prescription is not valid. They said it needs to have a date by the doctor's signature, and that it must also include a diagnosis.

Has anyone else run into this problem?

Also, any advice if they try to pawn off a used machine on me? (I looked up the user manual to see how to check, it's in the Info screen under the Phone In thing)...

Very common. Insurance companies require claims to include a diagnostic code. Usually the DME can provide this. The most frequent diagnosis code for Sleep Apnea is 327.23 or 780.57 for Central Sleep Apnea. The date by the physician's signature is a nit. Both of these problems should be able to be resolved without involving the patient. Did they they tell you they had requested the signature date, and code?

I called them again. They said that the prescription needs to have my DOB on the "Date" line, today's date by the signature, and the diagnosis code. My insurance company doesn't require pre-approval during the first 3-months rental period, only when converting it into a purchase.

They said that they've contacted my doctor, but having been in business for 20+ years, I know that nothing ever gets done right unless I do it myself. Perhaps it might eventually, but I don't want to wait an extra month to get the machine.

Delaying someone's treatment for crap like this is just unnecessary and a big problem. Imagine if casualty insurance companies tried to pull this stunt for every car accident before they'd approve repairs. They wouldn't be in business long with that reputation.

What insurance company is this. I'd like to avoid them.

It is CDPHP.

As I said, it's not the insurance company, it is Apria. They contacted the insurance company and were told that it doesn't require pre-approval (I checked with the insurance co). Apria are the ones saying it's not valid.

And they're the ones we all refer to as "Crapria" (thank goodness I'm in Canada!).

Quote :
Also, any advice if they try to pawn off a used machine on me? (I looked up the user manual to see how to check, it's in the Info screen under the Phone In thing).

No that is not the total machine hrs. .... you need to into the clinicians setup to get the total Machine Hours .....

like in theis craigs list add :

CPAP NEW Phillips Respironics auto 560P with humidifier - $400 (concord / pleasant hill / martinez)

There is supposed to be a Blower Hours in there, is that one resettable or something?

the hours in the user compliance section is resetable ... but not the hours in the clinicians section . Get the manual here :

http://www.apneaboard.com/adjust-cpap-p ... tup-manual

I dropped by my doctor's office, and they had switched the provider to LinCare, so I will be getting a ResMed machine instead (they couldn't tell me which model except "the automatic one"). I hope that one is as good as the Respironics...

Donot accept an "Escape" model it is a brick ... as in no data to help you with tharapy.

Lincare is only doing the AIrsense autosets.

Hmm looks like that one has wireless... Does that mean I have to give it my WiFi password?

nope it runs off of cell signal (not yours). It looks for the nearest cell tower.

Repeat after me: "Wifi, what's wifi? No, I don't have wifi".