Letter from Lincare Regarding Compliance

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
Starlette
Posts: 1725
Joined: Mon Feb 08, 2010 9:30 pm
Location: Denver, CO

Letter from Lincare Regarding Compliance

Post by Starlette » Sun May 28, 2023 11:13 pm

Attached is a letter from Lincare stating that I’m not in compliance with CPAP therapy.
Little do they know that I have other health issues that make it very difficult to maintain compliance with CPAP, sleeping in bed.

1) Restless Leg Syndrome (RLS)
2) Often, my nerves don’t let me lay down, I have to sleep sitting up. I have no other choice but to sleep on the couch.
3) Doesn’t help show compliance when I do use the machine that the mask comes off after an hour or so. I’ve learned to put on a chin strap which really has helped.

So, my question to you all is, “What to do, what to do”?

https://imgur.com/JCMDR45

_________________
MachineMask
Additional Comments: Silent Nite Dental Appliance

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Letter from Lincare Regarding Compliance

Post by palerider » Sun May 28, 2023 11:19 pm

So use the machine on the couch.

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
Get OSCAR

Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

User avatar
ozij
Posts: 10120
Joined: Fri Mar 18, 2005 11:52 pm

Re: Letter from Lincare Regarding Compliance

Post by ozij » Sun May 28, 2023 11:32 pm

palerider wrote:
Sun May 28, 2023 11:19 pm
So use the machine on the couch.
What he said.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023

User avatar
Starlette
Posts: 1725
Joined: Mon Feb 08, 2010 9:30 pm
Location: Denver, CO

Re: Letter from Lincare Regarding Compliance

Post by Starlette » Mon May 29, 2023 1:28 am

Honestly, I never quite thought of that. I could try that and see how it goes.

_________________
MachineMask
Additional Comments: Silent Nite Dental Appliance

User avatar
Starlette
Posts: 1725
Joined: Mon Feb 08, 2010 9:30 pm
Location: Denver, CO

Re: Letter from Lincare Regarding Compliance

Post by Starlette » Mon May 29, 2023 1:30 am

Also, how long does big brother monitor? Please don't say forever and ever amen!

_________________
MachineMask
Additional Comments: Silent Nite Dental Appliance

User avatar
chunkyfrog
Posts: 34378
Joined: Mon Jul 12, 2010 5:10 pm
Location: Nebraska--I am sworn to keep the secret of this paradise.

Re: Letter from Lincare Regarding Compliance

Post by chunkyfrog » Mon May 29, 2023 9:32 am

I started cpap in April of 2010.
My sleep doc downloads a month or three once a year, per Medicare requirements.

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Airsense 10 Autoset for Her

User avatar
ChicagoGranny
Posts: 14409
Joined: Sun Jan 29, 2012 1:43 pm
Location: USA

Re: Letter from Lincare Regarding Compliance

Post by ChicagoGranny » Mon May 29, 2023 11:26 am

Are you being treated for RLS? There are drugs that help. Results vary.

User avatar
Pugsy
Posts: 63942
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Letter from Lincare Regarding Compliance

Post by Pugsy » Mon May 29, 2023 11:45 am

Starlette wrote:
Mon May 29, 2023 1:30 am
Also, how long does big brother monitor? Please don't say forever and ever amen!
It depends on which insurance company you are using and what is the "compliance" trying to prove.
It is to prove compliance so that a recently received new machine will be paid for by the insurance company per whatever contract they have or is it proving "compliance" to get masks and other supplies.

If you have Medicare (or some other insurance company that goes by Medicare guidelines) and you just got a new machine not long ago...
Medicare compliance requirements for machine use is
70% of 30 consecutive nights (within a 24 hour period so doesn't necessarily have to be a consecutive 4 hours)with at least 4 hours of machine use. You don't have to be asleep either. They won't know if you are awake or asleep. Use it while awake and watching TV or reading a book if you are borderline meeting that 4 hour requirement.
So 21 nights out of 30 consecutive nights and once that is satisfied Medicare doesn't care and will pay for the machine.

If you don't have Medicare you will need to contact your insurance company and find out exactly what their compliance requirements are.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

D.H.
Posts: 3467
Joined: Sun Sep 04, 2016 7:07 pm

Re: Letter from Lincare Regarding Compliance

Post by D.H. » Thu Jun 01, 2023 2:39 pm

If the DME is well run, they would want you to be compliant. It's in their interest to get paid for the machine rather than to have to repossess it and have a used machine on their hands.

_________________
MachineMask
Additional Comments: Auto PAP; 13.5 cmH2O min - 20 cmH2O max

Grumpy48
Posts: 362
Joined: Tue May 12, 2020 7:57 am

Re: Letter from Lincare Regarding Compliance

Post by Grumpy48 » Thu Jun 01, 2023 5:03 pm

How about supplies that a DME provides for a CPAP that they submit a bill to Medicare/Insurance? Does the DME need to verify usage/compliance for them to submit a bill for payment? I've kinda wondered about this as I sometimes switch off my primary CPAP for a length of time to an alternate one the DME has no record of and can't access the data.

_________________
Machine: DreamStation 2 Auto CPAP Advanced with Humidifier
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion)
Additional Comments: Resmed AirSense 10 Auto with Humidifier

User avatar
Starlette
Posts: 1725
Joined: Mon Feb 08, 2010 9:30 pm
Location: Denver, CO

Re: Letter from Lincare Regarding Compliance

Post by Starlette » Thu Jun 01, 2023 5:16 pm

Very good question Grumpy48

_________________
MachineMask
Additional Comments: Silent Nite Dental Appliance

User avatar
ChicagoGranny
Posts: 14409
Joined: Sun Jan 29, 2012 1:43 pm
Location: USA

Re: Letter from Lincare Regarding Compliance

Post by ChicagoGranny » Thu Jun 01, 2023 5:41 pm

Grumpy48 wrote:
Thu Jun 01, 2023 5:03 pm
How about supplies that a DME provides for a CPAP that they submit a bill to Medicare/Insurance? Does the DME need to verify usage/compliance for them to submit a bill for payment?
No. But if insurance asks for compliance records and the insured can't provide them, the claim will be rejected.

Many DMEs have their own policy to require up-to-date compliance data to avoid this situation. For example, once per year, my DME requires the data and a statement from my doctor that I use CPAP and benefit from it. This helps the DME and me avoid rejected claims.