My visit to new sleep doctor

BleepingBeauty wrote:

Patrick A wrote:

jules wrote:we need someone with medicare knowledge to post - I thought that if you were on medicare then the doc you see can't send you to his own DME (one he makes money at) - might be similar statements about the lab ------ someone needs to get slinky or akcpapguy in on this thread for their expertise on these matters

They can not send you to any sleep lab or pharmacy they have a financial interest in . Acording to California law.

If that's the case, how can this new doc order a sleep study for you in his own lab and have it covered? Maybe I missed something.

I talked to the Sleep Center this afternoon, I guess the new sleep doctor does Not own the lab, but he does work with them. I guess I was wrong.

Unless his girlfriend owns the place !

Central sleep apnea is more likely to occur in conjunction with congestive heart failure or central nervous system pathology. There is a somewhat controverisal concept of "complex sleep apnea". This is described as the emergence of central apneas as the positve airway pressure is increased to treat obstructive apnea. The servo-ventilaror, SV, type machines seem to help that situation. Most patients, in general, will not benefit from the more expensive SV units. An auto bilevel might be fine for you. It depends on your symptoms and sleep study data. You should distinguish between a physician who interprets data in a sleep lab and a a physician that works in a lab that sells DME. Will your physician profit from the sale of your new machine? Usually private insurance companies allow the physician to provide DME but medicare does not. The exception being in rural settings Medicare may allow it. It makes sense that a private insurance that has previously provided a machine will not require a new sleep study but medicare does. Medicare is doing you a service by requesting a new study. This allows for confirmation of the diagnosis, checking for changes in your condition such possible emergence of central apnea, and determination of your optimal pressure range. There is a long history of DME fraud in Medicare, so a new study also keeps everybody a little more honest. For example, a person could be cured of the OSA by surgery, but still wants a new machine to sell or give to someone else. The comment made earlier about "Obama care" is irrelevant to this situation. If you are asymptomatic with your current auto-bilevel there is no urgency to do another sleep study, on the other hand there is no real need to wait either. If it makes you more comfortable to get another opinion, you can try a medical school affiliated sleep lab since faculty physiciand maybe less likely to be incentivized to do extra sleep studies or sell DME.

I went on Friday to see my Sleep Doctor. He was very pleased with my compliance. He wasn't too happy with my BP....I think if the assistants that he has working for him knew how to take blood pressure he would change his tune. He took my BP and it was good according to him but the assistant said it was bad, Go figure. Any way he was almost doing cartwheels around the exam room (firguratively)

Hi Patrick

Did you get your sleep study?

It's true your doctor looks a bit weird but IMHO I think after 5 years it could be a good thing to have a sleep study if you are not feeling well. For sure it depends on how much it cost, etc.

Imagine, I went to the hospital to try to change doctors and hospital and they told me it's a 6 months waiting, finally the second lady told she couldn't even give me an appointment before a doctor had taken a look to the results of my sleep study (from another hospital) I brought. We develop a big patience here Over there the doctors jump over patients here they run away from you

All the best

rosacer