Has everyone gone insane? CPAP Monitoring/Modems & SD Cards?

I started in March with a brick (I was naive) and then in April I got the S9 Autoset. I got a note and envelope in the mail in middle of April for me to send the SD card back, but I told him I was only on the machine for a few weeks, so he said send it in later. I never did, they never asked.
In July my insurance company changed DME's to Apria. I got a whole new machine and the other one was picked up by the other DME. (By the way I gave it back to them WITHOUT the SD card!)

So, basically my insurance company has never checked my compliance at all.

That shows you the extremes - modems monitoring everything to nothing.

Touchy subject, but I'll throw in my $0.02 from the DME perspective. The only group that requires a modem, is YOUR doctor. Insurance doesn't give a crap if it has a modem or not. All they want if proof that you are using the machine according to their guidelines. I have a doctor that refuses to refer his patients to companies that don't slap a modem on every cpap/bipap. He wants up-to-date information when his patients come in for their follow-up and feels that having the patient stop by my office and download their data card, is too inconvenient for them. I only have one doc that is like this.

The insurance companies have recently stepped up their game of finding ways to deny payments, and leading the charge is good ol' Medicare. Just about every insurance I deal with, requires that I PROVE that my customer is not only using their equipment, but also according to their standards. If I don't submit this data to Medicare they will not pay for the cpap rental past the 3rd month. Patients also have to have a face to face visit with the prescribing doc no sooner than 30 days after going on cpap, but not more than 90 days. At that visit, the doctor HAS TO WRITE IN THE CHART, that the patient is using and benefiting from the use of cpap. Even if the patient is using it every night, AHI went from 100 to less than 5, if the doc fails to do this, Medicare will not continue to pay the rental.

Now knowing this, just imagine how hard it is to get people to do what they are supposed to do without holding a gun to their head. People always seem to have time to go shopping, vacation, eat out, but can't seem to find the time to get that little card to me. Modems are the answer to this problem. I can slap a modem on a machine, look at the data in a couple of days to see if they are actually using the machine, taking it off halfway thru the night, or the pressure is not resolving their apnea. Before modems came out, we would call 3 days after somebody went on cpap and ask them how they were doing. People lie. I can't tell you how many times somebody told us everything was great, using the machine every night, then finally download it, and it hasn't even been touched!

So, if you have privacy concerns and you feel that modems and data cards are an intrusion, look to your insurance company, because believe me, nobody that is selling you a cpap wants to keep up with why, when, where, and how you are using it.

The answer to the modem thing........is to buy your own machine with cash $$$$$, then you don't have to comply to anyone but yourself.
Nan

Java wrote:I have Kaiser and Apria. I was not given a choice in my machine and I was given a plain old brick CPAP. I had to scream and fight and email my doctor everyday till she agreed to loan me one of their APAP machines with an SD card. I kept it for 4 weeks and when I went to return it, I had printed out all my data for her. She wouldn't even look at it. She didn't care.

I am learning from this forum that Kaiser is very variable. I am in San Diego. I went to see my sleep doctor to get a Provent prescription, and took my APAP SD card with me. As soon as I told the doctor I had it, he took the card and popped out of the room for a minute. A few minutes later someone came in, returned the card to me, and handed him a printout. He seemed very interested in the printout and discussed it with me. I also had a SleepyHead printout, but he preferred to look at what seemed to be a familiar format.

nanwilson wrote:The answer to the modem thing........is to buy your own machine with cash $$$$$, then you don't have to comply to anyone but yourself.
Nan

Exactly what you insurance company wants you to do.

Good info Mcdover. Does TriCare use medicare standards?

Lizistired wrote:Good info Mcdover. Does TriCare use medicare standards?

No, they have their own guidelines, but are much more forgiving and a lot easier to deal with.

No slam at the Medicare recipient themself, but I would much rather have a Tricare customer come in, than a Medicare customer.

So, if you have privacy concerns and you feel that modems and data cards are an intrusion, look to your insurance company, because believe me, nobody that is selling you a cpap wants to keep up with why, when, where, and how you are using it.

Completely agree with mcdover!

Medicare makes the rules...DME providers just follow them. We have many pts on modems and I do not know of one RT that has the time or interest in looking at data.
Can the data be abused as some have mentioned in this post. Sure they can but that can be said for all the info in our medical records.
I will say though that those modems can be a positive experience as well..they will alert the provider if a pts leak is too high or if their apneas are too high. Many a time we have called pts to inform them of what we are being alerted on and the pt has no clue-so we will refit them with a mask, send a chinstrap or call the MD to increase pressure if needed. Has helped many pts with their therapy and health.

I'm in my first 30 days, so I have my modem attached still. I called the RT about some mask issues, and before she called me back, she checked my data. I presume that was so she could see how I was doing to be prepared to help me. I had no problem with that at all. I'm actually going to see her today to switch out a mask, and she asked me to bring my equipment. I brought the modem along as well. I'm on Day 20, with 100% full night compliance, and even naps too! I'm wishfully thinking that she'll just take the modem a bit early.

teachcsg wrote:

So, if you have privacy concerns and you feel that modems and data cards are an intrusion, look to your insurance company, because believe me, nobody that is selling you a cpap wants to keep up with why, when, where, and how you are using it.

Completely agree with mcdover!

Medicare makes the rules...DME providers just follow them. We have many pts on modems and I do not know of one RT that has the time or interest in looking at data.
Can the data be abused as some have mentioned in this post. Sure they can but that can be said for all the info in our medical records.
I will say though that those modems can be a positive experience as well..they will alert the provider if a pts leak is too high or if their apneas are too high. Many a time we have called pts to inform them of what we are being alerted on and the pt has no clue-so we will refit them with a mask, send a chinstrap or call the MD to increase pressure if needed. Has helped many pts with their therapy and health.

It appears that, at least for those patients who are not 'into the data', having a medical provider look at it makes sense.
--NOT an old (or new) proverb: "The shades are always drawn on the house with the darkest secrets."

jmmass wrote:I will not plug in the stupid modem. I will return the freaking thing and tell them to shove it. I have no idea where the data is being stored, how it is being used…and more importantly…how it can be abused! I am in the technology field…trust me…this data is not secure!

Darwin is smiling.

However, I do agree we need to reinstitute our medical privacy, and keep the darn government and courts out of our medical records.

As someone points out, drivers are avoiding getting tested for apnea and other conditions because of the government bureaucracy involved.

Arch mcdover is right. The insurance companies push for regulation of anything that costs them money.
The people I know with untreated apnea know nothing about SDB. They only have a perception of bureaucracy. They have just heard rumors about "Joe" has to use this machine now, or "John" had to have a sleep study because his neck was 17". It's a shame they aren't more informed but I gave up talking to the wall.

archangle wrote: However, I do agree we need to reinstitute our medical privacy, and keep the darn government and courts out of our medical records.

As someone points out, drivers are avoiding getting tested for apnea and other conditions because of the government bureaucracy involved.

That will only lead to more rules - like that you MUST get tested to keep your professional licence.

Yes keeping your license no mater what is so important because other wise you might not be able to try to wipe out a classroom full of kids.
http://www.cbc.ca/news/canada/calgary/s ... crash.html
He had seizures but nobody reported it. 1 dead, 2 seriously injured and more. Let's keep these people on the roads, eh?

BlackSpinner wrote:That will only lead to more rules - like that you MUST get tested to keep your professional licence.

You're right. However, the current BS means a lot of apneacs avoid being tested and getting treated because they don't want to deal with big brother.

You probably have more apneacs driving untreated because of the bureaucracy than you have untreated apneacs who had their license suspended.

Some countries (Canada?) and some states require doctors to report apneacs and their licenses are suspended until they prove compliance, even for non-professional drivers. I'm sure this does more harm than good, too.

I definitely think untreated apneacs shouldn't drive. The problem is the threat of license suspension may lead to more untreated apneacs, not fewer. If I heard that my buddy got a sleep test and lost his driver's license, I certainly wouldn't get tested. I also wouldn't go back to Bill's doctor. I'll bet Bill would tell all his friends which doctor and which test to avoid, too.

archangle wrote: You probably have more apneacs driving untreated because of the bureaucracy than you have untreated apneacs who had their license suspended.

Some countries (Canada?) and some states require doctors to report apneacs and their licenses are suspended until they prove compliance, even for non-professional drivers. I'm sure this does more harm than good, too.

I definitely think untreated apneacs shouldn't drive. The problem is the threat of license suspension may lead to more untreated apneacs, not fewer. If I heard that my buddy got a sleep test and lost his driver's license, I certainly wouldn't get tested. I also wouldn't go back to Bill's doctor. I'll bet Bill would tell all his friends which doctor and which test to avoid, too.

The study in Ontario showed a decrease of accidents.
And as far as not going back to the doctor, just getting a family doctor is not something to give up lightly. You have a choice - sit for 6 hours in a clinic or make an appointment with your doctor. Your pain of having to use a cpap machine or lose your license is nothing compared to your victims families pain.