My Sleep Doc Dumped Me!

Actually, he dumped my Insurance due to Obamacare requirements...but this isn't about that.

I currently have no sleep doc, and my annual "Supplies 'script" will expire soon. I'm going to see if my GP will write one the next time I see him, but if that fails I'm screwed.

Any ideas other than breaking in another doc and convincing him/her that I can handle my own therapy?

Your sleep doc will likely see you as a patient without insurance.
The charges will be high but you won't be without a doc.
Such is life under Obamacare AKA Affordable Care Act.

If your apnea is plain Jane vanilla, your PCP should be sufficient.
If you don't really need a specialist, your insurance is likely to appreciate not having to pay for one.

LinkC wrote:Actually, he dumped my Insurance due to Obamacare requirements...but this isn't about that.

He probably dumped that insurance policy due to them negotiating too hard on prices and blamed Obamacare. The insurance company probably blamed Obamacare for their own desire to pay as little as possible.

I'm not saying Obamacare is good. I'm saying a lot of people are blaming all their problems on Obamacare, and using it as an excuse for things they do.

Of course, one of the downsides of Obamacare is that lots of people are using it as justification for their own unrelated unpopular actions and misdeeds.

Whatever the reasons, you got screwed, though.

JDS74 wrote:Such is life under Obamacare AKA Affordable Care Act.

yes, yes, we get it, you're not a fan, hide the soapbox, will ya?

LinkC wrote:Actually, he dumped my Insurance due to Obamacare requirements...but this isn't about that.

I currently have no sleep doc, and my annual "Supplies 'script" will expire soon. I'm going to see if my GP will write one the next time I see him, but if that fails I'm screwed.

Any ideas other than breaking in another doc and convincing him/her that I can handle my own therapy?

Your primary care doctor should agree to write future orders for CPAP supplies for you until you find another sleep doctor. Mine has been doing so for a few years now but I hope to hook up with a board certified sleep doctor soon; a pulmonologist who will be my new sleep doctor.


Stevoreno_55
MS Gulf Coast
07/17/14

I have been using my PCP for most of my needs for a year now. So far so good! Of course nothing bad has come up yet Who knows!

http://www.easybreathe.com/://www.easyb ... ew-80.html

My insurance reimbursed everything they submitted.

My situation may be unique, but this is what I've done:

1. Concluded that an educated OSA-only patient has no real use for a sleep doc once the doc has overseen the NPSG and written the Rx.

2. Been careful with my "supplies" to the extent that I make a purchase out of pocket for new nasal pillows and filters (from our hosts) about once every year or two. Sometimes I submit that cost for reimbursement from my payers. Other times, if the bill is low and I'm feeling flush, I don't bother. Lately I've gotten my pillows to last well over a year. And hose and humidifier chamber have lasted me up to 5 years and beyond, no problem. Once an Rx is on file with CPAP.com, it lasts a lifetime, I believe.

I mean, it may be nice to help docs and brick-and-mortar places make a living and all. But for me, it would be contradictory for me to drive my hybrid car but then not do all I can to make my CPAP supplies last as long as possible. I'm right now in the midst of an experiment to see if I can make my nasal pillows last 5 years. I like the idea of green footprints, or at least moving in that general direction whenever reasonably possible.

There once was a day when PAP technology advanced so much in five years that it made sense to replace blowers even when they were working fine--both for efficacy and patient comfort. These days, I find the technology sufficiently advanced to my liking that I plan to keep this blower till it no longer blows--barring any major industry advances that I can't even imagine at this point.

But hey, that's just me.

jeff, nice words, but since 2010 you have not even once showed your treatment results graphically on this website.

avi, nice observation, but since you've joined this site, you have not even once said anything I've found helpful to me or educational.

OK. Just kidding. You do make me laugh on a regular basis. And that alone is worth the price of your admission.

You lovable old coot.

My therapy has been so successful that I now simply glance at my trending data every 6 months or so to make sure nothing is spiking. I watched data like a hawk for the first few years. But then I settled in for the long haul and now only use data the way it was intended, instead of obsessing over it.

But hey, just . . . me.

jnk wrote:avi, nice observation, but since you've joined this site, you have not even once said anything I've found helpful to me or educational.

OK. Just kidding. You do make me laugh on a regular basis. And that alone is worth the price of your admission.

so, there IS something avi is good for, eh? comic relief.

avi123 wrote:jeff, nice words, but since 2010 you have not even once showed your treatment results graphically on this website.

yeah Jeff

If that's really your name

Day_Dreamer wrote:

avi123 wrote:jeff, nice words, but since 2010 you have not even once showed your treatment results graphically on this website.

yeah Jeff

If that's really your name

Only the NSA knows my real name.

And they haven't told me yet.

Until then, I'll keep using the name on my U.S. passport and leave all the other passports in the safe-deposit box.

My sleep doc dumped me too. He was out of network.
But my insurance requires my PCP to submit a referral to the medical group he belongs to. The group must approve the referral and they submit it to the DME, Apria, the only in network provider. The sleep doc had to submit his requests to the PCP to get the ball rolling. I always reviewed and edited the request to be sure it was specific enough to satisfy me and included dispense as written.
I am almost 4 years into PAP but just approaching 1 year on ASV. I am debating the need for a one year review with a sleep doc. But he would be almost irrelevant to an RX.