You are At Risk for Being Billed for
Your Device and Supplies!
At your equipment set-up appointment, you were informed that following the start of therapy, your insurance plan will require re-evaluation periods to continue paying for your PAP equipment and supplies. During the 90-day review periods, your insurance requires you to:
Use your PAP device for 4 or more hours per night for 70% of the nights (at least 21 days) during a consecutive 30-day period. During the rental of the equipment (generally 10 months) a re-evaluation period will occur every 90 days.
Make and attend a follow up appointment with your treating physician. Many Insurance plans requires that you attend a follow up appointment with your doctor to discuss your PAP therapy within the first 90 days, between the 31st and 90th day from the start of use of the CPAP or BiPAP equipment. It is your responsibility to make and keep this appointment.
Currently you are not meeting these requirements and are at risk that your insurance plan will not continue to pay for your machine or supplies.
What if you do not meet Insurance’s compliance requirements?
You have a few options:
You can re-qualify to continue your therapy by scheduling and attending a doctor’s appointment to discuss your PAP usage, then complete a repeat sleep study in a sleep lab.
You can purchase your machine outright. Please note that, you may also be financially responsible for future supplies as well.
You can call your local branch and arrange to return the device.