One of the frequent questions our reimbursement help desk gets from CPAP suppliers is:
“Does Medicare allow a second trail if the patient fails to document compliance in the first 90 days?”The answer:
“Yes, Medicare permits a second CPAP trial under certain circumstances, but Medicare doesn’t pay for a second trial.”Failed trials are costly, and CPAP users are significantly more complicated to service after failing their first attempt. Perhaps the better question is, “How can suppliers help CPAP users benefit from therapy during the initial trial?”
- Educate the patient,
- Evaluate the patient’s commitment and the therapy’s effectiveness, and
- Establish the financial consequences for patients that are not progressing toward compliance.
- Give the machine back, or
- Pay for it out-of-pocket.
- How often they are using their machines?
- Are they having any discomfort?
- If they are not using it, or taking it off after a short interval, why?
- Patient Compliance, or
- Equipment return.