If you just started CPAP or BIPAP therapy, you may have heard the word “compliance” and wondered what it means. In short, your insurance wants proof that you are using your machine before it keeps paying for it. Here is what it checks, and how we help you stay on track.
Your Machine Keeps a Record
Modern CPAP and BIPAP machines record how many hours you use them each night. That record is called a download. Some machines send it to the cloud, so we can pull it remotely. Others store it on an SD card that you bring in to us. Not sure which kind you have? Give us a call.
The Two Things Insurance Requires
- A compliant download. Use your machine at least 4 hours a night on 21 of 30 consecutive days, during any 30-day stretch within your first 90 days.
- A follow-up visit with your doctor. It must be face-to-face (not telemedicine), no sooner than day 31 and no later than day 90 after you get your machine.
If you have UPHP, Michigan Medicaid or UPHP Medicare Advantage Plans, your plan also requires a compliant 90-day download: at least 4 hours a night on 63 of your first 90 days.
Tips for Hitting Your Hours
- Put your mask on every time you sleep, including naps.
- If your mask leaks, pinches or feels wrong, call us. A better fit is often the fix, and we do mask fittings locally.
- Keep your supplies clean. A dirty cushion seals poorly and is less comfortable.
- Bring your download, or let us pull it, before your doctor visit.
After You Meet Compliance
Once you meet compliance, you become eligible for new supplies through insurance. Plan on a face-to-face visit with your doctor once a year to keep receiving them.
Our CPAP Compliance page has the full resupply schedule and cleaning guide. Questions before your appointment? Call either location and press 3 for our CPAP & BIPAP resupply line.
