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onemoretime
Unread post  Post subject: study fraud?  |  Posted: Thu Dec 01, 2016 6:01 am

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went for 2 sleep studies
1st one showed:91.7% efficiency REM 84 min moderate frag. arousal index 9.8 increased N2-N3 associated with reduced and fragged slow sleep wave AHI 7.1 mixed obstructive hypops and apnea w/ moderate hypoxemia during REM 91% above 89% Lowest 81%. avg sleeping HR 61 bpm very loud snoring contributing to sleep frag. 408 minutes of sleep/NREM 310 min./REM 98 min/respiratory arousals 48/2 central apneas(12 sec)/obstructive 2(13 sec)obstructive hypops 44 = RDI 7.1 index

2nd study initiated with 5 cpap. 62.1% sleep efficiency 257min TST/ NREM 186m/ REM 71m/ zero events other than 2 snores O2 sat 90% or greater -100% 1030pm 5 cpap..1145pm tech in as i was unable to fall asleep. changed settings to bipap 7/5 (tech documented work of exhalation prevented me from tolerating therapy --I never said that) 1245am bipap 7/5(awake) 116am sleeping N3 /147am REM /217am N2 /239am increased 8/5 snoring/ 309am bipap 8/5 N3 /410am REM /441am N2

RX from Sleep MD for bipap 9/5 with PSmin 2.....would not a cpap flex take care of this at 8/5? and how can bipap be justified without any sleep events on titration study?


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trish6hundred
Unread post  Post subject: Re: study fraud?  |  Posted: Thu Dec 01, 2016 10:22 pm

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Hi onemoretime,
WELCOME! to the forum.!
Hang in there for assistance with your report.
Good luck to you with your CPAP therapy.


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TheLankyLefty
Unread post  Post subject: Re: study fraud?  |  Posted: Fri Dec 02, 2016 5:51 pm
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onemoretime wrote:
RX from Sleep MD for bipap 9/5 with PSmin 2.....would not a cpap flex take care of this at 8/5?
It probably would. (we don't know for sure, but you had no sleep with CPAP, so I wouldn't rule it out)

onemoretime wrote:
and how can bipap be justified without any sleep events on titration study?
Tolerance is one way that Bilevel can be justified. You are correct that there has to be some dialogue between you and the tech where you complain about not being able to breath or exhale...etc. They just took it upon themselves....really not a good move on their part.

I don't know that I would call it fraud, but I would call it a crappy technician.

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onemoretime
Unread post  Post subject: Re: study fraud?  |  Posted: Sat Dec 03, 2016 6:27 am

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study office affiliated with dme....both have been calling insistently to set me up..when i call insurance they have no clearance or request from either company. DME did send me the paperwork they received from sleep office When sleep office found out they went off that it was not the official doctor reports. those reports do not address the less than 15 AHI event justification/documentation. My insurance goes through care centrex coordinators and they have nothing...really seems a little fishy


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jb.sing
Unread post  Post subject: Re: study fraud?  |  Posted: Sat Dec 03, 2016 4:21 pm

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When I started cpap I got a letter from my insurance company very detailed on what they would cover for supplies.
I had to wait about 6 weeks for this documentation.I would ask the DME or prescribing doctor when they submitted the request. And go from there.


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TheLankyLefty
Unread post  Post subject: Re: study fraud?  |  Posted: Sat Dec 03, 2016 5:09 pm
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onemoretime wrote:
really seems a little fishy
It's extremely fishy. You are in the range where an oral appliance is most likely to be effective. If the report has your AHI and RDI broken down by by body position, you may be able just avoid certain positions.

No events in REM, so they're not putting you on CPAP because of a REM specific component. Very odd indeed. I think I would start asking some pretty pointed questions. If there is no good response I would probably seek a second opinion if you are feeling symptomatic for sleep apnea.

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onemoretime
Unread post  Post subject: Re: study fraud?  |  Posted: Sun Dec 04, 2016 5:42 am

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i snore in any position, have hashimoto thyroid("Normal labs") and TMJ. If exp.pressure is 5 and 5 of cpcp is where I started how was i intolerant when i finally fell asleep the tech put bipap at 7/5. One other Question ...is the cpap/bipap controlled in the observation room? Is there one machine that does it all for the sleep tech to adjust?


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TheLankyLefty
Unread post  Post subject: Re: study fraud?  |  Posted: Tue Dec 06, 2016 11:03 pm
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onemoretime wrote:
If exp.pressure is 5 and 5 of cpcp is where I started how was i intolerant when i finally fell asleep the tech put bipap at 7/5.
Don't know....that's why it sounds like BS from the tech. They were probably trying something to make you more comfortable since you were awake for awhile, but it's very odd to not communicate with the patient at all and just change the pressure.

onemoretime wrote:
is the cpap/bipap controlled in the observation room? Is there one machine that does it all for the sleep tech to adjust?
Yes, it's controlled remotely. There is a machine that is capable of everything: CPAP, APAP (yes...even with a tech there), Bilevel Spontaneous, Bilevel Timed, Bilevel with back up rate, Auto Servo Ventilation, and AVAPS. Fun stuff.

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diamaunt
Unread post  Post subject: Re: study fraud?  |  Posted: Wed Dec 07, 2016 1:47 pm
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speaking of doing everything, I want to get my grubby paws on a Lumis Tx. :D

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onemoretime
Unread post  Post subject: Re: study fraud?  |  Posted: Tue Dec 20, 2016 1:54 pm

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primary md referrring me to a pulm.md to reeval study..when i told him monthly cpap was $80 out of my pocket vs bipap $180 he was shocked. Informed him i could not afford that extra $100/month. Such a shame DME's are able to collect over $1700/after 10 month rental for a cpap and over $7000 for the bipap (rent to own by insurance standard own after 10 months) can buy cpap for $600 and bipap for $1200


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