Miami, Florida
1 comment

A couple of months ago I received a letter from Apria requesting payments because Medicare would not pay few days later an agent called Carlos called me to request the flash card from my cpap machine I told him that I would take it personally to him the following day and I did .At that time I showed him the letter that I received and he "Carlos" told me that they by mistake got the wrong unit that with that chip everything was solved . Few weeks later I received my chip back and I called him "Carlos" to ask him if I was supposed to put the chip back he said yes Today April 24 a guy called me to tell me that he was coming to pick up the machine he said that they sent me a letter that I never received and I asked him why he said that medicare refused to pay because i was not using the machine I told him that I used it every night this guy didn't gave me his name but he has all my information and HE didn't give me his name I called this Carlos and I am still waiting for him to call me back.

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Medicare requires 4+ hours/night of use ≥

70% of the nights in 30 consecutive days for continued coverage for PAP therapy. If your card download didn't show this, they can take back the equipment. Medicare also requires the documentation of benefit from PAP treatment of obstructive sleep apnea. There needs to be a face-to-face meeting

between your doctor and you documenting one of the following symptomatic improvements:

Daytime sleepiness/fatigue, Observed apneas/choking/gasping during sleep, Morning headache. If these things didn't happen, beneficiaries who fail the initial 12 week trial are eligible to requalify for a PAP device but must have both a Face-to-Face clinical re-evaluation by the treating physician to determine the etiology of the failure to respond to PAP therapy, and a repeat sleep test in a facility-based setting (Type 1 study).

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