First Steps:
Do You Think You Have Sleep Apnea?
If you suspect you have sleep apnea or another form of disordered breathing, make an appointment to see your primary physician. He or she will evaluate your signs and symptoms and, if necessary, refer you to a specialist or for a sleep study. Depending on your symptoms and insurance guidelines, you may have an in-home sleep test or an in-lab test. Your physician will decide based on the results whether or not to prescribe a CPAP machine. You can also take our sleep apnea quiz to see if any of your symptoms could match up.
Do You Have a Prescription For A CPAP Machine?
If you have already had a study and your physician has written a prescription for a machine, you want to verify that your referral paperwork has been sent to our office. Once we receive your records we will verify that we have everything required to bill your insurance policy, and research your eligibility and coverage. If prior authorization is required, we will take care of getting your insurance company everything needed for them to approve your equipment. Once we have authorization, you will be scheduled to meet with a therapist for your setup. CPAPnow, Inc offers weekend and after hours appointments as well as in home setups.
What to Expect At Your CPAPnow Setup
The first 15 minutes of your appointment will be spent with an intake specialist. You will be able to ask any questions regarding the insurance billing of your equipment and address any other questions or concerns you may have. You will then have 60-90 minutes with a respiratory therapist who will discuss your sleep study, instruct you on the machine, and fit you for a mask. You may consider taking notes during your session.
Are You a Current CPAP User
And Would Like to Be Set Up With CPAPnow?In order to establish an account with us, we are required to have a copy of your sleep study and an updated prescription on file. We are happy to handle the transfer of records with a signed medical release, or you can request them from your physician or provider. Click here for a copy of our Medical Release. Once we have your records on file, we will make an appointment to do paperwork and if you would like, to meet with a therapist.
For New Patients:
Thank you for choosing CPAPnow, Inc. for your PAP therapy needs! We want to help you get started on CPAP with ease.
We ask that for every appointment you please come prepared with your insurance card. The first 15 minutes of your appointment you will meet with a billing specialist to go over your insurance coverage. CPAPnow makes every effort to give you accurate, updated information on your policy, however we recommend being familiar with your deductible and coinsurance amounts prior to your appointment. You will have the opportunity to ask questions, go over your estimated out of pocket cost, and set up a payment plan. You will then have approximately 60-90 minutes to meet with a respiratory therapist who will instruct you on your equipment and fit you for a mask.
If you need to cancel or reschedule please contact our office as soon as possible. If you will be more than 10 minutes late to your scheduled appointment without notification, you may be asked to wait for the next available time or reschedule. This helps keep our therapists and patients on schedule.
Because there will be a lot of new information, you may consider bringing a pad and paper for notes. It can also be helpful to bring a spouse, bed partner, friend or family member along with you.
A Note About Insurance
- CPAPnow works will all major insurance companies, with the exception of Humana.
- For over-the-counter transactions, we try to stay competitive with online prices. If you see a lower price from an online vendor, let us know!
- We understand this equipment can be expensive and never want a patient to go without therapy because of the cost. We have flexible payment plans available with no extra fees as well as a financial hardship program. Contact our billing department for more information.
Frequently Asked Questions
The medical system can be confusing. Let us demystify some things for you so you’re fully aware of the process before we begin.
Yes, a current doctor’s prescription is required for CPAPnow to treat patients needing PAP therapy assign any charges to insurance. However, patients may purchase general CPAP supplies over the counter without a prescription.
This depends on both your provider and the coverage level of your policy. Some providers, like Medicare, require a patient to rent a machine for a certain period before they will reimburse a purchase. Some providers will reimburse any purchase from any company.
Yes, we will bill most major insurance providers.
Typically, this is a personal issue of comfort. You may want to consider a full face mask if you breath through your mouth while sleeping and/or if you have allergies. If you don’t like the feeling of wearing a full mask over your face, then a nasal pillow may be a better alternative. We can help you decide which brand and model of mask is right for you.
All machines used by CPAPnow have a heated humidifier. These machines can deliver more moisture due to the higher temperature of the air. Many patients prefer the comfort of the heated air, as well.
A CPAP machine is designed to deliver a straight pressure. An auto CPAP machine is set at a range, and the machine automatically delivers the lowest pressure required to treat the user. CPAPnow always provides patient’s with an auto capable machine, even if they are ordered a straight pressure. This is helpful if the patient ever needs an auto pressure. A bi-level or bi-pap machine is designed to deliver two pressures, an inhalation pressure and an exhalation pressure, sometimes with a back up rate.
Learn About Insurance
Here are some important insurance terms you may come across during the billing process.
This is the amount an insured patient must pay out-of-pocket for medical expenses before the insurance plan begins to pay. Deductibles range in amount according to the terms of the specific policy.
This is the amount considered by a health insurance provider to be reasonable when deciding on a reimbursement rate.
This is the percentage of coverage that a patient is responsible for paying, after insurance has paid their agreed-on portion, as stated in the patient’s policy. Co-insurance rates vary greatly depending on the health plan, and may also be subject to your deductible. Keep in mind that co-pay is an entirely separate term from co-insurance. A co-pay is a set, out-of-pocket expense the patient pays, often for an appointment with a physician or when picking up prescription drugs. Co-pays are not typically subject to deductibles.
A request from a healthcare provider or patient, presented to a healthcare provider, for payment of services performed.
This is a document attached to an insurance-processed medical claim, in which the insurance provider explains the services they will cover for a patient’s healthcare treatments. An EOB might also explain any issues if a claim is denied.
HCPCS is a widely-used coding system used to reference services, devices, and diagnoses administered in the healthcare system. Billing specialists use codes in the HCPCS regularly to file claims. If you want to contact your insurance company to find out if a particular item or service is covered under your policy, they may request the associated HCPCS. CPAPnow is very familiar with the system and we can supply you with any codes you might need.