CPAP Insurance Documentation / Requirements

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Insurance Requirements

As with most insurance coverages like home or auto, health insurance companies often require quite a bit of documentation before they are willing to reimburse a patient for a claim.  Of course, this makes sense to ensure that people are not attempting to defraud the company.  Here at Health Sqyre, we have plenty of experience dealing with the necessary nuances of these policies, so we have compiled a list of the most common insurance documents that may be required during your CPAP purchases.

When buying CPAP supplies or filing an insurance claim, your insurance company may require certain documentation depending on the CPAP supply that you are purchasing.  This includes, but is not limited to:

cpap-prescription

  • A Prescription (RX) – an instruction written by a medical practitioner that authorizes a patient to be provided a medicine or treatment

  • Assignment of Benefits (AOB) – an arrangement by which a patient requests that their heath benefit payments be made directly to a doctor or hospital

  • Medical Records (e.g. Sleep Test Results) – a record of a patient’s medical information

  • Prior Authorization – a process used by health insurance companies to determine if they cover a prescribed procedure, service, or medication

doctor writing cpap doctor notes

  • Doctor’s Notes – an entry into a medical record made by a physician or nurse

  • Compliance – a set of guidelines determining if a patient uses their CPAP therapy enough to receive insurance coverage

For more information about any of these terms, visit our CPAP Insurance Glossary!

While this list may seem overwhelming, when you order from Health Sqyre, you can upload each of these items or just tell us who your doctor is and we will get all of the necessary documents for you and submit the claim to your insurance company – all for FREE.

Compliance

Rule Book

Many insurance companies require that “compliance” while using CPAP Therapy is maintained to a certain extent.  Many insurance companies follow the Medicare Compliance requirements.  Simply put, compliance is defined as use of PAP devices for 4 or more hours per night on 70% of nights (21 out of 30 nights) during a consecutive 30-day period.  If you would like to learn more in-depth about compliance, visit Health Sqyre’s How to be Compliant Help Page!

If you sign up with Health Sqyre, we will help you fill any requirements necessary to get reimbursement from your insurance provider!

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