Providers: Don’t Snooze on Your Patients
For some health illnesses – like a broken bone – the care process has a destination. For others, it’s the journey that counts.
Sleep apnea, like many other chronic conditions, has no beginning, middle, or end. As a result, an engaged healthcare provider throughout the journey is essential to better patient outcomes, from diagnosis, to prescription management, to promoting compliance.
You Can’t Treat What You Don’t Diagnose
Sleep apnea is a common occurrence in the U.S. – nearly 1 in 10 adults are living with it. Shockingly, 90% of individuals with sleep apnea, nearly 20 million people, are unaware they have it. The challenge with sleep apnea is that it’s hard to self-diagnose; its primary symptoms are irritability and excessive sleepiness, which can be attributed to numerous other conditions. Potentially, the greater problem is that patients simply are not being tested for it.
According to researchers at the University of Michigan, half of Americans older than 65 are at high risk of sleep apnea, but only 8% have undergone sleep studies to test for it. The study found that in the rare times patients were evaluated, nearly all tested were diagnosed with sleep apnea.
It’s easy to see why without provider intervention it becomes much less likely that patients will be diagnosed and treated for sleep apnea. Timely intervention by a provider makes the difference between a patient who experiences adverse health effects because of sleep apnea and a patient who is given proper treatment, and whose quality of life drastically improves.
Managing the Medicare Insurance Maze
In addition to being the catalyst for treatment, providers also play the role of gatekeeper in a patient’s sleep therapy journey. The Food and Drug Administration categorizes CPAP machines as a Class II medical device – meaning that they require a prescription from a patient’s provider. This prescription is necessary for insurance to cover costs, and for providers to recommend correct machine settings to meet the patient’s specific needs.
In cases where Medicare comes into play, every item billed to Medicare requires a provider’s order or a special form called a Certificate of Medical Necessity (CMN). Providers sometimes also need to forward additional documentation, such as copies of office visit notes from prior visits and test results relevant to the prescription of medical equipment. Without diligent prescription management by providers, the delivery of patients’ medical equipment can be delayed, prolonging the time patients spend without much needed treatment.
The use of CPAP machines is proven to enhance both the quality of life and health outcomes among sleep apnea patients – from improved mood to fewer accidents to decrease in blood pressure. Yet, patient compliance still remains an obstacle.
As trusted health advisors, providers are in a unique position to educate patients about the positive outcomes and confront negative connotations patients may have about sleep therapy and CPAP machines. These positive impressions, as well as ongoing follow-ups, can help boost patient compliance, and ultimately, outcomes.
Providers face a tall order when accompanying their patients on their sleep therapy journey – but with Reliable Respiratory, they don’t have to do it alone. Reliable makes sure the journey from diagnosis to distribution is seamless for provider and patient. Our expert team of Sleep Coaches leverages the latest remote monitoring technology to efficiently resolve patient issues and encourage compliance among patients.
We know that our patients and providers don’t just need specialty medical equipment providers, they need advocates. On the journey to better outcomes, our aim is to pave the way.