Compliance

Most compliance periods last for 90 days.  To be considered compliant a patient must use their sleep therapy device for 70% of a 30 day period.

  • This equates to a minimum of 21 out of 30 days.
  • To be counted a machine must be used a minimum of four hours per day
    • A patient who uses their machine for 3 hours per day 21 days in a 30 day period is considered 0% compliant.
    • A patient who uses their machine 4+ hours per day 21 day in a 30 day period is considered 70% compliant.
    • The four hour minimum is counted cumulatively, not consecutively – patients who sleep with their machine for one hour in the afternoon then three hours at night meet their four hour requirement for that day.

Insurance

All insurance companies have different compliance rules.  Be sure to ask your provider for your own plans specifics.

  • Any 30 days
    • Some insurances require that a patient meet compliance in any 30 days of their 90 day compliance period
    • Examples: Many BCBS plans, and Medicare
  • Last 30 days
    • Some insurances require that a patient meet compliance in the last 30 days of their 90 day compliance period
    • Examples: Tufts, Harvard Pilgrim, and Masshealth.
  • 10 month compliance
    • Some insurance (many BCBS plans) require three consecutive 90 day compliance periods
  • Follow up notes
    • Some insurance require that a patient follow up with their doctor after 30 days of treatment.
    • Examples: Medicare, United Medicare Advantage

Issues

It is important to address any issues with your provider as soon as possible.  Reliable Respiratory patients can expect prompt service in addressing any issues with sleep therapy.

  • Mask issues – mask issues (poor fit, leaking, discomfort) are a leading cause of non-compliance, never hesitate to call your provider about these issues.
  • Therapy issues – starting therapy can be intimidating, but your provider should be there to help along the way. This included all issues regarding pressure, machine problems, etc.