CPAP/Bi-Level Starter Guide & Help Page

Reliable Respiratory is here to help you embark on your journey to a better night’s sleep! Our Respiratory Therapists are here to help answer any questions that you may have about your new therapy.

 

The current generation of PAP machines are truly plug and play! Your device is programmed according to your provider’s prescribed settings, and comfort features such as humidification are automatic as well.

Video Tutorials

ResMed AirSense/AirCurve Series
Respironics Dreamstation Series

Insurance Guidelines & Pap Usage Requirements

Most insurance companies have a usage requirements. Information regarding your specific guidelines are located on a colored index card included with your setup bundle for easy access.

What is "Compliance"?

Compliance is a usage requirement set forth by your insurance company. Satisfying compliance requirements ensures that your insurance company will continue to cover their portion of the cost of the PAP machine and supplies until you own it. Some insurance companies require ongoing compliance to cover their portion of the cost of any supplies you receive after you own your machine.

Compliance defined: 4 hrs of daily use, for 21 days out of a 30 day period. The four hours do not have to be consecutive, and the 21 days of usage do not have to be either!

In addition to meeting your compliance guidelines, your insurance may have an additional requirement for a face to face visit.

*Please call our compliance team at 781.551.3335 x 3391 or email support@reliablerespiratory.com with any additional questions about your specific plan’s compliance requirements.

Compliance falls into two models: Best 30 days, and Last 30 days.

Compliance Models: Best 30 & Last 30

Best 30 day model:

Under these requirements, insurance evaluates the BEST 30 day period of usage, within the 90 day usage trial. It could be in the beginning, middle, or end of the 90 day period. Your machine transmits this data automatically, and we are able to determine when you meet your usage goals. Our Clinical Support Team will work with you to help you to meet your compliance requirements.

Example: if you received your machine on 8/15/2020, your 90 day trial lasts from 8/15/2020 to 11/15/2020. Satisfying compliance requirements within this time frame requires you to use your PAP unit for 4+ hours, for 21 out of 30 days within these 90 days.

You could meet your insurance requirement as early as the first three weeks(8/15-9/4) by using the machine every day for 4 hours or more. Alternately, you could meet your usage requirements as late as 10/15-11/15.

Last 30 day Model:

With this style, your insurance company only evaluates the LAST 30 days of your usage data. It might be helpful to view the first two months of therapy like practice- it’s a time for you to become comfortable with therapy, where you can then satisfy the usage requirement during the last month of the trial.

Example. You receive your machine on 8/15. Your 90 day trial is from 8/15-11/15.

Insurance evaluates your usage from 10/15/20 to 11/15/20. Your usage would need to be 4 hours or more daily, for 21 days in the 30 day period of 10/15-11/15.

 

*Please call our compliance team at 781.551.3335 x 3391 or email support@reliablerespiratory.com with any additional questions about your specific plans compliance requirements.

What is a Face to Face Visit?

After beginning treatment with your machine, a follow-up visit with your doctor is required by some insurance plans. This is a time for your provider to review your objective and subjective use and benefit of the machine.

Traditionally, the face to face is required to be in person, most insurances allow a Telehealth appointment to substitute an in-person encounter.

Typically, the Face to Face is required between 31-90 days after you receive your PAP equipment. For some BiLevel machines (ST/ASV), the Face to Face is required between days 61-90. Reliable Respiratory’s customer service Team can confirm the required date range for your Face to Face visit.

If your doctor is unsure what to document during your follow-up visit, our Billing Documentation Department is happy to answer any questions, and can be reached at (781.551.3335 x 3622).

If you’re unsure if your insurance requires a Face to Face, or when you need to have one, please call our Compliance Team at 781.551.3335 x 3391 or email support@reliablerespiratory.com

Best 30 Days
Last 30 Days

Frequently Asked Questions

Where is my tubing/hose?

For ResMed machines, your tubing is located inside the travel bag, above the PAP unit and water chamber, located inside a small zippered compartment.

I cannot get used to this – what do I do?

Be patient and ease into your therapy, wear the mask while awake watching TV, reading, or anything that distracts your mind from the mask/machine.  Adjusting to wearing a CPAP mask takes time, although it can be a healthy lifestyle change!

Why can’t I fall asleep?

Acclimation to PAP therapy is a slow process. Your body needs to become adjusted to the therapy, which often results in a longer time to fall asleep. Your goal should be to fall asleep using PAP therapy each night. We find that the “slow and steady” approach is most successful, as you are forming a new nighttime routine.

My mask leaks – what do I do?

Reposition it on your face; refer to user manual to perform “Run Mask Fit”(ResMed AirSense 10) or ”Check mask fit”(Philips DreamStation) test; Adjust the straps until you get a green smiley face (ResMed) or green bar (Philips).

Why won’t my machine turn on?

Verify power connections; unplug the power cord and plug back in; try a different outlet.

Why am I taking my mask off while sleeping?

This is common for patients new to PAP therapy; try to become comfortable by wearing your mask while awake.

Is the pressure too high when you wake up in the middle of the night?

Turn the device off, then turn it back on. The pressure will start lower whenever you turn the device back on.

Cleaning Procedures

These are general cleaning instructions for your equipment and supplies. Please refer to your user guides for any cleaning instructions specific to your model.

How to Access Usage Data

All of our devices have cellular connectivity for automatic access to your data to track your progress online. See below for information regarding your model’s free smartphone app.

ResMed AirSense Model Paps: MyAir (by ResMed)

Philips DreamStation Model Paps: DreamMapper (by Philips)