CEREBROSPINALECTOMY
Insurer: "The machine reports three point nine hours a night." Me: "And your threshold is four." Insurer: "Correct." Me: "You are taking his breathing machine away because he slept six minutes short of a round number." Send this to anyone who has fought an adherence download.
EXPLAINED (ACCURACY-CHECKED)
US payers commonly require documented positive-airway-pressure adherence of at least four hours per night on 70% of nights within a 30-consecutive-day window during the first 90 days of therapy in order to continue coverage; the device's own usage telemetry is the arbiter.
CMS and commercial payer PAP adherence criteria: >=4 h/night on 70% of nights over 30 consecutive days in the first 90 days.
PERMANENT LINK
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