CPAP & BiLevel Prescription Requirements A physician must write a prescription for CPAP & Supplies prior to delivery. Also necessary is Diagnosis, and length of need. A written prescription is required prior to delivery. Insurance Requirements Medicare, Medicaid, and Commercial Insurance Certain insurance polices may pay for your CPAP & Supplies, but payment is based on Sleep Study, diagnosis, and other information. The information listed below will help you to determine insurance coverage. Medicare – In addition to a prescription, Medicare requires a current Sleep Study preformed by an accredited Sleep Lab. CPAP requirements are as follows; Complete description of equipment & supplies Length of need Diagnosis, such as Obstructive Sleep Apnea Current Sleep Study Physicians Signature Date Third Party Insurances- All third party insurances require a prescription as described above. Requirements for CPAP & supplies are different for each insurance plan. We will contact your insurance company for you and request benefit coverage, and obtain prior authorization if needed. Mass Health – CPAP & Supplies is a Prior- Authorization item and can take up to 4 weeks for approval. Prescriptions must be within 30 days of the initial date of request, and written on the physicians prescription pad or letterhead. CPAP may be authorized for 3 months and renewal documentation for authorization must show compliance. A Sleep Study done at an accredited lab is also required. The prescription requirements are very strict and must contain the following information written on the physicians prescription pad; The recipients name, address and MassHealth number The CPAP & Supplies requested The diagnosis associated with the prescribed therapy Specific therapeutic objectives The estimated length of time that the equipment will be used The prescriber’s address and telephone number Signature and date of the prescribe -------------------------------------------------------------------------------- BiLevel Prescription Requirements A physician must write a prescription for Bi-Level & Supplies prior to delivery. Also necessary is Diagnosis, and length of need. A written prescription is required prior to delivery. Insurance Requirements Medicare, Medicaid, and Commercial Insurance Certain insurance polices may pay for your Bi-Level & Supplies, but payment is based on Sleep Study, diagnosis, and other information. The information listed below will help you to determine insurance coverage. Medicare – In addition to a prescription, Medicare requires a current Sleep Study preformed by an accredited Sleep Lab. Bi-Level requirements are as follows; Complete description of equipment & supplies Length of need Diagnosis, such as Obstructive Sleep Apnea Current Sleep Study Physicians Signature Date Third Party Insurances - All third
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