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Re: Yet Another Cigna Denial. . .

Posted by - Sleepy Coote on December 18, 2002 at 10:44:57:

In Reply to: Re: Yet Another Cigna Denial. . . posted by SleepyTimeGal on December 18, 2002 at 09:00:01:

Hi again, STG. Hope your efforts with your insurance company prove fruitful! I am not suprised my doctor's prescription was initially denied by Cigna/Gentiva. I'll appeal, and if fixed CPAP doesn't seem to be as effective for me as it should, then I'll probably try an auto-CPAP out of pocket. Before that I'd probably end up going back into the lab for a retitration, but I had hoped auto-CPAP just might obviate the need for going back into the lab.

However, I am admittedly a bit skeptical about an auto-CPAP's ability to effectively trigger and respond to the diverse breathing/snoring patterns of many patients. My guess is that they do exceptionally well for patients possessing "common denominator" characteristics. And I really don't know what percentage of patients that represents. My education in design and my professional background as a system engineer include plenty of experience trigerring various events. I bet auto-CPAP triggering can be quite a design challenge to say the least. It does seem to work for many, though, and I'd be willing to bet 3rd generation auto-CPAP machines are even better than their predecessors.

I'm personally considering the Remstar Auto, which does not have an established track record as of yet. As such I discovered that the Respironics website has a very handy section called "Reimbursement Information". Aside from these medical studies which I have copy/pasted for you below, that website has plenty of other highly relevant tidbits as well.

Some auto-CPAP related medical studies follow:
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Two Months Follow Up of Auto-CPAP Treatment in Patients with Obstructive Sleep Apneoa.—Boudewyns A, Grillier-Lanoir V, Willemen MJ, De Cock WA, Van de Heyning PH, De Backer WA. Thorax 1999 Feb;54(2):147-9.


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Constant vs. Automatic Continuous Positive Airway Pressure Therapy.—Marie-Pia d'Ortho, Veronique Grillier-Lanoir, Patrick Levy, Francoise Goldenberg, Evelyne Corriger, Alain Harf, Frederic Lofaso. CHEST 2000; 118:1010-1017.


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Comparison of Automatic (Auto-CPAP) and "Manual" CPAP Pressure Titration in Patients with Obstructive Sleep Apnea.—Plywaczewski R, Zgierska A, Bednarek M, Zielinski J., Pneumonol Alergol Pol 2000;68(5-6):232-7.


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Efficacy of Auto-CPAP in the Treatment of Obstructive Sleep Apnea/Hypopnea Syndrome.—Meurice JC, Marc I, Series F. Am J Respir Crit Care Med 1996 Feb;153(2):794-8.


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Positive Pressure Therapy.—Strollo PJ Jr, Sanders MH, Atwood CW. Clin Chest Med 1998 Mar;19(1):55-68.


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