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Re: MMA insurance and CPAP compliance

Posted by seattlebill on December 30, 2005 at 17:35:05:

In Reply to: Re: MMA insurance and CPAP compliance posted by mikeinboston on December 30, 2005 at 16:13:22:

Nope...you are totally right.

First, your sleep doctor needs to write the letter of necessity. He needs to refer you for surgical therapy because you have been refractory to non-surgical interventions and treatments.

Then your surgeon needs to write a second letter confirming that you're a good candidate to have your apnea treated by a surgical procedure.

This is part of why they get paid (particularly the surgeon).

Your letter is to request an appeal, or to summarize who is sending in the medical letters of necessity. Beware of using self-diagnostic terminology (like claustraphobia), it'll encourage another diagnosis, another treatment pathway and further delays, etc... It is far better to not be tolerant and refractory to CPAP therapy due to high pressures, aerophagia, dermatologic irritation from the mask, improper sealing due to micronapthia, etc, etc...

Good luck,

Happy New Year guys.

Bill

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