Donna Canepari, CRT, RPSGT, RST, and Craig Anderson, RRT, RCP, believe that the best outcomes occur when the sleep center, the homecare company (HME/DME), and the patient tackle sleep-disordered breathing as a joint effort, not in their own bubbles. At a breakout session (“The Potential to Improve All Outcomes of SDB Testing”) during the 2018 AAST Annual Meeting, to be held Sept 28-30 in Indianapolis, they will share real-world expertise as to how sleep professionals can improve outcomes by working together.
“Working in the sleep field and for a short time on the DME side I have learned the frustrations of patients, centers, and DME companies when it comes to insurance for testing, initial coverage, and continued coverage of therapy that is essential to improve daily living,” Canepari says. The center where she currently works, Yale New Haven Health Sleep Medicine Center, has made strides toward improving their own outcomes.
“We have developed a close relationship with the core DME companies we use with good communication in regards to set ups, initial coverage, and yearly requirements,” Canepari says. “I have personally obtained copies of as many insurances policies that I can with the insurance requirements for covering testing, initiation of therapy (testing results needed, documentation required, comprehensive scripts, etc), and requirements needed of the sleep center for continued coverage. I have also became the main liaison between the center and our DME companies for communication and updates.
“For me the main learning objectives are that a center should have an obligation to not only meet the needs of diagnosing their patients but what is required to assist them in obtaining and maintaining the necessary documentation and visits needed to continue coverage of their therapy.”
Anderson adds, “It is critical that both the lab and the DME company partner with facilities that not only complement each other but also strive to improve as well as refine their processes, policies, and procedures on a daily basis. Acceptable is no longer good enough. On a daily basis we see insurance companies tying compliance to both outcomes and reimbursement. As we move forward this continues to make both sleep labs and DME strive for better adherence and outcomes.”
Anderson anticipates that attendees at their session will gain “practical knowledge that they can both relate to and implement immediately to not only make their position easier to accomplish but also to improve their product, therefore, better outcomes.”
Sree Roy is editor of Sleep Review.