Initial Start to Investigate a Sleep Disorder
These are the steps in the order they should be completed:
Face-to-Face Visit with your Provider or Sleep Specialist.
- This visit has to be face-to-face. It cannot be done over the phone. The visit has to have everything listed in the Face-to-Face Checklist for Sleep Study Approval in the provider’s report at the time of the visit. CMS will not accept addendums.
Sleep Study within six months of the Face-to-Face Visit.
- If you wait too long before scheduling the test (we generally have a two to three month wait for testing), you stand a chance to have to repeat the face-to-face visit.
- ** If you are within five years of receiving Medicare benefits please advocate “to be scored by Medicare Standards” **
Treatment Ordered within six months of the testing.
Face-to-Face Visit with your provider to download the machine and discuss the treatment within 31-90 days of receiving the machine (i.e. if you come in for this visit too early or too late CMS will not accept the information).
- The download of the machine must show compliance of use. CMS states that compliance is ≥ 4 hours per night 70% of the time within a 30-day period.
- Should you not show compliance, the treatment device will be taken back by the Equipment Company and the entire process will have to be repeated.
- Your provider must have all the information listed in the Face-to-Face Checklist for Continuation of Supplies checklist.
- Once again all the information on this checklist should be in the provider’s report. An addendum or telephone conversation will not be permitted.