Must have a prescription in order to file on insurance.
Must have a copy of the prescription for the nebulizer medication being used for our file.
- Must have a qualifying diagnosis: COPD, bronchitis, emphysema, bronchiectasis and/or asthma.
- Client suffers from severely impaired breathing and needs the machine to administer bronchodilator drugs.
Must have a prescription to dispense or to file on insurance.
- Common diagnoses are COPD, CHF, bronchitis, emphysema, cystic fibrosis, bronchiectasis or pulmonary hypertension.
- ABG’s (arterial blood gas) are at or below 55 mm or an oxygen saturation (pulse oximetry reading) at or below 88 percent on room air.
- Testing must be done within 2 days of discharge of a hospital stay or in a chronic stable state outside of a hospital. Emergency room testing will not qualify for oxygen.
- Tests done during sleep will not qualify patients for portable oxygen.
- If tests are 56 mm to 60 mm or 89 percent on room air then the client will have to be retested within 60 to 90 days. Any readings above these will not qualify for oxygen.
- Client must be mobile within the home to qualify for portable oxygen.
- Client must have specific written orders for liquid portable oxygen or a conserver device.
- Diagnosis alone WILL NOT qualify for oxygen.
CPAP / BiPAP
A prescription for the CPAP or BiPAP along with a copy of the qualifying sleep study results are required whether to file insurance or private pay.
A CPAP device is covered for the treatment of obstructive sleep apnea (OSA) if criteria A through C are met:
- A. The patient has a face to face clinical evaluation by the treating physician prior to the sleep test to assess the patient for OSA.
- B. The patient has a sleep test that meets either of the following criteria (1 or 2):
- The apnea-hypopnea index (AHI) or respiratory disturbance index (RDI) is greater than or equal to 15 events per hour with a minimum of 30 events.
- The AHI or RDI is greater than or equal to 5, and less than or equal to 14 events per hour with a minimum of 10 events and documentation of:
- Excessive daytime sleepiness, impaired cognition, mood disorders or insomnia
- Hypertension, ischemic heart disease or history of stroke
- C. The patient and/or their caregiver has received instruction from the supplier of the device in the proper use and care of the equipment.
A BiPAP device is covered for those patients with OSA who meet criteria A through C above, in addition to criteria D:
- D. A CPAP has been tried and proven ineffective based on a therapeutic trial conducted in either a facility or in a home setting.
CPAP Cleaner and Sanitizer
We are a dealer for SoClean, the world’s first automated CPAP cleaner and sanitizer.