National Sleep Therapy FAQ

How do I know if I have sleep Apnea? If you have any two of these symptoms, you may have sleep apnea: daytime sleepiness, hyper tension, snoring, or if someone has witnessed that you stop breathing during the night. If you have any two of these symptoms, you should contact your doctor and discuss the possibility of sleep apnea. <back to top>

What do I do if I think I have Sleep Apnea? If you think you may have sleep apnea, contact your doctor, If your doctor suspects sleep apnea, they may refer you to a sleep specialist who may suggest a sleep study. There are various types of sleep studies and your doctor can explain the differences and merits of each. <back to top>

What are the therapies available for Sleep Apnea? The most prevalent therapy for sleep apnea is CPAP, which stands for Constant Positive Airway Pressure. CPAP consists of mask worn on the face, and a special machine that gently uses air pressure to keep your airway open while you sleep. For most patients a simple CPAP machine will provide excellent therapy helping you regain your sleep. <back to top>

How long do I use the CPAP equipment for? Your doctor will prescribe for how long you will need to use the CPAP machine. Many people use CPAP indefinitely, while others through diet and exercise can reduce their dependence on it all together. For this reason, National Sleep Therapy will keep in touch with you periodically to ensure that your therapy is optimized for you at all times. <back to top>

Do I have to clean the mask and other parts? Yes! The mask parts, hose, and humidifier chamber can get dirty with use. You should be cleaning your mask cushion and hose daily if possible or no less than once per week. Please refer to the cleaning instructions that came with your set-up packet. You can also download a cleaning instruction and schedule card. Proper cleaning will help you avoid unnecessary complications such as skin blemishes, rashes and general discomfort. <back to top>

When do I replace the parts? And which ones? Many of your parts are considered disposable. Although it may be tempting to try to use the same parts for an extended time, you really should replace certain parts routinely to have the best results possible with the fewest complications. Please refer to your replacement schedule and watch the Healthy Advantage Supply Program video. <back to top>

Will I have to pay for replacement parts? Most insurance companies provide a benefit that allows you to replace your disposable parts according to a schedule. A typical schedule can be downloaded here, but you will need to refer to your specific insurance plan to find out your CPAP benefit. Please keep in mind that there may be a copay with your replacement order. National Sleep Therapy stocks all replacement parts and can direct ship your parts to you free of charge! <back to top>

Can I sign up for a supply program that will automatically ship supplies to my house? Your mask, hose, and filters should be replaced periodically. Watch the Healthy Advantage Supply Program video to learn more about automatic resupply. To sign-up for our automatic supply program, click here. <back to top>

Who do I call if my equipment isn't functioning properly? If you have any questions about your equipment, please call us toll free at 888.867.8840 or email us <back to top>

What if I'm feeling dry when I wake up? If your mouth and nose are dry from CPAP, you may need additional humidification. If you are using a nasal mask, then you may be opening your mouth during sleep and may want to use a chinstrap to keep your mouth closed. <back to top>

If you are a Medicare patient, your sleep therapy equipment is covered for the first 3 months. Medicare calls this your "trial period". After this period, you must meet minimum compliance levels to keep your equipment benefit. During your trial period, Medicare requires that you meet certain compliance requirements for continued coverage. If you do not meet these minimum usage levels, then you will have to either pay for the equipment yourself, or return your equipment to us. If you are not tolerating CPAP therapy, your trial period can be extended if your doctor prescribes Bi-Level therapy. These are strict Medicare guidelines for which your doctor and National Sleep Therapy must comply. The Medicare guidelines are as follows. During the first 90 days of use, you must: 1 Use your machine at least 4 hours per night 2 Use your machine for at least 21 days over your best 30-day period 3 Visit your doctor after 31 days and before 90 days Please try your best to meet these compliance guidelines and keep your doctor's appointments. If you do not, you may jeopardize your continued therapy. <back to top>

You can use your CPAP machine with a battery designed for this purpose. It may also be possible to use a car or marine battery with an inverter that takes DC current and converts it to AC current. National Sleep Therapy does not support or advise this method however due to the variability in configurations that can damage your machine, jeopardize functionality and void the warranty. Please see our Equipment section for specific information on your machine. Please click here to go to the Respironics website that details the use of a battery with your Respironics machine. <back to top>

Rainout occurs because of the water vapor from your breath and the humidifier cooling against the inside of the hose that is at a lower temperature. Tiny vapor droplets become larger drops and collect in the hose and mask. Please try these solutions; 1) warm the room, 2) use a hose cover to insulate the hose and keep it warmer, 4) place the hose under your bedcovers, 5) make sure your machine is lower than your head, and 6) slightly lower your humidifier setting. <back to top>

Many times, your insurance company will send our check to you directly. When you received your equipment, you assigned payment to National Sleep Therapy and agreed to endorse and send the check promptly to us. We are notified when your insurance company sends you the check. When you receive it, please write "PAY TO THE ORDER OF NATIONAL SLEEP THERAPY", sign it, and mail it to us in the envelope in your blue folder. If we do not receive the check right away, you may be obligated for additional costs and fees. Click here for more information. <back to top>

How much does my insurance company pay for CPAP? When National provides your CPAP and supplies, the total amount paid for your equipment may include what the insurance company pays us, and any co-payment or coinsurance you may owe (deductible or co-payment, etc). Here’s how it all works: • When we first receive a prescription from your doctor, we call your insurance company and they tell us your CPAP benefit and an estimate of how much you will owe. The amount you may owe is estimated and shown on your original order. Because you may be using other health services, the amount you may owe depends on that specific day we check your benefits. • The amount your insurance company pays for your CPAP and supplies is set by your insurance company and not based on what we may bill as shown on your order. Medicare, Blue Cross and almost all of the insurance companies set their own rates independent of what is billed. They pay National Sleep Therapy and most other CPAP providers the same rate (usually lower that what is billed). The payment rate they set is called the “Allowable”. Anything you may owe is based on the Allowable, and not what was billed. • After you receive your equipment (which could be a few days or a few weeks after we checked your insurance benefit), we submit a claim to your insurance company and they process the claim, which can take days to weeks. Depending on when they process your claim, the amount you owe maybe different that the amount at the time we first checked your benefits. This can be due to the time of year, your deductible, or other plan requirements. Ultimately, your insurance company dictates what they pay us and how much you may owe. While we try to give you as much information as possible when we first provide your equipment, the amount you owe may change (it may be more, or less). It’s always a good idea to call your insurance company yourself to verify your benefits and coinsurance amounts. <back to top>

What is my coinsurance amount? • Your coinsurance amount is based on your health insurance policy and not National Sleep Therapy. It is usually a percentage of the Allowable that your insurance company does not cover. It is not based on the amount we bill, but the Allowable rate set by your plan. • For example, National may bill your insurance company the retail price of $120 for a CPAP mask. The Allowable rate set by your insurance company may only be $100. If your particular health benefit covers 80%, then you would be responsible for 20% or $20 of the Allowable charge for that mask. Your insurance company would pay us $80, and you would be expected to contribute $20 to the cost of the mask. • You may have other charges as well before your plan pays its portion. If you have a deductible for example, you may be required to pay this before your plan starts paying anything. You should call member services at your insurance company anytime you have questions about your charges. The number is usually on the back of your insurance card. <back to top>

Do I own my CPAP machine? Your machine may have been provided to you as a “rental” or a “purchase”. Your insurance plan dictates which method we must use. How the machine was billed can be found on your original Delivery Ticket from National Sleep Therapy. If the machine is rented to you, your insurance company will pay us a monthly rental fee for some number of months (range is often somewhere between 3 to 13 months). You may be required to pay part of that rental fee if your insurance coverage is less than 100%. Once you and your insurance company complete all payments, you own the CPAP machine. Medicare for example, pays a rental fee during the 3-month trial period. If you meet compliance requirements, Medicare will continue to pay a rental fee for an additional 10 months at which time you will own the CPAP machine. If your insurance company instructs us to bill your CPAP machine as a purchase, you will own your machine once all payments are received from you and your insurance company. *Please note that in some cases, your insurance company may have instructed us to bill your machine as a rental or purchase, and then at the time they process the claim, they may instruct us otherwise. Please call your insurance company if you have any questions. <back to top>

How does National differ from other companies? Because all CPAP companies receive the same fixed rate for all CPAP equipment regardless of quality or features, it encourages some CPAP providers to maximize profit and give people a less expensive (and less featured) machine and mask. National Sleep Therapy is different. Unlike other companies trying to cut corners, our goal is to maximize your Health by providing you the ABSOLUTE BEST service and equipment at NO EXTRA CHARGE to you or your insurance company. We provide only top of the line equipment because we want you to have the very best therapy experience and success. No other company provides the level of support, education, and access to the latest products and services. <back to top>

Does National charge my insurance company for support services? No. National Sleep Therapy is not paid for for any clinical support services. Insurance companies only pay for equipment and expect us to service that equipment. Nearly all revenues from our Healthy Advantage resupply program are reinvested to cover the expenses for clinical staffing, patient outreach support calls, mask refits, modem fees, and call-in and online support to our clinical support team. This is our investment in helping you stay healthy. <back to top>

How does National help reduce insurance costs? As you may know, treated sleep apnea can have a positive impact on overall health by reducing blood pressure, improving sleep, lowering the risk or coronary diseases, and many other well documented medical conditions. Because we have one of the most compliant patient populations, we have more people getting healthy, and more people lowering their risk for other diseases. When people are healthier, they cost less to the entire healthcare system. The owners of National Sleep therapy have met with some of the leading insurance companies who are amazed at the results of our compliance programs and patient support. Studies have shown that people who are compliant to CPAP therapy can save medical treatment costs of up to $3,000 per year. National Sleep Therapy strongly believes that lowering medical spending costs can be better achieved by providing people with access to the best possible medical treatments and giving them they support they need to be successful, and at a reasonable cost. National is doing all these things better than anyone else. For the same cost as other CPAP companies, we provide better equipment, expert clinical support services, and a better chance for living a healthier life. <back to top>

You may return any unopened product back to us within 21 days of receiving it. If for any reason you do not want some or all of the products, or have a copay or deductible that you cannot pay, please call us to discuss your options. We will make arrangements to have the unwanted product(s) shipped back to us free of charge and credit your account accordingly. Any product that has been removed from it’s plastic package cannot be returned. We cannot accept any product that has been opened and/or resealed in any way. We will not accept any returns unless we are notified within 21 days the day that you received your package. If we sent you the wrong supplies, we apologize. Please contact us right away. We will provide a return shipping label for you to return the incorrect products free of charge. We will gladly re-ship the correct items to you at the same time. You will be responsible for any payments associated with this shipment unless we are contacted within 21 days. <back to top>

There are times when your insurance company will not pay for a CPAP item such as a mask or hose if you're not eligible at the time of need. For example, if you need a new mask because your current mask is not comfortable, but you're not eligible for another 2 months, you may need to pay for the mask, and then seek reimbursement from your insurance company. Click here to find out more and download a form you can use to submit a claim directly. http://www.nstherapy.com/pdfs/How to Bill Your Health Insurance.pdf <back to top>