Sleep Apnea Claim

[EODCMC]

Hi, I am a 30 year retired vet. I retired 13 years ago. I as recently diagnosed with "very severe" obstructive sleep apnea. The machine they gave me is preset on the highest output flow. My episode exceed 35 times an hour with some lasting more than 30 seconds. 

I was diagnosed with sleep apnea a couple of years prior to retirement and the study and diagnosis is documented in my record. In fact, they wanted to operate on my uvula. There lies the rub. The operation could have ended my career so I didn't persue. Additionally, while on active duty I developed severe chronic sinusitis and allergic rhinitis and this also is documented in my service health record. I have been living with this and chalking it down to getting old.

Fast forward...I recently got a machine that they say I have to wear for the remainder of my life. I just learned that Tricare Prime does not pay for it all. So, I researched online and submitted a claim the E-benefits and it has been received and was under review until today when they changed this to "gathering of evidence" Development Letter Sent.

Does anyone know what this means? What do I have to look forward to concerning the process. I watch the news. It doesn't look good, right?

thanks in advance.

[Gastone]

While your at your VMC, stop by the Veteran Learning Center, usually on the 1st floor. Tell the MFIC that you want to get authenticated for your My Healthy Vet account and also your E-Benefits account, if you haven't already done so.

Probably be a good idea to take your SA DX info. After you get registered, stop by the Sleep Dept, check out when they have Walk-ins to see the Cpap Nurse. Might be able to get your Equipment issues squared away.

Your VMC PCP should write you a referral to the Cpap clinic, that could take a couple weeks. If you have the time, stop by for a walk-in.

I've used the Det VMC since 2008, great Staff & great Service. Get all my Meds, even Non VA Formulary Meds from the VA. Use my Medicare A & B as backup and opt to pay $225.00 per mos for United Health Part B Supplemental. If I have a life or death situation or just want a second opinion, I want to be able to see the "Pros From Dover," at my private hospital of choice.

Merry Christmas to All

Semper Fi

[EODCMC]

Gastone, thank you! Merry Christmas amigo.

[EODCMC]

OK, so: Today DFAS informed me that their audit was completed on Dec 15 and sent to VA. VA informs me that they have not received the audit from DFAS yet. Must be holiday stand-down.

[EODCMC]

Nadas 

[EODCMC]

Retro showed up in my bank account today. May 4, 2016 - Jan 10, 2017...beginning to end. Thanks everyone, for your help.

 

[Andyman73]

Well, there ya go! Hope that makes you feel a little better.