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Cigna Sleep Management ProgramAdherence MonitoringRequirementsFisher & PaykelF&P InfoSmart Web105/30/2013
IntroductionRequired EquipmentAll DME providers participating in the Cigna Sleep Management Program must provide customers withequipment standards that include either Fisher & Paykel , Philip (Respironics) or ResMed PAP TherapyDevices equipped with modem technology for adherence monitoring purposes. All PAP TherapyDevices must be equipped to provide both usage and efficacy data monitoring. Examples of these typesof devices would include the Philips Respironics System One Remstar Auto Device, ResMed S9 AutoSetDevice and the Fisher & Paykel Icon Auto CPAP or Promo CPAP.Therapy Adherence: Monitoring RequirementsDepending upon the PAP Therapy Equipment utilized, you will be required as a partner in the CignaSleep Management Program provider network to:1. Enter your patients into your F&P InfoSmart Web account for Fisher & Paykel equipment,EncoreAnywhere account for Philips (Respironics) equipment, or your EasyCare Online accountfor ResMed equipment, AND2. Provide Access to the Cigna Sleep Therapy Adherence Department to view, monitor and reporton this data.This document will provide the detailed instructions on how to enter your patients into the F&PInfoSmart Web compliance monitoring database and provide access to the Cigna Sleep TherapyAdherence Department. Please reference the Philips EncoreAnywhere or the ResMed EasyCare OnlineAdherence Monitoring Requirements Manuals for the Philips and ResMed products.All patients must be set up using wireless modems. If the patient lives in an area with poor wirelesscoverage, then you may provide the patient with the info USB adapter to collect data. The Cigna SleepTherapy Adherence Department must be notified of this via the Provider Set-Up Form. This should beby exception only.205/30/2013
Providing Access to the Cigna Sleep Management Program toF&P InfoSmart WebIn order for our clinicians to monitor therapy adherence, your company will be required to provideaccess to the Cigna Sleep Therapy Adherence Department in the F&P InfoSmart Web. Below are thesteps to provide the appropriate access.1. Log onto your F&P InfoSmart Web account, and click on CONTACTS. You will see the list of contactsyou already have registered for your account. To provide access to the Cigna Sleep ManagementProgram, click on New2. Select “Find a Physician”305/30/2013
3. Adding Cigna Sleep Management Program Access to PatientsA: Type in “Sleep Management Solutions” in the search bar.B: You will see the physician name appear below.C: Click on Select. IMPORTANT: Sleep Management Solutions must be registered as a physiciancontact to be able to add the contact to each patient record associated with the Cigna SleepManagement Program.ABC4. Select “Read Only” access to allow the Cigna Sleep Management Program to download and reviewreports.405/30/2013
5. Once added you will see Sleep Management Solutions under your contact list and you maythen begin to add this contact to the Cigna Sleep Management Patients that you set up inthe F&P InfoSmart Web.Setting Up a Patient in F&P InfoSmart Web1. Click on the PATIENTS screen and select New505/30/2013
2. Complete the required fields identified by the blue boxes. Please Note: In order to receive theappropriate compliance information for a patient, the patient’s date of birth must be accurate.Click Save when completed.3. To allow Cigna Sleep Management Program access to view your patients data and run adherencereports, you must add Sleep Management Solutions to the patient’s contact list. To do so, selectPatient Contacts.605/30/2013
4. Click New.5. Select Sleep Management Solutions from your list of Contacts. You can type Sleep ManagementSolutions in the search bar to find. If you unable to find, you will have to add Sleep ManagementSolutions to your Contact List. Please see page 3 of this document.IMPORTANT: You must attach Sleep Management Solutions as a contact to each patient in order forthe Cigna Sleep Managmement Program to view and run compliance reports.705/30/2013
6. After selecting Sleep Management Solutions as a contact for your added patient, you will see thecontact drop to the patient’s contact list. You have now successfully provided the Cigna SleepManagement Program access to your patient’s adherence information.7. Continue to set up your patient to include adding the appropriate device and prescription.805/30/2013
Summary of the Cigna Sleep Therapy Adherence RequirementsTherapy Adherence:Therapy adherence is defined as a patient using their equipment for 70% of nights for at least 4 hoursper night with improvement of apneic events as captured via efficacy AHI improvement from thebaseline AHI. The data utilized for the therapy adherence determination will be taken from objectivecompliance data obtained via F&P InfoSmart, EncoreAnywhere or EasyCare Online, based upon theequipment utilized by the provider. The data obtained for the continued authorization of equipmentwill be the data obtained from the 45th day post set-up through day 83. If adherent, an authorizationextension will be issued for the remaining rental units.Borderline Adherence:1) If the patient has used their equipment for 55-69% of nights for at least 4 hours, or has used forat least 70% of nights for 3.00 to 3.59 hours a “borderline” authorization extension will berecommended yielding an authorization for 30 days.2) If the patient has utilized their equipment less than the above amount and a materialreconfiguration of equipment has taken place within the last 30 days (ex: pressure change,mask refit, etc ) a “borderline” authorization extension will be recommended yielding anauthorization for 30 days.Non Adherence:If adherence documentation does not exist, or the data does not demonstrate adherence as statedabove, no authorization extension will be provided.905/30/2013
A: Type in "Sleep Management Solutions" in the search bar. B: You will see the physician name appear below. C: Click on Select. IMPORTANT: Sleep Management Solutions must be registered as a physician contact to be able to add the contact to each patient record associated with the Cigna Sleep Management Program. 4.
