Cigna Sleep Management Program Adherence Monitoring Requirements Fisher & Paykel F&P InfoSmart Web 1
Introduction Required Equipment All DME providers participating in the Cigna Sleep Management Program must provide customers with equipment standards that include either Fisher & Paykel, Philip (Respironics) or ResMed PAP Therapy Devices equipped with modem technology for adherence monitoring purposes. All PAP Therapy Devices must be equipped to provide both usage and efficacy data monitoring. Examples of these types of devices would include the Philips Respironics System One Remstar Auto Device, ResMed S9 AutoSet Device and the Fisher & Paykel Icon Auto CPAP or Promo + CPAP. Therapy Adherence: Monitoring Requirements Depending upon the PAP Therapy Equipment utilized, you will be required as a partner in the Cigna Sleep 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 account for ResMed equipment, AND 2. Provide Access to the Cigna Sleep Therapy Adherence Department to view, monitor and report on this data. This document will provide the detailed instructions on how to enter your patients into the F&P InfoSmart Web compliance monitoring database and provide access to the Cigna Sleep Therapy Adherence Department. Please reference the Philips EncoreAnywhere or the ResMed EasyCare Online Adherence 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 wireless coverage, then you may provide the patient with the info USB adapter to collect data. The Cigna Sleep Therapy Adherence Department must be notified of this via the Provider Set-Up Form. This should be by exception only. 2
Providing Access to the Cigna Sleep Management Program to F&P InfoSmart Web In order for our clinicians to monitor therapy adherence, your company will be required to provide access to the Cigna Sleep Therapy Adherence Department in the F&P InfoSmart Web. Below are the steps to provide the appropriate access. 1. Log onto your F&P InfoSmart Web account, and click on CONTACTS. You will see the list of contacts you already have registered for your account. To provide access to the Cigna Sleep Management Program, click on New 2. Select Find a Physician 3
3. Adding Cigna Sleep Management Program Access to Patients 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. A B C 4. Select Read Only access to allow the Cigna Sleep Management Program to download and review reports. 4
5. Once added you will see Sleep Management Solutions under your contact list and you may then begin to add this contact to the Cigna Sleep Management Patients that you set up in the F&P InfoSmart Web. Setting Up a Patient in F&P InfoSmart Web 1. Click on the PATIENTS screen and select New 5
2. Complete the required fields identified by the blue boxes. Please Note: In order to receive the appropriate 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 adherence reports, you must add Sleep Management Solutions to the patient s contact list. To do so, select Patient Contacts. 6
4. Click New. 5. Select Sleep Management Solutions from your list of Contacts. You can type Sleep Management Solutions in the search bar to find. If you unable to find, you will have to add Sleep Management Solutions 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 for the Cigna Sleep Managmement Program to view and run compliance reports. 7
6. After selecting Sleep Management Solutions as a contact for your added patient, you will see the contact drop to the patient s contact list. You have now successfully provided the Cigna Sleep Management Program access to your patient s adherence information. 7. Continue to set up your patient to include adding the appropriate device and prescription. 8
Summary of the Cigna Sleep Therapy Adherence Requirements Therapy Adherence: Therapy adherence is defined as a patient using their equipment for 70% of nights for at least 4 hours per night with improvement of apneic events as captured via efficacy AHI improvement from the baseline AHI. The data utilized for the therapy adherence determination will be taken from objective compliance data obtained via F&P InfoSmart, EncoreAnywhere or EasyCare Online, based upon the equipment utilized by the provider. The data obtained for the continued authorization of equipment will be the data obtained from the 45 th day post set-up through day 83. If adherent, an authorization extension 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 for at least 70% of nights for 3.00 to 3.59 hours a borderline authorization extension will be recommended yielding an authorization for 30 days. 2) If the patient has utilized their equipment less than the above amount and a material reconfiguration of equipment has taken place within the last 30 days (ex: pressure change, mask refit, etc ) a borderline authorization extension will be recommended yielding an authorization for 30 days. Non Adherence: If adherence documentation does not exist, or the data does not demonstrate adherence as stated above, no authorization extension will be provided. 9