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Information for Patients
Ordering an ARES Study
To order an ARES In-Home Sleep Apnea Study from ABM, download and complete the ARES Order Form, and review the ARES terms and conditions. We recommend that you be prepared to discuss the ARES with your physician. You should also review your medical insurance coverage. Once your physician signs the prescription (included in the downloadable form), you or your physician should fax it to Advanced Brain Monitoring at 760-720-3337.
Your ARES Unicorder will be delivered by UPS. Make sure you provide a shipping address to a secure drop-off location for the Unicorder if you are not available to sign for the package. Detailed Patient Instructions are included with the ARES Unicorder. You will be provided 4 nights to complete the study. Once you have completed the study, simply drop off the Unicorder at a UPS location using the pre-paid return label provided with the ARES Unicorder.
Your ARES report will be sent to your physician. The Patient Guide for Diagnosis and Treatment of OSA provides information about OSA, the ARES report, and treatment considerations If you are diagnosed with OSA, there are numerous treatment options that you should discuss with your physician.
Transportation:The United States Department of Transportation guidelines require all drivers with commercial licenses to have a fitness-for-duty physical upon hire and every two-years thereafter. There are over 9 million commercial drivers in the U.S. Undiagnosed OSA is one of the leading causes of fatigue in the workplace. The DOT guidelines require drivers diagnosed with OSA (i.e., AHI > 30) wear CPAP. A recent study found a 50% prevalence of undiagnosed OSA in transportation workers holding commercial drivers licenses. A number of large transportation companies, including Schneider National Inc., have recently implemented OSA management programs for commercial drivers. Recent reports suggest that the health care savings for treating previously undiagnosed drivers is over $5000 per year. ABM recently collaborated in a commentary on the legal implications for drivers, employers or clinicians who might ignore this national safety concern.
Disease Management: Many of the conditions covered by disease management programs, including coronary heart disease, hypertension, heart failure, obesity, diabetes, clinical depression and smoking cessation are ailments which have been closely linked to OSA. However, few programs routinely screen, diagnose and treat OSA as a means to achieve better outcomes in the management of the other co-morbid disease. ARES Quest can provide a link for disease management and wellness programs to screen all of their patients online, and then refer 'at-risk' patients to a sleep specialist for diagnosis and treatment.
Referral Management Program: The ARES Referral Management (ARM) Program provides an integrated approach to easily and accurately identify patients at risk of having undiagnosed obstructive sleep apnea (OSA). Its purpose is to use technology to assist sleep centers in providing a high level of support to their referral sources. Using a validated questionnaire, referral sources can simply and easily input responses and review the results with the patient during an office visit.
Engage Your Physician
You will need a prescription from your physician to have an ARES study, and the ARES Report will be returned to your physician. Your physician may not be familiar with the ARES or may be used to referring patients to a sleep lab for an OSA diagnosis. With the ARES, your physician can quickly and accurately determine if you have OSA and prescribe treatment if necessary.
Information to Show Your Physician
This section contains reference materials that you can print and take to your physician visit. Because not all physicians are specialists in OSA, they may not be familiar with the latest test procedures or most recently published studies. If your physician has any questions, please refer him or her to Advanced Brain Monitoring. Advanced Brain Monitoring can connect your physician with one of our board-certified Sleep Medical Review Officers to assist in making the best treatment decision for you.
About the ARES Study:
Interpreting an ARES Report · ARES Clinical Validation
Complications from OSA:
OSA & Cardiovascular Disease · OSA & Surgery · OSA & Pregnancy · OSA & Children
Treating OSA:
Treatment Options
Review Your Medical Coverage
In-home unattended studies like the ARES (CPT code 95806) are not currently covered by Medicare and some health insurers. However, in some cases the cost to order an ARES study may be less than your deductible for a laboratory sleep study. If you choose to pay out-of-pocket for an ARES study, you and your physician should confirm that your insurer covers OSA treatment based on the ARES results.
Insurers may cover the cost of the ARES in case of documented medical necessity. If you are pregnant or scheduled for surgery, waiting 1 to 3 months for a laboratory sleep study can pose a health risk. If you are drowsy at work and have a commercial driver's license (CDL) or operate heavy equipment, you may need to get treated immediately because of safety concerns.
To pursue reimbursement from your insurer, it is important that your physician establishes the medical necessity for the ARES in-home study. This means documenting symptoms that suggest a strong likelihood of undiagnosed OSA and the potential health risk to you and/or liability if you are not quickly treated.
OSA Treatment Considerations
CPAP: When CPAP is initially prescribed, your insurer pays for a monthly rental. Once your treatment provider establishes that you're using the CPAP, your insurer purchases the device for you. Since you'll be wearing your CPAP every night, consider paying out-of-pocket for equipment upgrades that increase comfort. To obtain the highest quality OSA treatment, you'll need to be knowledgeable and ask for what you want. We encourage you to research different brands and features and request them from your Durable Medical Equipment (DME) provider.
Between 20% and 50% of patients with a CPAP don't use it regularly, because of difficulty or discomfort wearing a mask. The quality and style of your CPAP mask can greatly influence its comfort. If you find your first choice isn't working, request a different model. Remember, your provider will not get reimbursed for the CPAP unless you are using it.
If you live in a region of the country where it is very dry, or if you have sinus trouble, adding moisture to the room air increases comfort and prevents your sinuses from drying. Pass-over humidification is sometimes provided instead of heated humidification because it is less expensive, but it is not as effective as heated humidification. Heated humidification requires a prescription from your physician, so discuss this treatment option with your physician.
Surgical Procedures: You should consult with your Ear, Nose and Throat specialist and insurance provider to determine appropriate surgical procedures covered under your policy. If you physician is not familiar with the surgical options, print the reference material on treatment options. If you select one of these treatment options, consider ordering a follow-up ARES study to make sure your oral appliance or surgical procedure was effective.
Oral Appliances: Insurance reimbursement for oral appliances differs from policy to policy. The cost of these appliances ranges from $1,200 to $2,000. Some insurers cover the cost of an oral appliance only after a patient is shown to be unable to wear the CPAP. If your physician is not familiar with these treatment options, print the reference material on treatment options. If you select one of these treatment options, consider ordering a follow-up ARES study to make sure your oral appliance or surgical procedure was effective.