Terms & Conditions
Cost of Services
American Sleep Association (ASA) will bill your insurance company or Medicare for the cost of the oral appliance or CPAP so you will only be charged for the $4.95 cost of shipping (you authorize ASA to bill your credit card $4.95 for the cost of shipping). You are responsible for paying your applicable co-payment and/or deductible.
If you experience any problem with your oral appliance or CPAP, please contact American Sleep Association. For all medical related questions, please contact your caring physician.
Procedures / Responsibilities (Have Sleep Study)
If you already have a sleep test performed by board certified doctor, ASA will send you an Oral Appliance kit where you will follow the detailed instructions to take an impression of your upper and lower teeth and mail the impressions back to ASA along with a copy of your previous sleep test. ASA board certified doctors and dentists will review your sleep test and determine if you qualify for an Oral Appliance. If you qualify, ASA's dentists will fabricate and mail you an oral appliance that is FDA approved to eliminate or reduce sleep apnea or snoring. Your responsibilities (responsibilities) are as follows:
- Fax Patient Order form and Authorization to Request and Disclose Health Information form to ASA.
- Take and mail back impression to ASA.
- Pay your applicable co-payment and/or deductible.
Procedures / Responsibilities (Do Not Have Sleep Study)
If you do not already have a sleep test performed by a board certified doctor, ASA will send you a Physician Order Form and an Oral Appliance kit. You then visit with your caring physician and have him/her verify if you are a candidate for a home sleep test and have them sign the Physician Order Form. Fax the signed Physician Order Form to ASA. If you are a candidate for a home sleep test, ASA will arrange and mail you a home sleep test that you administer in the comfort of your own home that you mail back to ASA along with your impressions. ASA board certified doctors and dentists will review your home sleep test and determine if you qualify for a CPAP and Oral Appliance. If you qualify, ASA will mail you both an Auto Titration CPAP and an Oral Appliance. If you prefer the CPAP, keep the CPAP and ASA will bill your insurance company or Medicare for only the CPAP . If you prefer the oral appliance, mail back the CPAP and ASA will bill your insurance company or Medicare for only the oral appliance. Your responsibilities (responsibilities) are as follows:
- Visit caring physician to verify that you are a candidate for a home sleep test.
- Fax Physician Order Form and Patient Order form to ASA (if you are not a candidate for a home sleep test, fax Physician Order Form to ASA and your responsibilities are completed).
- Perform the home sleep test in your home and mail back to ASA.
- Take and mail back impressions to ASA.
- Pay your applicable co-payment and/or deductible.
If you decide to keep oral appliance:
- Sign and fax form stating that you cannot tolerate CPAP.
- Mail CPAP back to ASA.
If you decide to keep CPAP:
- Wear CPAP 70% of the time for 30 days (if you opt for the CPAP).
- Mail back memory card from CPAP after 30 days that reflects CPAP being worn 70% of the time (if you opt for the CPAP).
- Visit caring physician to determine that CPAP is being effective and have physician sign and fax form indicating that CPAP is effective or not.
30 Days to Complete Responsibilities
If you are not able to complete your responsibilities as stipulated above within 30 days, give ASA a call to extend delivery of your responsibilities. If your responsibilities are completed within 30 days of this order and you have not made arrangements with ASA, you authorize and consent ASA to bill your credit card for the equipment. If you complete your responsibilities at any time after the 30 days, ASA will refund you service charge.
Acceptance by ASA
American Sleep Association only agrees to send you the product only after ASA has verified that your insurance or Medicare cover the oral appliance, sleep study and/or CPAP.
Oral Appliance Use
You agree to the following terms prior to using the oral appliance:
- You have already consulted with your dentist and he approves that you may utilize the oral appliance.
- You will consult with your dentist prior to use so he can continue to consult you on how to use the product & if you experience any problems.
- You do not have severe sleep apnea, heart problems, or any other health related issue.
- You do not have loose teeth, loose crowns or any other loose dental work.
- You do not have periodontal problem, or decayed teeth.
- American Sleep Association only guarantees that which is in writing (no implied guarantees) and does not guarantee against tooth sensitivity, movement of teeth, teeth problems, against trays that don’t fit due to a bad impression nor against failure of the post office.
- You have reviewed and agree to the 'Terms and Conditions' found at www.americansleepassociation.com/terms.html .
- Customer agrees that the total liability is limited to the amount of the product.
You understand that most or all of the physicians, dentists and possibly some non-physicians providing health care services to me are independent contractors and are not agents or employees of ASA. You will consider them independent contractors unless you receive notice that such individual is an agent or employee of ASA. You acknowledge and agree that ASA is not responsible or reliable for the judgment, conduct, actions, or inactions of independent contractors who treat or provide professional services to you. You have had the opportunity to ask questions about employees and independent contractors and have had them satisfactorily answered.
ASA complies with state and federal laws regarding patient confidentiality outlined in the Notice of Privacy Practices. The Notice of Privacy Practices may be revised at any time and you may ask to see a current copy of it at any time.
Assignment of Benefits
You authorize ASA, to request and directly collect all public and private insurance coverage benefits on my behalf, however you understand that it remains my responsibility to ensure that my bill is paid.
As the patient, or the authorized agent that is legally responsible to pay for the care of the patient, you will pay all applicable co-payments, deductibles, co-insurance, and all charges for non covered services, regardless of the amount paid by insurance or any third party payer.
Release of Information
You authorize ASA to obtain any information that is pertinent to my care from other agencies, hospitals, physicians, and other health care providers. You also authorize the release of any information about me needed to substantiate and process a claim for payment of health care or related services to the Tricare administrator, carriers or program administrators, Social Security Administration or its intermediaries, the state, or to any other applicable payer.
If you are using Medicare, you will sign the ABN form.
Oral Appliance Warranty
The American Sleep Association provides a 2 year warranty on any Oral Appliance purchased through them. They will fix or repair the Oral Appliance for 2 years from the date of the original purchase. If the product fails under conditions of normal use American Sleep Association will repair or replace, at its option, the Oral Appliance. This Limited Warranty does not cover any damage caused as a result of improper use, abuse, modification or alteration of the product.
To make a warranty claim the consumer must return the defective Oral Appliance to American Sleep Association shipping prepaid.
ResMed warrants that your ResMed product shall be free from defects in material and workmanship for the period specified below from the date of purchase by the initial consumer This warranty is not transferable
Product Warranty Period
ResMed humidifiers, ResControlT~ I ResLink™
ResMed flow generators
Accessories, mask systems (including mask frame, cushion, headgear and tubing). Excludes single-use devices.
Note: Some models are not available in all regions.
If the product fails under conditions of normal use, ResMed will repair or replace, at its option, the defective product or any of its components. This Limited Warranty does not cover.
a) any damage caused as a result of improper use, abuse, modification or alteration of the product;
b) repairs carried out by any service organization that has not been expressly authorized by ResMed to perform such repairs;
c) any damage or contamination due to cigarette, pipe, cigar or other smoke;
d) any damage caused by water being spilled on or into a flow generator. To make a warranty claim, the initial consumer must return the defective product to the point of purchase, freight prepaid.
This warranty is in lieu of all other express or implied warranties, including any implied warranty of merchantability fitness for a particular purpose. Some regions or states do not allow limitations on how long an implied warranty lasts, so the above limitation may not apply to you.
ResMed shall not be responsible for any incidental or consequential damages claimed to have occurred as a result of the sale, installation or use of any ResMed product. Some regions or states do not allow the exclusion or limitation of incidental or consequential damages, so the above limitation may not apply to you. This warranty gives you specific legal rights, and you may also have other rights which vary from region to region. For further information on your warranty rights, contact your local ResMed dealer
or ResMed office.
Due to the fact that the oral appliance is custom made for the patient and the CPAP is ordered specifically for a patient, only the oral appliance or CPAP may be returned. Either the CPAP or oral appliance will be billed to your insurance company or Medicare.
Sleep Study Billed and Performed
The sleep study will be billed and performed by another company besides American Sleep Association.
If you have any questions about your product, you can contact us directly through email, phone, or in person.
American Sleep Association
51 E 400 N Bldg 1
Cedar City, UT 84720
Hours of Operation
Monday thru Friday 9:00 am to 5:00 pm MST
You may contact us afterhours by calling 866-620-3670 ext 5.
If you have any complaints or grievances please email them to firstname.lastname@example.org .