CPAP and respiratory subscriptions (mask replacement schedule, RX validation), how does the workflow run?
CPAP supplies (masks, cushions, headgear, hoses, filters) are the highest-LTV medical-supplies category because Medicare and most commercial payers reimburse on a fixed replacement schedule:
- Nasal cushion: 2/month
- Full-face cushion: 1/month
- Mask frame: 1/quarter
- Headgear: 1/6 months
- Hose: 1/quarter
- Disposable filters: 2/month; non-disposable: 1/6 months
The Magento subscription workflow stores the schedule per customer per SKU, fires an auto-order on the eligible date, validates the RX is still current (CPAP requires a valid prescription with diagnosis E66.2 or G47.33), checks for an in-person follow-up compliance per Medicare (90-day adherence requirement for new CPAP users), and routes the order through the standard prior-auth + EDI flow.
RX validation: RX captured as a customer-account document (PDF/JPG, encrypted at rest), expiry tracked, auto-prompt to customer to upload renewal 30 days before expiry. If RX expires, subscription pauses and customer-service is notified to follow up with the prescriber.
Adherence tracking (optional): for new CPAP users on Medicare, we integrate with ResMed myAir or Philips DreamMapper to pull modem-reported adherence data (90-day rule: 4+ hours/night for 70% of nights). Magento subscription auto-cancels if adherence fails the rule, required for Medicare reimbursement.
Subscription LTV on CPAP averages $1,800, $3,200/yr per beneficiary. The retention work is the platform job, not a sales-team job.