Frequently Asked Questions

What is Airway Clearance Therapy?

Strong lungs play an important role in staying healthy. One function of the lungs is to secrete mucus to trap inhaled fine particles and harmful bacteria, viruses, and spores. Other mechanisms, called cilia and cough, then work to move this mucus from the body. Many diseases and conditions impair the ability of the system to regulate mucus secretion and to clear it thoroughly from the airways. Conditions include but are not limited to:

• Bronchiectasis
• Chronic bronchitis
• Cystic fibrosis (CF)
• Neuromotor/neuromuscular
• Primary ciliary dyskinsia
• Post-lung transplantation
• Quadriplegia/high-level spinal chord injury
• Ventilator dependence

As a consequence of poor secretion clearance, contaminated mucus builds up in the lungs and airways. Retained secretions promote development of serious complications including:

• Inflamed airways
• Chronic cough
• Lung congestion
• Shortness of breath
• Decreased exercise ability
• Respiratory infection
• Pneumonia
• Lung damage
• Respiratory failure

A treatment called airway clearance therapy (ACT) is prescribed to help clear airway secretions when they are not being evacuated naturally.  Many forms of ACT are available. An ideal ACT should be:

• Effective
• Reliable
• Comfortable
• Convenient
• Easy to administer
• Require no special skill
• Permit independent use

What is the inCourage™ system?

The inCourage™ system, introduced by RespirTech in 2005, provides a well-established form of ACT called high-frequency chest compression (HFCC). HFCC has been prescribed since 1988 for more than 70,000 people with airway clearance needs. It is the ONLY method meeting all the criteria of an ideal therapy.

The inCourage™ system equipment consists of 1) an inflatable jacket; 2) two interconnecting hoses and; 3) a pulsating therapy unit (PSU). The therapy works by administering rapid but gentle compressive forces via the inflatable jacket to the chest to produce oscillations within the airways. These oscillations work to:

• Loosen mucus lodged in the airways
• Thin sticky, thick secretions to promote clearance
• Produce an airflow bias to move secretions to central airways for clearance by cough, swallowing or suctioning
• Accelerate clearance time

Therapy with the inCourage™ system is highly effective, comfortable, and easy to use:

• All lobes of the lungs are treated at the same time
• Some aerosolized medications may be used during treatments*
• No special skills are necessary
• Little or no caregiver assistance is required
• For most users, it may be used independently

             *Ask your doctor for specific instructions

What sets the inCourage™ system apart?

The inCourage™ system incorporates the most recent advances in HFCC technology, design and comfort.

Triangle waveform: The shape of the waveform delivered by HFCC machines is shown to be important in maximizing mucus clearance:

• A comparison of triangle versus older sine waveform technology found a mean volume increase of 20% in mucus cleared - with a range up to 41% - with the inCourage™ system technology
• Triangle waveform therapy maybe more effective because peak airflow and maximum lung volumes occur at the same frequencies
• Triangle waveform therapy may be more comfortable because duration of peak pressure is shorter

Jacket: The design improves efficacy, comfort and ease of use:

• QuickFit feature permits precise sizing
• Precise fit ensures consistent therapy
• Active venting improves tolerance and comfort
• Widest range of standard jacket sizes are available
• Custom jackets are available to accommodate all sizes and shapes

Standard and Custom Programming: The inCourage™ system is pre-programmed to provide easy-to-follow instructions with an easy-to-understand menu. The machine is equipped with a touch button digital control panel and a choice of three simple treatment sessions to assure reliable, individualized treatments

QuickStart: A pre-programmed 30-minute session that begins immediately and ramps up and down through a full range of therapeutic frequencies

AutoPause: A pre-programmed 30-minute session that pauses at five minute intervals for users to perform huffing and coughing maneuvers. Sessions are resumed with a simple touch of a button

MultiStep: A custom programming feature that permits users to enter and save up to 3 individualized sessions containing up to 12 steps.

Therapy Unit Design: I pulsating therapy unit (PSU) is designed to be lightweight, aesthetically pleasing and portable. It does not look like an obvious piece of medical equipment and fits unobtrusively into most living spaces

How do I get started with the inCourage™ system?

Delivery: RespirTech ships via leading parcel delivery services within 2-3 business days after receiving:

• Physician's prescription
• Patient consent form
• Insurance verification

Training: RespirTech maintains a nationwide network of healthcare professionals to provide prompt, thorough instruction on the use of the inCourage™ system. Services include:

• In-home training: A trainer in your area will arrange a convenient time to provide complete instruction on proper use and maintenance
• Phone training: Persons familiar with HFCC therapy may elect to be trained by phone
• Treatment protocol education
• Airway clearance health maintenance education
• Treatment adherence counseling

What results may I expect from the inCourage™ system?

Nearly twenty years of clinical experience and over 80 research studies show the benefits of HFCC therapy. As with all medical treatments, results vary from user to user. However, after starting therapy with most users will notice:

• Greater volumes of secretions cleared
• Improved energy levels
• Reduced use of antibiotics and other medications
• Fewer respiratory infections
• Easier breathing
• Greater exercise
• Fewer clinic visits

How may I get the most from the inCourage™ system?

RespirTech understands the burden of managing chronic lung problems. The inCourage™ system is designed to make treatments as easy and comfortable as possible. However, even the best therapy does little good if treatments are frequently skipped or cut short. I should be used just as your doctor has instructed. Many insurance companies deny payment when is not used conscientiously.

Follow-up services

To ensure optimal results for every client, RespirTech maintains a follow-up program. After completion of training, a series of calls are made at intervals. Follow-up services are intended to help both you and your doctor. At each call, a RespirTech specialist will:

• Ask how the device is working for you
• Discuss changes in your symptoms
• Ask about your respiratory and general health status
• Answer questions about the device
• Record the reading on your hourly usage meter

Hourly usage meter

The inCourage™ system is equipped with a built-in hourly usage meter. Information is collected and used for three purposes:

• To help you monitor use
• To help your doctor adjust your therapy program
• To satisfy your insurance company's usage requirements, if required

When a RespirTech specialist calls for usage meter information, please respond as accurately and as promptly as possible. All your clinical information will be protected in strict conformity to HIPPA privacy laws.

How do I maintain my inCourage™ system?

TECHNICAL SUPPORT SERVICES: RespirTech's highly qualified team of technical experts provide:

• 24-hour technical support (800-793-1261)
• Next business day product replacement
• Diagnostic assessment of returned equipment

WARRANTY: RespirTech provides a limited lifetime warranty at no cost in the U.S.A. and Canada:

• All parts and accessories
• All labor and shipping costs
• Replacement of outgrown inflatable jackets
• Certain conditions apply (See User's Manual)

ACCESSORIES: RespirTech offers for purchase:

• A custom travel bag
• An 800 Watt Power Inverter easily installed in most automobiles

MAINTENANCE: Consult the User's Manual for specific maintenance instructions

Will my insurance plan pay for the inCourage™ system?

Reimbursement Policies for High-Frequency Chest Compression therapy: HFCC therapy is approved for payment by over 900 commercial insurance plans and at least 250 government programs. However, eligibility criteria differ greatly from plan to plan. Most payers automatically provide reimbursement for the inCourage™ system for patients with cystic fibrosis (CF) and, after satisfying certain conditions, most patients with other diagnoses for whom the therapy is medically necessary.

How will RespirTech help me work with my insurance company?

Filing a healthcare claim is rarely easy. RespirTech understands that most submission processes are complicated and require considerable effort and patience. RespirTech's Reimbursement Services department will work with you to maximize the likelihood of your claim being approved as quickly as possible.

RespirTech staff will work with you to:

• Compile and submit all documents required to receive plan-specific prior authorization
• Satisfy all insurance company requests for additional information/paperwork
• Protect patients' HIPPA privacy rights
• Take responsibility for timely filing of paperwork
• Inform clients promptly of approval or denial decisions
• Inform patients of their appeal rights
• Draft and coordinate appeals for denied claims

Your responsibilities:

RespirTech will partner with you to help you obtain the inCourage™ system. To be successful, you must:

• Use the inCourage™ system daily as directed - Payors will not honor claims for inconsistently used equipment
• Respond promptly and accurately to Reimbursement Department requests for information
• Supply accurate hourly usage readings - evidence of compliance with prescribed treatment is typically required
• You may be responsible for a co-payment according to the requirements of your insurance plan

How long does the insurance approval process take?

After submission of documentation, insurance approvals typically take 30-60 days. It is not unusual for the process to take even longer. When one or more appeals are required, final approval may take 6 months or more. For users who are treatment adherent and show benefit, persistence and patience are usually rewarded.

What happens if my Insurance denies payment?

Denials for healthcare claims are not unusual. If this happens to you, RespirTech will work with you on appeal options. If possible, we will work to support your appeal.

What should I do if I have questions about the inCourage™ system?

RespirTech’s skilled Custom Care professionals are happy to respond to any questions that arise concerning use or effects of the inCourage™ system. Your calls are welcome at any time during business hours at: 800.793.1261(Toll Free) or 651.379.8999. After business hours, please call 800.793.1261.

For medical emergencies, please call 911 or your personal physician.

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This site contains information that does not substitute for the advice provided by a medical professional. The inCourageTM System is only available upon a physician's order. Always consult a physician if you have health concerns and call 911 for a medical emergency.