Insurance rejects Dr's Sleep Study referral

[metsfan302]

sorry but i am going to remove that comment i have seemed to offended. I do a lot of work for free yes

"We aren't talking about q-tips. It was some type of flushing procedure. It takes some time, uses equipment that must be sterilized, and uses supplies. Why should she do it for free? Do YOU work for free?"

Sorry did not hear that part, I went with the annual exam


well i cannot seem to remove it, carry on

[metsfan302]

Never thought I would become a Hurdle Jumper, but it's what this has become.

All set with the orig sleep Dr. Appt this Monday, Am sure he will help for sure!

I get a call this morning, it's the lady who called the other day from the sleep study center -

I quickly told her what was going on, what the tech said, that i had an appt with my orig sleep dr etc......

She said my insurance approved and wanted a home sleep study done, I mentioned that it might not detect the centrals, she agreed but said it might she has seen it twice this week in other cases. That said yes it was silly but it is what it is and insurance is just that way - that I will prob end up doing an in lab study but in order for that to be covered id have to do this in home one, I told her I have my sleep dr appt. Monday - she scheduled me to pick up the equipment Wednesday night at the lab I was going to go to for the in lab study - they show me how to hook myself up, I do that then mail it off lol - so if my sleep dr does not want me to do that I can just not go get the equipment etc... Crazy but if its what I have to do to lower these events and AHI it is what it is

[sleepylynn]

Fingers and toes crossed that they get this figured out for you sooner rather than later.

[metsfan302]

Right lol So damn tired all the time!!!

[metsfan302]

Well looks like my insurance rejects my Sleep Dr's Request for an Attended Sleep Study ...... Whatever this is BS

[Cardsfan]

This is a little hard for me to follow. I have a ? about the at home sleep study. You say it may not detect centrals. I did an at home study and reading off my report, it states how many centrals they recorded. I did the at home test for 3 nights in a row.
Are you saying I could have had more centrals, and they don't catch it on at home studies?
I had a finger monitor, a nose cannula for recording snoring, and a chest strap. It was Snap Diagnostics at home test.

Sorry you have to go thru all this run around. My husband made the comment" The Insurance co.s drag this out so long hoping you give up". Keep fighting for yourself. That's all you can do. I feel sorry for people who are too sick or not internet savy enough to fight for their health benefits.

You have a machine necessary to treat your centrals now, right?
Do you have approval for the at home study?

[metsfan302]

I did have the approval, the dr had it canceled as he said it would not detect central apnea, it to him was worthless.....

[Cardsfan]

If the at home test is all your insurance is wiling to pay for, at this point, I don't understand why your Dr would not at least do that. Then after the at home test, if your dr still says you need an in lab test, the insurance co. may approve it.
Sounds like one of those times when the ins. co would rather pay a little money up front for an at home test, then pay more
money if it proves you need a more expensive in lab test.
Can it hurt anything to do the at home test? (insurance wise)
http://www.snapdiagnostics.com my test results have all kind of data on central apneas that they recorded.

[metsfan302]

I dont know anymore i am lost, just lost....

I have already had an in lab study, we know i have obstructive apnea ....... its the new centrals

[Cardsfan]

Contact your insurance Co and get a written copy of the approval for your at home study. Then you at least have the option
to get the at home study from another in network Dr.

[fj62]

Metfan302, I could have had a sleep study last night if my insurance company didn't need to approve. I may have a problem because my old machine was replaced because it malfunctioned. My PCP said I most likely need a bi pap.

[SimbaLion]

Your doctor, unfortunately is not doing his/her job correctly. In your case, since you are seeing central's, your doctor can request to do a peer to peer discussion with one of the insurance's medical review/approval staff (usually a doctor). That's what my doctor did when my insurance initially rejected the in-lab study (although I did have a home study first). You may need to find a doctor who is better/more willing to deal with billing/insurance problems. My doc is at a big city academic institution and he's swamped, but he was still willing (without me prodding) to get everything done...

[metsfan302]

yea ive already had one scheduled for last week that was 2 months ago, insurance rejected it. same boat it sucks

[metsfan302]

well this is the first rejection / denial from the specialist - lets see how he does on the appeal / thing u say

[SimbaLion]

I'm actually a bit lost in your story. Aren't you the same person in another thread who just started ASV? How did you start on ASV without an ASV lab titration?