Sleep time during Sleep Study and Insurance

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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sleepwellgal
Posts: 5
Joined: Fri Aug 27, 2004 6:23 am

Sleep time during Sleep Study and Insurance

Post by sleepwellgal » Fri Jun 01, 2007 3:52 pm

I was recently told by a DME that the total sleep time for my diagnostic sleep study was too short. How can this be? I just had the sleep study done about 2 weeks ago!! The sleep tech woke me up to start the CPAP because my apneas were so bad. Now, I cannot get the replacement machine I need.
Tell me: can a sleep time be too short????

SleepWellGal.....nightie night

tingaling

Sleep time

Post by tingaling » Fri Jun 01, 2007 3:58 pm

Yes, the sleep time for a sleep study can be too short? Do you have Medicare as your insurance? Or possibly a Blue Cross Blue Shield plan?
The minimum sleep time, without a CPAP in place, is 120 minutes. That is not the amount of time your were RECORDED... but the amount of time you were ASLEEP.
It is so frustrating, I know, to go the lab and have the test and then fall short. It happened to me. I had to go back and have a repeat study. I could not believe it at all.
Good luck.


yosemitelor
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Location: Rural Northern California
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120 minute time requirement for sleep study

Post by yosemitelor » Sat Jun 02, 2007 12:40 pm

I had the same problem. Sleep tech accidently woke me up after 110 mins. instead of 120 mins. to hook me up to cpap. I found out when no DME would fill my prescription because they said my sleep study was to short for the insurance company to approve payment. I called Blue Cross ( my insurance co) and they said they had no such 120 minute requirement and sent me a letter saying so. The DME's still would not accept that. I went back to the company that did my sleep test (SleepMed - who by the way SUCKS) and complained and after wrangling with them they redid the sleep study at no cost to me or my insurance company because it was there screw up. I was not at all happy about having to re-do the test, but happy i finally got it to the time it needed to be.

If you had alot of trouble getting to sleep (which i did on both occassions) i would suggest if you re-do the test you take your own pillow, and ask your doctor for a sleep aide for that night like ambien or such. If he will not prescribe you can try the herbal sleep aide Kava Kava.

Best of Luck to you!!!!


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Slinky
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Location: Mid-Michigan

Post by Slinky » Sat Jun 02, 2007 2:08 pm

Yep, Medicare requires 2 hours sleep out of 6 hours "bed time". I had to go thru two titration studies as well. But it was neither the sleep lab's fault nor mine. I just plain couldn't get to sleep.

I only slept 42 minutes the first titration study and 98 minutes the second titration study. FORTUNATELY, 42 and 98 add up to 130 minutes 'cause I don't think I could have gone thru yet a 3rd titration study!!!! There was no gap to speak of, 2 or 3 nights at most between the two titration studies due to a cancellation.

I just know I was so exhausted that I didn't even have the energy to be or get snarky w/anyone. Not even enough energy to be frustrated. I was just plain NUMB w/exhaustion. I was sleeping (???) bad enough on my own before the titrations!!!


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calculatin'man

Sleep Test Sleep Time

Post by calculatin'man » Sat Jun 02, 2007 4:46 pm

Well, this sets my mind at ease, a similar thing happened to me.
The first DME I visited said my diagnostic sleep time was too short. I contacted the insurance company. I was also told by my insurance that there was no such 120 minute rule in place.... but there really was!!
I found a DME that was too out of it to know the "real" rules. They set me up with equipment, submitted the claim, it was denied, they appealed, it was denied again. Because the sleep time during the diagnostic study was too short to prove medical need. Then I was out DME pricing when I could have just bought the equipment on cpap.com at a much lower price!!! I was not going back for a repeat diagnostic study.
What I learned is this: the people who submit the claims, and do it well, probably know what they are talking about.
Sorry this happened to you. I understand the heart ache.