Sleepy study for 16yo son $$$$

[Hugewreck]

Holy cannoli I just received a call from the Children's Sleepy Center for a copay of $553 for my son's sleep study in a few weeks. I was stunned dumb and just paid it, now I have all kinds of questions. lol.

The place is in network and the family deductible that was left to cover was $475 before i paid this, so i'll be on the phone all day trying to figure out insurance and why so high of a copay. Time to schedule my tonsillectomy after hitting all the deductibles.

My son has been a horrible sleeper even before he was born, he sleepwalks, talks a lot in his sleep, super cranky, snores, naps at a drop of the hat and complains of morning headaches.

[slowriter]

When I had my first sleep study done a couple of months ago, I think my out of pocket was about $450.

They're expensive, and insurance in the US increasingly stingy.

[ChicagoGranny]

so i'll be on the phone all day trying to figure out insurance and why so high of a copay.

Insurance people speak in terms of procedure code(s). To save yourself some time, find out which code(s) the sleep lab is using. Then give these code(s) to your insurance company during your discussion.

(The CPT code for a lab study is 95810. If the lab intends to do CPAP titration during the study, the CPT code is 95811.)

My son has been a horrible sleep even before he was born, he sleepwalks, talks a lot in his sleep, super cranky, snores, naps at a drop of the hat and complains of morning headaches.

Has your son's airway been evaluated by an ENT? It's possible he has enlarged tonsils and/or adenoids. This could cause breathing problems during sleep. Surgical removal might cure the breathing problems.

Good luck!

[ChicagoGranny]

They're expensive, and insurance in the US increasingly stingy.

And, US customers want the best treatment with the latest technology with stingy premium payments.

[Hugewreck]

(The CPT code for a lab study is 95810. If the lab intends to do CPAP titration during the study, the CPT code is 95811.)

Has your son's airway been evaluated by an ENT? It's possible he has enlarged tonsils and/or adenoids. This could cause breathing problems during sleep. Surgical removal might cure the breathing problems.
Good luck!

- Thank you for those codes

- Yes we had to jump through hoops to get this far. Had to have consult with the office ENT Doctor before he would even say Sleep Study. No issues with his tonsils/adenoids or allergies. Its in his genes. I have sleep issues and his dad is a freight train just like his dad.

[ChicagoGranny]

No issues with his tonsils/adenoids or allergies. Its in his genes. I have sleep issues and his dad is a freight train just like his dad.

Underdeveloped jaws are common - genetic and epigenetic factors. This is a major reason that so many children need orthodontic treatment - the jaw is not large enough to accommodate a full set of straight, uncrowded teeth. Also, an underdeveloped jaw results in a narrow airway that is subject to collapse during sleep = obstructive sleep apnea (OSA).

An orthodontist who is up on his game can use palate expanders and other appliances to increase the jaw size of a developing child. In the best cases, OSA would be cured.

I have sleep issues and his dad is a freight train just like his dad.

More sleep studies in the near future? Stick around here a while, and people will tell you how serious untreated snoring and sleep apnea are.

[Janknitz]

Try to schedule it ASAP so that if he turns out to have sleep apnea you can get the equipment before the year ends and you have another deductible.

[chunkyfrog]

Try to schedule it ASAP so that if he turns out to have sleep apnea you can get the equipment before the year ends and you have another deductible.

I second that!

[Janknitz]

Underdeveloped jaws are common - genetic and epigenetic factors. This is a major reason that so many children need orthodontic treatment - the jaw is not large enough to accommodate a full set of straight, uncrowded teeth. Also, an underdeveloped jaw results in a narrow airway that is subject to collapse during sleep = obstructive sleep apnea (OSA).

An orthodontist who is up on his game can use palate expanders and other appliances to increase the jaw size of a developing child. In the best cases, OSA would be cured.

Yes, we did this with my daughter. But it's still a few YEARS of treatment (3 stages over 8 years), and meantime his apnea needs to be treated. And wait until you see how much orthodontia costs!!!! We call my daughter's mouth "the million dollar mouth" BUT . . . no sleep apnea. Worth every penny.

[zoocrewphoto]

My sleep study in 2012.



I am glad I did NOT know the cost before. I probably would not have done it. It seems to be one of the more expensive sleep studies from what I have seen, but I have to say, it was also one of the best. I was very comfortable. The techs were awesome (And picked the perfect mask for me). I slept enough to do the diagnosis in 2 1/2 hours, then slept REALLY well with the mask. It was the best start to cpap possible. I had some issues at home with mask fit, leaks, etc. But I KNEW from that first night in the lab that it was possible with that mask AND I got a taste of what great sleep FELT like.

Totally worth it.

[bwexler]

Yes, we did this with my daughter. But it's still a few YEARS of treatment (3 stages over 8 years), and meantime his apnea needs to be treated. And wait until you see how much orthodontia costs!!!! We call my daughter's mouth "the million dollar mouth" BUT . . . no sleep apnea. Worth every penny.

WOW!
Inflation has really hit hard. My Wife has less than $100,000 in her mouth. I refer to it as a Mercedes.

[chunkyfrog]

If you live within range of a college of dentistry, teaching subjects can get huge discounts.
Dental students need to learn this stuff somewhere.

[palerider]

They're expensive, and insurance in the US increasingly stingy.

And, US customers want the best treatment with the latest technology with stingy premium payments.

Says someone who has no concept of private insurance in the US in the last decade.

[colomom]

Your son and my son sound very much alike. Like with your son, from birth sleep for my son sleep has always been a problem. Like your son my son could barely stay awake during the day, had morning headaches, and experienced crazy nighttime parasomnias.

CPAP changed my son’s life, hopefully it will help your son as well. The health care system can be a nightmare to deal with, but keep fighting that battle. It sounds like they are overcharging beyond your deductible. Ask for an EOB. If you are being overcharged your health insurance company should have advocates who can help you. My son has had 4 sleep studies, we live in a rural area where health care costs are high, but each study ended up costing our insurance about $3500 (fortunately we had already met our deductible).

[Hugewreck]

This son's mouth is fantastic - perfectly spaced teeth, no crowding, no gum issues, all coming in straight and never a cavity. Son2 has too many teeth in a tiny mouth, total mess. lol At 8.5 yo he had to have pallet expanders top and bottom for almost 1.5 years, then crazy looking braces for a year. Took about 1.5 years off of no braces per orthdontist, doc wanted to see how the jaw line was going in puberty. Currently he is wearing Invisalign and totally happy with his mouth. He's my perfect sleeper, i finally got some sleep when he came along. No issues with him, i've watched and listened.

I am currently a cpap user, diagnosed 6 years ago AHI of 76 if i recall correctly. Mostly centrals back then, got that under control and now snoring & open mouth breathing (sinus & allergies) is messing me up. Getting older stinks. lol

Dh is fighting hard to not use his machine. So he is spending the night at the sleep center with son1, the techs will not be happy to hear his snoring while testing the boy.