insurance won't pay for the sleep test

johnthomasmacdonald · Post by **johnthomasmacdonald** » Wed Oct 24, 2012 7:28 am

Insurance won't pay and the cost at this center is $6000 so i guess i'm back to trying to figure out how to treat this on my own. Last night using the same conditions that gave me an ahi of 4.5 gave an ahi of 13.5. I lived a decade in England, anyone that thinks US healthcare is superior to europe is in denial or has never lived there.

Sheriff Buford · Post by **Sheriff Buford** » Wed Oct 24, 2012 7:31 am

johnthomasmacdonald wrote:Insurance won't pay and the cost at this center is $6000 so i guess i'm back to trying to figure out how to treat this on my own. Last night using the same conditions that gave me an ahi of 4.5 gave an ahi of 13.5. I lived a decade in England, anyone that thinks US healthcare is superior to europe is in denial or has never lived there.

You are the best testimonial for anti Obama' care...

Sheriff

Pugsy · Post by **Pugsy** » Wed Oct 24, 2012 7:37 am

Well, crap. Since I can't say what I really mean.
I assume there are appeals processes maybe?

I really wish DeltaDave had stopped by your thread with your reports in it to give us his thoughts. Maybe he will see this note and go look.

johnthomasmacdonald · Post by **johnthomasmacdonald** » Wed Oct 24, 2012 7:41 am

And it's not like i'm trying to rip off the system - I paid for my own home test, my machine, five different masks and all the pad a cheek stuff AND a dental appliance for $1000 that i'm still waiting to get

Pugsy · Post by **Pugsy** » Wed Oct 24, 2012 7:47 am

You have crappy insurance.

I don't know what to offer right now. I am totally confused by the fact that you can have some quite decent reports (though they are rare) along with some horrible reports. That doesn't compute.

Send me the files for the last 2 nights please...I need to see a good night again.

justpam · Post by **justpam** » Wed Oct 24, 2012 8:11 am

Wow !! $6000?? And I thought my two overnighters were expensive. My BCBS gave the 'go-ahead' for the studies,
however, my deductible hadn't been met. Imagine my surprise when I pulled the EOB out of the mail box.
I'm now feeling pretty fortunate though. My total was $2300 and I'll never complain about it again if others are
having to pay the amount you stated.

I wish you all the best in trying to obtain optimum therapy. I'm glad this forum is here.

Pam

Janknitz · Post by **Janknitz** » Wed Oct 24, 2012 8:41 am

I haven't been following your threads so I don't know WHY your insurer won't cover your sleep test. Why do they say that? Is it a covered test under your Evidence of Coverage? (EOC is the actual contract your insurer has to pay for your healthcare. You'll need to contact your insurer in writing to obtain a copy).

That said, if your insurer legitimately can deny coverage for the sleep test, you have the freedom to shop around. Check with sleep labs in your area and see if any will give you a reasonable discount for out of pocket payment. Don't be afraid to bargain. Explore home testing, which is usually much less expensive. Be a wise consumer.

RandyJ · Post by **RandyJ** » Wed Oct 24, 2012 9:15 am

The Sleep Center at my local hospital charged my insurance around $2000 for my sleep test in March 2011.

In what universe should a sleep test cost $6000???!!!!

chunkyfrog · Post by **chunkyfrog** » Wed Oct 24, 2012 9:24 am

My BCBSNE allowed under a grand for each of my two tests.
Definitely shop around, Somebody's talking like a pirate to you!

Madalot · Post by **Madalot** » Wed Oct 24, 2012 9:27 am

My last sleep test, done with an RT as me as his only patient, with NEW equipment they'd never used before AND prepared to switch to their ventilator if necessary -- billed just under $4000. And the allowable charge for it was just under $1000 --

Slartybartfast · Post by **Slartybartfast** » Wed Oct 24, 2012 9:31 am

It sounds like it might be more an issue of what the sleep lab is proposing to charge. 6 kilobucks is more than twice what they usually cost. And even the $2000 that my sleep study cost was outrageous. Something's wrong with that figure.

Pugsy · Post by **Pugsy** » Wed Oct 24, 2012 9:33 am

If everything so far has been paid for out of pocket...does the insurance plan even offer coverage for anything related to sleep apnea? Some policies/plans don't.

Pachyderm's Nose · Post by **Pachyderm's Nose** » Wed Oct 24, 2012 9:39 am

Sheriff Buford wrote:
johnthomasmacdonald wrote:Insurance won't pay and the cost at this center is $6000 so i guess i'm back to trying to figure out how to treat this on my own. Last night using the same conditions that gave me an ahi of 4.5 gave an ahi of 13.5. I lived a decade in England, anyone that thinks US healthcare is superior to europe is in denial or has never lived there.
You are the best testimonial for anti Obama' care...

Sheriff

Yes! Obviously a full fledged endorsement of single payor!

ekubaskie · Post by **ekubaskie** » Wed Oct 24, 2012 9:52 am

RandyJ wrote:The Sleep Center at my local hospital charged my insurance around $2000 for my sleep test in March 2011.

In what universe should a sleep test cost $6000???!!!!

The one where there's only one sleep center in a 200-mile radius? Mine charged 5K - per night. There is one competitor in town, nothing else for 300 miles.

MTEng · Post by **MTEng** » Wed Oct 24, 2012 10:43 am

My sleep center charged $2000 with a 10% discount if you paid the bill in 20 days to eliminate the bureaucracy.

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