Does anyone have a insurance fee schedule for sleep studies?

[firefoxsilver9]

I'm trying to see if i can negotiate paying off my sleep study done last year. The cost was around $2000 out of pocket as my crappy insurance at the time didn't want to pay for it. Since then i've gotten it down to $1100 but not comfortably. It hurts my wallet a bit having to pay it down and its already been a year since and i only got it down to 1/2. a friend of mine suggested that if i could find a fee schedule from an insurance carrier, preferably my current one UnitedHealthCare i could use that information as leverage to have the sleep center i got the study from negotiate a lower bill for me. Anyone have any similar experience with such a task or advice?

[chunkyfrog]

I would imagine negotiations might be easier before the sleep study.
Good luck.

[hyperlexis]

Welcome to the USA, where healthcare coverage is a privilege for the wealthy and not a right. At least until 2014 when that will effectively and finally change. But until then you have very little leverage at all other than not paying and ending up in collections or just pleading poverty. You did know the cost after all when you got the study. You should have done this then, not now.

My Blue Cross supposedly pays the sleep tech people approx $1,100 at their in-network provider rate. I have read it goes from 8-900 and up depending on insurer and county. You may want to find out what your state's Medicaid pays and argue from there.

Perhaps a better way is to appeal to try and get your prior insurer to pay for the test. If it was a needed test, and you met the annual deductible, why would they not pay a valid claim? Could be an improper denial. Contact your state insurance department for help with that.

[firefoxsilver9]

Perhaps a better way is to appeal to try and get your prior insurer to pay for the test. If it was a needed test, and you met the annual deductible, why would they not pay a valid claim? Could be an improper denial. Contact your state insurance department for help with that.

i wouldn't even know how to begin with that. I called my insurance at the time before the study and they flat out said no they don't cover sleep studies so there was never a claim that was processed to appeal. I thought i would be able to pay for the study in full but i was unemployed for a period and got behind and i'm trying to deal with other stuff also. I was able to negotiate with them before the study as far as upfront payments and a lower monthly bill so i'm hopeful.

[hyperlexis]

Perhaps a better way is to appeal to try and get your prior insurer to pay for the test. If it was a needed test, and you met the annual deductible, why would they not pay a valid claim? Could be an improper denial. Contact your state insurance department for help with that.

i wouldn't even know how to begin with that. I called my insurance at the time before the study and they flat out said no they don't cover sleep studies so there was never a claim that was processed to appeal. I thought i would be able to pay for the study in full but i was unemployed for a period and got behind and i'm trying to deal with other stuff also. I was able to negotiate with them before the study as far as upfront payments and a lower monthly bill so i'm hopeful.

If you had actual health insurance, and not a 'minimed' plan (just google it, it's complicated....) then how could they not cover it? You may have something to fight over. Seek help with your state's dept. of insurance. They should assist you get to the truth and whether the first insurer should have paid and whether they may owe you for any amounts you paid.

[Guest]

if you can pay say 50% cash offer that to them as payment in full
else offer them $10/month then set them up on a bill pay plan

[firefoxsilver9]

Perhaps a better way is to appeal to try and get your prior insurer to pay for the test. If it was a needed test, and you met the annual deductible, why would they not pay a valid claim? Could be an improper denial. Contact your state insurance department for help with that.

i wouldn't even know how to begin with that. I called my insurance at the time before the study and they flat out said no they don't cover sleep studies so there was never a claim that was processed to appeal. I thought i would be able to pay for the study in full but i was unemployed for a period and got behind and i'm trying to deal with other stuff also. I was able to negotiate with them before the study as far as upfront payments and a lower monthly bill so i'm hopeful.

If you had actual health insurance, and not a 'minimed' plan (just google it, it's complicated....) then how could they not cover it? You may have something to fight over. Seek help with your state's dept. of insurance. They should assist you get to the truth and whether the first insurer should have paid and whether they may owe you for any amounts you paid.

This is what i had

http://www.lesliebenefits.com/plans/gsmi.htm

from what i read about Mini-Med plans, this sounds exactly like what i had. I even had a tough time getting them to pay for a routine annual checkup so they were awful. After several months and going through an appeal process i finally got them to pay the medial bill.

[greatunclebill]

you could try telling them you are under water with debts and going to file bankrupcy on all of your bills including their bill. if they think they are getting no more out of you, they may be willing to accept some sort of lump sum settlement. don't ask them what they would accept, give them a number and see if they accept or counter with their own offer.

[hyperlexis]

Perhaps a better way is to appeal to try and get your prior insurer to pay for the test. If it was a needed test, and you met the annual deductible, why would they not pay a valid claim? Could be an improper denial. Contact your state insurance department for help with that.

i wouldn't even know how to begin with that. I called my insurance at the time before the study and they flat out said no they don't cover sleep studies so there was never a claim that was processed to appeal. I thought i would be able to pay for the study in full but i was unemployed for a period and got behind and i'm trying to deal with other stuff also. I was able to negotiate with them before the study as far as upfront payments and a lower monthly bill so i'm hopeful.

If you had actual health insurance, and not a 'minimed' plan (just google it, it's complicated....) then how could they not cover it? You may have something to fight over. Seek help with your state's dept. of insurance. They should assist you get to the truth and whether the first insurer should have paid and whether they may owe you for any amounts you paid.

This is what i had

http://www.lesliebenefits.com/plans/gsmi.htm

from what i read about Mini-Med plans, this sounds exactly like what i had. I even had a tough time getting them to pay for a routine annual checkup so they were awful. After several months and going through an appeal process i finally got them to pay the medial bill.

Oh Gd yes. This is a mini-med plan. a.k.a. a 'Limited Benefits' plan. My poor father is now on one at his temp job. Terrible waste of money. $5,000 max benefits per year. Good luck with that kind of 'insurance'.

Technically, these mini-med plans are now actually illegal under the new Affordable Care Act (Obamacare) because they offer such paltry benefits and can be deceptive to insureds (i.e. your situation), often leaving many in bankruptcy (where they'd be even without having paid premiums for 'insurance') if a serious health problem occurs -- however many businesses like McDonalds complained so loudly that Congress allowed Minimed insurers to apply for waivers to continue operating until 2014 when they will all, finally, be banned.

Still, I would call your state's insurance dept and ask for help. Even a minimed may have had to pay the claim under the policy terms. So definitely call the insurance dept. -- at least to get to the bottom of things.

[firefoxsilver9]

Just an update for you guys. I sent a certified letter to the clinic that did my sleep study and they are willing to accept a $200 settlement instead of the remaining balance of $1027 that i still owed. i'm getting them to email me confirmation letter stating as such so i'm not held liable for any future payments and will mail a check as soon as i get it. I'm very happy about this.

[Nooblakahn]

I have umr. They would not pay. I had to pay at their rate and it goes towards my deductible. The cost was 750 and change per study. I hope that helps... but as the insurance wasn't a factor at the time im not retain that would help you.

Sorry.. I had not seen your update before I replied. Congratulations!