50% Compliance Issue: Give Up? or Forced To Quit By Cost?

And so it begins....$2,200 for the PSG. Two weeks later (after changing masks once) they tried to talk me into another study. How can they do that when there isn't enough data to make that kind of decision? $214.00 new patient charge which was no more than 8 minutes and The Sleepiness Scale and the pronouncement of needing a PSG. There was no history taken, no discussion, no questions. I made the mistake of telling them(not a doctor..some "intake" person) that this was my last hope. Big mistake I suppose. How do they know I'm not some raging alcoholic, or its depression not sleepiness, or something else entirely. It's $130.00 to walk through the door to spend 5 mins to see how you are doing, then another $120.00 to download the data...all same visit...then it's "come back in two weeks and we'll check again. The rent on the CPAP is $271.00/mo..$60.00/month for the humidifier. Initial set up was $180.00. The list goes on and on and on......$35.00 for a 1" x 1" disposable filter, $70.00 for a hose....(good grief)

The PSG resulted in many things being "moderate" they told me....told me, I never saw any results, nor got copies....not that I would've known anything. I'm wondering how much of a "Snake Oil Saleman" the Sleep Clinics are? And it's because I didn't ask, my mistake.

This wonderful forum has helped me so much, and I am much the wiser now. They never mention I could push buttons and look at my own data. I learned about that from this forum. I don't exactly know what the numbers mean but I am determined to learn from this message board.

I can understand the delimma facing many people, escpecially when you don't see any improvement in the way you feel.

I am so eager for the CPAP experience to finally be the answer to what and how I am feeling. Many of you know from my posts that my attitude is great, my sense of humor is intact, and my desire for success is great........(if CPAP is the answer).

I'm also smart enough to understand the insurance game and the doctor billing games, but it is disheartening to receive the bill with "your remainder" and you have to consider how much financial jeopardy you are putting your family in.

I have now requested a copy of my study, I want to know billing status and insurance payment status. This forum has helped me to become a proactive CPAP'er. Even if I decided, from a financial standpoint, that I can't continue, I will always be thankful for this bulletin board.

Thank you for listening/reading.

If you want to ride their train, they sell the tickets, but you don't have to ride their train.

You can get your script, use it at cpap.com, get a APAP and HH, Find the software and get the reader. Then the major cost would be over, a new mask & filters every now and again.

Get off their train, but stay with treatment, and make it work. Jim

I would suggest:

1. You call your sleep doc and OBTAIN a copy of your PSG. Those findings are YOURS by law, once the findings have been delivered to you by a licensed doctor, those findings are YOURS. Many doctors don't like to give you the actual results of your tests for fear of malpractice. When any doctor does not share my test results or declines to it is adios for that quack. You can also go back to your sleep lab and/or request a copy in writing.

2. Armed with your PSG results, take those back to your GP doctor and explain the situation to them. If your GP is any kind of doctor at all and knows you, your medical history, they should have no problems writing you a script for a autopap where you can take control over your own therapy and expenses. If you have a copy of your original script, that is all you need.

Get yourself a A-Flex machine and you will never look back. Sleep medicine is a racket, only thing worse (expense wise) is owning an old broken down houseboat, a hole you pour money in.

Consider the financial jeapardy and the emotional jeapardy your family will be in if you die of the apnea itself or any of its comorbid diseases. I'm not willing to take that risk. I'd go into debt if I had to, in order to keep my health. You can't take good health for granted.

Yes, the whole cpap process is frustrating, but if you think your doctor is a sheister, get your psg reports and see a different one for a second opinion.

As far as your still feeling tired, there are lots of reasons that could be. You might need more time--ie, you might not be getting enough total hours of sleep each night. If you are using a nasal mask, you could be leaking your therapy right out of your mouth. Your pressure might not be optimized. You would need to check your data to know the answer to that.

And, you might just need more time, period. Sometimes it takes a while to see results. It really depends on your age, your overall health, the severity of your apnea and how long the problem had been going on. I myself was lucky, being only 35, I have bounced right back and even saw my high blood pressure go down, the first of the secondary diseases that was developing for me caused by apnea. Had I gone on untreated, like my mother has and my grandfather did, I would likely have developed diabetes and heart problems in addition just like they did. Both of those family members also developed cancer too.

By taking care of my apnea now, I am protecting myself at least partially from developing those conditions. Personally, I'd rather live with the hassle of cpap than develop those conditions. And I get the bonus of feeling good, awake and smart to-boot.

Hope that helps you. I get the frustration, but you have to get past it. It sounds like you have insurance. I'm sure you know that the premiums you and your employer pay are probably a pittance compared to what cpap costs. YOU are certainly worth the expense and the trouble.

Jen

Sorry to hear about your misfortune. I have noticed that some of those sleep clinics are indeed victimizing OSA patients because they know they are easy prey .... desparate and cognatively impaired from nightly hypoxia and daily exhaustion. They are set up with docs, sleep lab, and DME for the one, two, three punch.

As the others said, cut your losses now, demand your records and Rx, and take your treatment into your own hands may be what you should strongly consider. Hopefully your primary care doc is on your side.

Best of luck!

After reading the few of your responses I am ready to don the gloves and counter the One, Two, Three punch...because that's exactly what it is....Sleep Doc in A Box....One Stop Serves All.

Well, Pffffffffffft, to them. I'm going to be in charge. As my Dad always said..."If you are not the lead dog, the view never changes!"

And also, I'm going to learn what the numbers mean on my machine. Time to take control.

YeeeeeeHaw!!

socknitster wrote:Consider the financial jeapardy and the emotional jeapardy your family will be in if you die of the apnea itself or any of its comorbid diseases.

Excellent point, Jen.

BrnEyez, I don't blame you a bit for being frustrated by what your DME has done (or more like, "not done") so far. And disheartened by the "your remainder" bills.

At least now that you're seeing a lot more information on this message board than you'd ever get from your DME, and perhaps even from your doctor....information to help you help yourself....you can take heart that there's light at the end of the tunnel. Or perhaps that should be -- at the end of the cpap hose.

I'm really glad that you are going to fight as quitting is not an option if you do in fact have SA. Are you paying the $371/month equipment rental out of pocket, or is it covered by insurance?

BrnEyez wrote:And so it begins....$2,200 for the PSG.

Thank you for listening/reading.

BrnEyez, I hear you and can feel some of that same pain myself. I'm only out a few co-pays at this point, but I'm trying not to get fleeced by my DME who seems "slick" and a bit too "aggressive" for a medical outfit to suit my taste. But I think I have a good sleep lab. At least I do at this point. And a good sleep doctor, so far. They both charged similar to what you saw for yourself, and that was a bit shocking. $385 for a doctor's visit, but it did last over an hour, and was "in depth". So I'm crossing my fingers.

I haven't even gotten my equip yet because I've been trying to make sure I understand exactly what it will cost and how everything will happen. My sleep doc's already written me a letter trying to get me on CPAP ASAP, but I'm going to "gut it out" until after Jan. 1 to try and make the most of my $300 + 10% deductible for durable medical equip. Hopefully, I'll be ok until then.

One thing you might want to check out before buying yourself an autoPAP (APAP) is to make sure you aren't having "central apneas" like I am. If your GP knows about this and can see them (or not) on your study data, then you are set. But you wouldn't want to use an APAP in autoPAP mode if you experience "central apneas" when you are hooked up to a CPAP. At least, that's how I understand it at this early stage in my educational process. I'm sure someone will correct me if I'm wrong about this.

I have what the doctor referred to as "underlying central apnea" and "complex sleep disordered breathing" which may require a newer type machine called a "adaptive servo ventilation" (ASV) unit. Thank god I have insurance because that puppy costs around $4k on cpap.com. Who knows what a local DME will charge if they get $70 for a $10 hose!

Unfortunately, even if you have the "central apnea" issues, your doctor may not have mentioned it. Mine didn't. I discovered it after requesting a copy of my sleep study summary. Boy was I surprised. But at least then I knew why they wanted to do another sleep study in a couple months. I wouldn't be surprised if they want a couple more after that, since they'll probably try a biPAP machine if the CPAP doesn't cut it, and then on to the ASV unit. Lots of fun ahead.

Hang in there. I know the frustration that can accumulate just from talking to some of these provider people (I won't call them clowns). Sometimes I just have to take a day off from thinking about it and making phone calls. Tomorrow I need to call the DME billing dept and see "exactly how much this is going to cost my insurance, and therefore me, via deductible + 10%", and then call the DME respiratory guy back and reschedule my appt for after the new year. I'm pretty sure they'll be "put out" again and probably let me know it. They are real jewels, but at least I've gotten a 2nd respirator therapist now (I asked to deal with someone else besides the surly RT I started with), so I'm going to stick with them all for now due to a possible series of machines I might need. And hell, I only half know what I'm doing and talking about.