Cost Effective Treatment

I would like to take the sleep apnea test, but my insurance will only cover up to $100 of the test, which runs about $5,000. Does anyone know of any organizations, or clinics that can help me?

Thank you

Where do you live?
That amount is extremely high for a sleep study.
Most studies are about 1/2 to 1/4 of the figure you mentioned.

I live in Rockland County, NY. I contacted Bon Secor/Good Samaritan Hospital, for an estimated cost.

Donna

Anonymous wrote:Where do you live?
That amount is extremely high for a sleep study.
Most studies are about 1/2 to 1/4 of the figure you mentioned.

wow
my sleep study was billed at $1600 per night so a total $3200 out of the ins paid a flat rate of $540 per night

if you are without insurance (join the crowd), you can get a script for a home PSG from SleepQuest. It costs about $495 last time I checked. Your doctor can obtain the diagnosis from this where they would write the Rx for cpap if you need it.

http://sleepquest.stores.yahoo.net/testsection.html

or... if you knew of someone who could loan you a recording autopap for a night you could print out the report and doctor could use that for the diagnosis.

1. Go to your GP, explain your symptoms, if they agree, they can give you a script for a Pat-100 Home Study.
2. Then Go to the above link, purchase the Home Study, fax over copy of the script from your doctor.
3. When the device arrives, you wear it to bed in your own home.
4. You send the unit back and they send you the report and diagnosis.
5. Once you have the diagnosis, get a script from your doctor for an Autopap.
6. Buy the autopap from cpap.com it arrives and you read the manual and start using it.

An autopap will cost you about $750 with a humidifier, then another $140 or so for a mask. So your minimum costs would be:

$065.00 for a Dr. Visit (est.).
$495.00 for the SleepQuest Pat-100 test
$750.00 for an autopap & humidifier.
$140.00 for a mask
$1,450.00 total for test and equipment.

OSA is an expensive disorder even at minimum costs. If you had a friend with a autopap that had recording software and knew what they were doing that would save you $495.

that is if your doctor accepts the autopap report for the OSA Dx diagnosis.

If you have a good repore with your GP doctor, they may accept the autopap diagnosis in which you could either rent a autopap machine from local DME or buy one on-line. But if you buy one for the diagnosis and you don't have OSA you cannot return the machine. I suggest renting one for a day or two from local DME. Ask what they would charge, you would also need a mask.

I do have insurance, but the RX plan is a discount plan, and the medical portion has pretty large co-pay, and it does not cover everything. Do insurance companies usually cover anything on these items?

Donna

[quote="Snoredog"]if you are without insurance (join the crowd), you can get a script for a home PSG from SleepQuest. It costs about $495 last time I checked. Your doctor can obtain the diagnosis from this where they would write the Rx for cpap if you need it.

http://sleepquest.stores.yahoo.net/testsection.html

or... if you knew of someone who could loan you a recording autopap for a night you could print out the report and doctor could use that for the diagnosis.

1. Go to your GP, explain your symptoms, if they agree, they can give you a script for a Pat-100 Home Study.
2. Then Go to the above link, purchase the Home Study, fax over copy of the script from your doctor.
3. When the device arrives, you wear it to bed in your own home.
4. You send the unit back and they send you the report and diagnosis.
5. Once you have the diagnosis, get a script from your doctor for an Autopap.
6. Buy the autopap from cpap.com it arrives and you read the manual and start using it.

An autopap will cost you about $750 with a humidifier, then another $140 or so for a mask. So your minimum costs would be:

$065.00 for a Dr. Visit (est.).
$495.00 for the SleepQuest Pat-100 test
$750.00 for an autopap & humidifier.
$140.00 for a mask
$1,450.00 total for test and equipment.

OSA is an expensive disorder even at minimum costs. If you had a friend with a autopap that had recording software and knew what they were doing that would save you $495.

that is if your doctor accepts the autopap report for the OSA Dx diagnosis.

If you have a good repore with your GP doctor, they may accept the autopap diagnosis in which you could either rent a autopap machine from local DME or buy one on-line. But if you buy one for the diagnosis and you don't have OSA you cannot return the machine. I suggest renting one for a day or two from local DME. Ask what they would charge, you would also need a mask.

I just want to chime in that $5k is robbery for a PSG. Going rate seems to be $2k.

I would first try speaking with a Sleep Specialist in your area and ask them to suggest a Sleep Lab to you and I would specificially ask them about any private Sleep Labs that they know of. They will always be less expensive than a full blown Hospital-based Sleep Lab.

I'm not sure where exactly in the county you are, but there is a Neurologist named Dr. Damon Salzman in Suffield who should be fairly familiar whose office should be fairly familiar with local services. I don't know a thing about him, but it's a name for you.

I would also double check with your insurance and specify that WITH a physicians prescription, exactly what is your OUT OF POCKET expense for a Sleep-Lab performed PSG. What is the allowable charge and what is the co-pay or patient responsibity.

Good luck!

Anonymous wrote:Where do you live?
That amount is extremely high for a sleep study.
Most studies are about 1/2 to 1/4 of the figure you mentioned.

This was ME, last night. I was just getting ready to shut off my computer when I saw your post.....too lazy to log back in.

Donna,

Another thing you might do is talk to your doctor about doing some overnight pulse oximetry studies. That checks your blood oxygen while you sleep. If you have apnea related events, your blood oxygen will most likely drop. The pulse oximetry is free from a local DME shop, but does require a prescription. They give you a device that records the information (clips to the end of your index finger on a long cable) and then you take it back to the DME and they download the data and send it to your doctor.
This method is being used more and more. There are a number of other things that sleep studys check for, but an overnight pulse oximetry will help determine if it may be apnea.

Another thought would be to check for other sleep labs.....do some price checking.
MOST insurance plans cover the sleep-related medical issues.

Best wishes,

Den

For a price comparison, if no other reason, I would suggest that you contact the Clinilabs Sleep Disorder Institute at St. Luke's Roosevelt Hospital here in Manhattan. The main # is 212.994.5100. I had my two full-night sleep studies done there and they were billed to my insurance at a total price of less than $2,000.

Good luck!

Kurtchan

RG occasionally posts a link from a sleep doc who has an approach to patients with limited finances.

She suggests that in those cases in which a presumptive dx of apnea is made, the patient is sent home with an autopap for a few nights data and then the patient is given a PAP based on the data.

A psg study can give much more data and helps rule out or diagnose other disorders that COULD cause legal problems ny failing to dx other conditions.

These are so rare that if a patient could hold the doc harmless, then they could be diagnosed and treated very cheap.

The CYA factor is a very big portion of virtually all medical provedures. Some thing a zero risk is realistic. Thank you, lawyers.

You can apply for a free sleep test (at home) and / or donated equipment through http://www.awakeinamerica.org the application is online at their website.

If you contact sleep labs in your area, and state you will be paying privately, and ask for a "split night" study, they are generally willing to discount the price, as they will not have the hassle of dealing with insurance. Many will take a credit card, or may work out a payment plan.

I gotta ask a curious, and possibly dumb, question: If that home test works as well as they claim, why does anyone ever use a sleep clinic? That thing has one wire hooked up to the patient's finger, going into one little box. At my sleep study, I had 80 gazillon wires (OK, maybe I didn't do an exact count!) hooked up to me, I was monitored by a supposedly trained RT all night, with banks of computers to crunch the data and had a video camera trained on me all night long. All the jokes about the medical industry aside, how does one test really compare to the other?

[quote="MandoJohnny"]I gotta ask a curious, and possibly dumb, question: If that home test works as well as they claim, why does anyone ever use a sleep clinic? That thing has one wire hooked up to the patient's finger, going into one little box. At my sleep study, I had 80 gazillon wires (OK, maybe I didn't do an exact count!) hooked up to me, I was monitored by a supposedly trained RT all night, with banks of computers to crunch the data and had a video camera trained on me all night long. All the jokes about the medical industry aside, how does one test really compare to the other?

I think the thread was for "cost effective" study.

If you need a car to get to work you can get a loaded porsche or you can get used a VW beatle ... depends what you consider to be "cost effective" I guess.

- roberto