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There are some sleep labs in California that make a net of 2-300,000/month! just running a 4 bed lab!
I've owned a lab for over 12 years and it's beyond amazing the money sleep makes.

Because the Medicare guidelines don't address split-night studies, many sleep labs are forcing patients to do two night studies.

They say it's better. Well they should also spell out the costs of it and the delays. I see some patients with A/H indexes of over 60 not getting a split night study and waiting weeks to months for a CPAP. All the while they are paying for 2 doctors visits and 2 sleep studies.

The labs are in a battle with portable laboratories now and they are doing anything they can to keep laboratory testing viable because of the great amount of profit in it. Many patients are basic OSA patients, and they do not need in house testing let alone 2 nights of testing.

Of course 2 nights of testing is better; but using that example, arent' MRI's better than x-rays? So why do x-rays?

Almost all private insurances have protocols for their split-night studies. Most say that if you sleep for 2-4 hours and your A/H index is over 20/hour, you should then attempt CPAP. Many private insurances will NOT pay for the second night if their guidelines are not met.

Also, California and Georgia have laws that ONLY Respiratory Therapists can set up CPAP's for patients going on home CPAP. Many sleep technologists; including Registered Technologists; have NO medical degree. Some are lay people that have been trained by the sleep center and have passed the test and become registered.

Sleep is woefully behind when it comes to regulations and continuity. I'm sorry but anything over $2500 for a sleep study is ridiculous.

This is my second sleep test. The first one was in 1998 at the tune of $3500 which I ended up paying $1000. The second test was performed in Nov 2010 at the tune of $9500 (in NJ) and I did not pay a dime (met both personal and family deductions). The second test was a re-evaluation of my sleep issue as I am using old bipap machine (12 yrs old, and weight lost in 12 yrs). The sleep technician tends to wake up people at around 5 am to rush them out of the center. They could have gather another hour of data. Also, they asked what time you would like to wake up at the start of the test. I wrote 6:30 and they woke me up at 5am. But anyway, I had a lousy nite and went home, shower and enjoy my old bipap machine for another 4 hours of "quality" sleep.

Also, be vocal and armed with information as the doc and DME think that this is the only way to resolve your sleep apnea. I had to be assertive to get what I need (continue used of bipap as my lungs are weak to exhaust the pressure; also I cannot run more than 50 feet, asthma, non-smoker, flat feet) and DME are aim to get the most profit from you. I ended up using cpap.com for my equipment and deal with the insurance later.

DoriC wrote:Hi Dreamer, sorry to hear you're not sleeping well. Hope you get some answers soon. BTW, did your pressure requirements change at all? Keep us posted.

Technically no. The sleep lab's equipment was only capable of whole numbers. So, they started me at 7 and changed it to 8 during the night. The sleep doctor concluded that 7 is what I should be using, and told my DME to change my machine to 7.

Debated not doing it, but I guess at this time I'd get caught if I didn't. So, my AHI has crept back up to where it was when I was original prescribed 7...and not when I had fiddled with my pressure and changed it to 7.5

Thing is that it took me time to adjust to sleeping at 7.5 from 7.0....weird, but true. I'm sure being at 8 probably messed up the MSLT, but they won't admit to it. Now I'm trying to adjust back to 7....there were already times with 7.5 I would wake thinking I wasn't getting enough pressure, its even worse at 7.0

The Dreamer.

A lot of $$$$.

first night 1888 insurance rate max 1408 they paid that I paid 0
second night 2080 insurance rate 1537 they paid that i paid 0

Equipment I got lucky they billed for 2659 and paid 1288 and I paid 0 now my plan has a 5K deductable that was already met this year so I am happy, now I just need to make the supplies last as long as I can.

My insurance is ducking out on me now, say its a pre-exist.

Cuda wrote:My insurance is ducking out on me now, say its a pre-exist.

Give your state insurance commissioner office a call. Saying SA is pre-existing sounds like a cop out to me, unless you had a specific diagnosis before you got covered by them. I take it this insurance is not a group policy from work?

Insurance plus my $10 copays totaled between $750 and $890 on each of the three sleep studies.

The thing that surprised me was the almost $150 difference between the cost of the diagnostic study (a mere $750 and the titration studies (each in the neighborhood of $890)

Back in 2006, $2,500 first night--then they said I had to come back again for a 2nd night which put me into my new deductible. The second night was around $2,000.

I had sleep study Nov. 2010...BC BS allows approx. $900 for sleep study + $900 for titration study.

My so-called "sleep study" (which was an overnight SpO2 oximetry reading that was read by an ENT doc who specializes in Sleep Apnea) cost me a whopping CAD 0.00$... it was covered under my monthly MSP (Province of BC's Medical Services Plan) premium, and since I get that paid for through work, I didn't pay anything.

idamtnboy wrote:

Cuda wrote:My insurance is ducking out on me now, say its a pre-exist.

Give your state insurance commissioner office a call. Saying SA is pre-existing sounds like a cop out to me, unless you had a specific diagnosis before you got covered by them. I take it this insurance is not a group policy from work?

I own a small business so yes, its Blue Cross Blue Shield of Illinois. I pay them $9600 a year but they try and duck out of everything.

Split Night 4,900.00
Insurance Paid 3,897.92
My part (Deductable) 1,002.08

I tried the machine for two weeks. I wake up more times a night now. Blood pressure has increased.
I feel worst now than any other time in my life. My Doctor is on vacation and I will talk to him about
getting off the machine before it kills me.

1 night sleep diagnostic = $3297.69
My employers ins. paid = $1439.61
My wife's ins. paid = $1468.40
_______________________________
Difference = $389.68

I owe $0 ???

I don't understand it but whatever, they say I don't owe so I'm not gonna ask questions

Two sleep studies done 4 days apart. $2073.87 each. I've even been billed for on office visit that hasn't happened yet! ($86)

$2021.64 for the machine and assorted paraphanelia.

Guess I need a second job. Still trying to figure out what insurance is going to cover.