In home sleep studies a no go.

AUTOMATIC · Post by **AUTOMATIC** » Wed Jan 19, 2005 9:38 am

Wader and crew,
Still trying to figure how to manuever thru this site.
Just received an up date from Medicare Coverage Advisory Committee and they specifically stated that there will be no reimbursement for in home sleep studies at this time. How omniscient the government bag boys are...AUTOMATIC

wading thru the muck! · Post by **wading thru the muck!** » Wed Jan 19, 2005 9:54 am

Hi Automatic,

Thanks for looking in to that. So I guess they are telling us if you live in the wilds of "Big Sky Country" (Montana) you will have to spend a day of driving (trying not to fall asleep) to get to the nearest sleep lab for a study.

Just for fun here's a link to an article showing the benefits of an in-home sleep study vs a lab study:

Link: Benefits of an in-home sleep study

AUTOMATIC · Post by **AUTOMATIC** » Wed Jan 19, 2005 10:18 am

Wader,
What is happening is the sleep lab community is screaming louder than that of those who preach logic. You have physicians, clinicians and big money backing those who lobby in Washington. They are not interested in saving money. The system needs to be fixed. Just doing a one night titration study with pulse oximetry could rule out the need for a full polysomnagram. We would at least be saving 50% of what is being paid out now. About 10 years ago we were doing in home studies. I believe that these gave a clearer picture as to what was going on. Having read a few of the forums the common thread is lag time between availability of studies and equipment setup. Mean while the poor patient is still suffering, probably getting discouraged and second guessing the viability of treatment.....Automatic

chrisp · Post by **chrisp** » Wed Jan 19, 2005 10:43 am

Perhaps they should read their own magazine http://www.sleepreviewmag.com Click on Search past issues . july /August 2004 Advantages of home testing. Sorry the direct link is broke.

Yea, I agree its all about protecting their turf. Who owns the sleep labs?Doctors or at least they get a kickback.

Chris.

wading thru the muck! · Post by **wading thru the muck!** » Wed Jan 19, 2005 10:52 am

Here's that link:

"Advantages of Home Testing" from http://www.sleepreviewmag.com

AUTOMATIC · Post by **AUTOMATIC** » Wed Jan 19, 2005 10:54 am

Chrip,
Hospitals own a great many sleep labs. They are also owned by private companies, physicians and share holders. I believe they are necessary for the more thorough diagnosis. Just seems reasonable to do initial consult in ones home where they can be more comfortable at a less expensive cost. This would also be a good time to educate the family on OSA with dvd/videos and pamphlets. Will continue to work at cracking this egg. I believe we will have reform and that the industry is going to witness a fantastic leap in technology. You all are the front runners to this. Keep on yaking and getting the word out.....AUTOMATIC

chrisp · Post by **chrisp** » Wed Jan 19, 2005 11:15 am

One more thing. Some are still of the mindset that sleep apnea is a "old persons " problem. I'm not "old" enough or "disabled " or indigent enough for medicare or medicaid. So it comes down to paying out of pocket or insurance. I think the insurance would love it due to lower costs. The holdup is the sleep labs and Drs. It cuts into their profits and prestiege. Boo Hoo.

We have people from all over the world on this forum. Seem to have the same problems no matter what method they have to pay. Ignorent Drs. Sloppy DMEs and a big insurance paper push weather you call it NHS , Medicare or private insurance. It shouldn't cost several thousand $$$ to purchase thru insurance what I ca get for less than $$1000 on the internet by private pay. We're all getting ripped of since we all pay taxes or insurance premimums.

Cheers,

Chrisp

wading thru the muck! · Post by **wading thru the muck!** » Wed Jan 19, 2005 11:28 am

chrisp said:
It shouldn't cost several thousand $$$ to purchase thru insurance what I can get for less than $1000 on the internet by private pay. We're all getting ripped off since we all pay taxes or insurance premiums.

Everyone needs to realize that going with a more expensive provider because "the insurance is paying" is not saving anyone any money. This is one of the reasons insurance premiums are astronomical. And don't say "I don't care it's my empoyer paying for the insurance premiums." The total cost of employing you is figuired into the value of the work you do, hence more money for insurance, less money for wages.

AUTOMATIC · Post by **AUTOMATIC** » Wed Jan 19, 2005 11:43 am

Several years ago I was called to set up a high ranking airforce guy on cpap. He expained that the military medical community and reimbursment group ie. your tax dollars wanted to do surgery first. After months of suffering and a slow healing process it turns out that his apnea had not abated, so back to good ole cpap. Turns out he had developed so much scar tissue that the cpap no longer worked either. Moral of the story The government ended up paying out the yin yang, lost a good soldier to medical discharge and still has not learned from its mistakes. If your car doesn't start check the battery don"t do an engine overhaul...AUTO

rested gal · Post by **rested gal** » Wed Jan 19, 2005 11:59 am

hi Automatic,

You wrote:!

Just received an up date from Medicare Coverage Advisory Committee and they specifically stated that there will be no reimbursement for in home sleep studies at this time.

Sorry to hear that. Last year, after following a link on Binarysleep.com (where I just lurk-read) I had "waded through" quite a lot of the public comments at the medicare site. Clinics and doctors were indeed putting forth a full court press to prevent Medicare coverage for in-home studies. Too bad. Thanks for the update.

Guest · Post by **Guest** » Wed Jan 19, 2005 2:50 pm

chrisp wrote:We have people from all over the world on this forum. Seem to have the same problems no matter what method they have to pay. Ignorent Drs. Sloppy DMEs and a big insurance paper push weather you call it NHS , Medicare or private insurance. It shouldn't cost several thousand $$$ to purchase thru insurance what I ca get for less than $$1000 on the internet by private pay. We're all getting ripped of since we all pay taxes or insurance premimums.

Not everywhere. In Australia, my sleep study was not expensive. Because I had private insurance, I had the choice between waiting three months for the public hospital and paying $50, or waiting four weeks for the private hospital and paying $80. You could argue that that still means that the Australian system is bad because of the long wait-time for the public hospital, but your comment above was talking of expense, not wait-time. And there was absolutely no hassle about whether or not I would be allowed to have a sleep-study done; I was referred to a sleep specialist, she heard my history and immediately said I should have a sleep study done.

The expense for me was in the machine + mask + humidifier, which came to about $1500 altogether, of which the private health cover was willing to rebate $500, but I don't think there was any price-gouging going on -- the machine itself was about $1000, and judging by comparative prices on some of the Australian internet sites, that's par for the course for a basic machine, in Australian dollars. And even if it wasn't, the great service I got would make the extra price worthwhile.

wading thru the muck! · Post by **wading thru the muck!** » Wed Jan 19, 2005 3:04 pm

Guest said:

In Australia, my sleep study was not expensive. Because I had private insurance, I had the choice between waiting three months for the public hospital and paying $50, or waiting four weeks for the private hospital and paying $80.

What was the actual cost of the sleep study? Not $50 or $80, that is just the portion that you are paying. Somebody else is paying for the difference which could be thousands of dollars (Australian or otherwise)

The $1000 AUD you paid for your "basic" machine is about double what they are selling for on cpap.com in AUD. It's great that you are happy with the service you received. Many pay these prices and more and get poor service. Consider yourself half-lucky.

In home sleep studies a no go.

In home sleep studies a no go.

Wader thanks for sleep solutions article

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