RE: Cost of sleep study - Humana
(08-02-2018, 04:56 PM)sheepless Wrote: but if you want a prescription from them and you want to run it through insurance they'll likely require a night in the sleep center for titration. at least that's how it worked for me with premera insurance.
It seems there is a lot of variation in how different insurances handle xPAP. After doing the home study, I saw a Pulmonologist who wrote my prescription for an APAP.
08-05-2018, 10:59 AM
(This post was last modified: 08-05-2018, 11:02 AM by fs12.)
RE: Cost of sleep study - Humana
I also have a high deductible plan. I've done two sleep studies and had to pay them both out of pocket. I'm with BCBS, so your mileage may vary.
First Sleep study charge was $2150 and I paid $1099 after insurance adjustment.
Second Sleep study charge was $2320 and I paid $1155 after insurance adjustment.
So about half on each of them. The second one was a bit more expensive because it was a titration study.
And of course, when I asked the lab if it would be covered, they said - yes 100%! But I forgot that did not mean I wouldn't have to pay my deductible, so it was a bit of a rude awakening on my end... Most expensive hotel room I've ever had, but I think it was totally worth it.
Hope this helps!!
RE: Cost of sleep study - Humana
Well, today we finally got the report from the home study. Mild OSA with an AHI of 11.9. They want to schedule a titration lab study, and when I protested that we were hoping just to get an APAP and go from there, they said the study says he is not a candidate for an APAP because of significant hypoxemia (SPo2 less than 90% for 14.4% of the night). Does this sound right to you guys?
09-18-2018, 04:55 PM
(This post was last modified: 09-18-2018, 05:02 PM by Sleeprider.)
RE: Cost of sleep study - Humana
Mild AHI and severe hypoxemia is very possible with severe flow limitation that does not show up as apnea. I think the titration study is a good idea, especially if you can discuss it ahead of time to try bilevel. Read this wiki
http://www.apneaboard.com/wiki/index.php..._and_BiPAP
APAP would be a great choice for obstructive apnea, but it may not be ideal when AHI is low and hypoximia is high. I would go for the study and ask the doctor if they will look at bilevel treatment or if it is a simple CPAP titration. You want the study to specify to proceed to bilevel if SpO2 is less than 92%. Resolving apnea, but not solving the low blood O2 levels is unacceptable. Make sure the doctor has ordered a study to ensure SpO2 objectives are met. In other words, you should support your doctor's order for a titration study, provided that study evaluates CPAP and moves to BiPAP if oxygen is not good. Without this specific order, the technicians will only do a CPAP titration until apnea is resolved.
RE: Cost of sleep study - Humana
I'm jealous of the prices posted. My first sleep study:
$6117.00 with Cigna discount of $1835.10. Had to pay $1993.20 out of pocket since I had to meet my deductible. Insurance covered 75% once my deductible was met.
Slightly more for the second sleep study since it was with the cpap machine. Doctor billed separately too for what I assume was reading the results. Those two charges were $2000 but most was discounted. So all in all, was billed a total of around $14,500 for two sleep studies. DME charged $3500 for my Resmed Airsense 10 with humidifier.
The US needs some serious healthcare reform.
RE: Cost of sleep study - Humana
Holy cow, Fozzy! I was told 2,700.00 for the in lab study not counting any Humana discounts. I got the EOB today for the home study - they billed 700.00, and about 250.00 was written off. I agree about US health care. This is not sustainable...
Sleeprider, thanks so much, that is great information to have!
RE: Cost of sleep study - Humana
HIPAA (federal law) give you the rights to your records. They cannot be ransomed for another appointment. Here are your rights:
https://www.hhs.gov/hipaa/for-profession...index.html
Here is how to file a complaint online
https://www.hhs.gov/hipaa/filing-a-complaint/index.html
Many lawyers would enjoy talking to you if you follow these steps and don't get a response.