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robdotexe Offline

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Post: #1
Help!
Okay guys, quick question.

I am insured through my job at the county. I went in to gather the take home equipment for the sleep study. I did it and returned it the next day. They wanted to perform an overnight study at their center but I was told my insurance would not cover it so we just did a second take home equipment study again. My results were sent to my doctor, who then recommended me to a medical supply place literally right around the corner from work. How convenient right?!

But that's not the problem. My issue is, I received a bill from the diagnostic place for $825 for an electroencephalogram! I called the company and questioned the large charge; They said it was the bill from the sleep study. I was shocked but was ready to start monthly payments.

Still curious, I looked up what an electroencephalogram was. It is a test or record of brain activity produced by electroencephalography. I took a look at a few Google images to find several patients with electrodes on various parts of their head. I then realized that moment that I was being billed for something I didn't have done! What I had done when I took home both at home tests was wear a finger oximeter and a nasal cannula that connected back to a small, black box to test O2 levels and breathing patterns, nothing to do with brain activity.

I called back to question why I was being billed for something I never had performed. They could not answer me and I was told I would receive a call back. I am still awaiting my call back.

My question to you guys, in your experience with having sleep studies and diagnostics done, does this seem shady to you? Thank you for your time.
10-08-2015 06:12 PM
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DariaVader Offline
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Location: Oregon

Post: #2
RE: Help!
It seems shady to me... but apparently that is how it's done. My home sleep study also came with an eeg charge even tho there was no such thing done. my insurance, however, happily paid the contracted charge for it. (which was no where near as high as yours)

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
10-08-2015 06:15 PM
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DariaVader Offline
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CPAP Pressure: 8-15
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Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

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Post: #3
RE: Help!
By the way, they are not allowed to bill *anything* above the amount they contract with the Insurance... provided you used an in-network provider

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
10-08-2015 06:20 PM
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surferdude2 Online

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CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
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Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #4
RE: Help!
I suspect the person you talked to on the phone told you the wrong term for the home sleep test. The price isn't out of line considering that you got two home sleep tests for $825.

If your insurance is any good at all, they'll pay at least 80% of that which leaves you with only $165 for your share. That sounds like a bargain to me.

I've never had a home sleep test done but I can tell you that the lab test I had was billed at $3500.

Dude
(This post was last modified: 10-08-2015 06:25 PM by surferdude2.)
10-08-2015 06:22 PM
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DariaVader Offline
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Machine: Resmed S9 AutoSet
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Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #5
RE: Help!
I had this charge in addition to the sleepstudy charge. They charged $263 and were paid $210.40. Long way from > $800, but still a separate EEG charge. I wore no leads on my head, so I really don't know how that works!


ELECTROENCEPH. $263.00 $52.60 $0.00 $210.40 $0.00 100% = $210.40 $0.00 $0.00 0248

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
10-08-2015 06:29 PM
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justMongo Offline

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Post: #6
RE: Help!
I recall they glued a single electrode to my scalp. It was an in-lab study; and they can tell what phase of sleep one is in.
As for one with a home study, I do not know.

robdotexe: Did you get a copy of the sleep studies? Best to ask for them.
Might just refer to it.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(This post was last modified: 10-08-2015 06:43 PM by justMongo.)
10-08-2015 06:43 PM
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surferdude2 Online

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Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
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Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #7
RE: Help!
robdotexe, If the charge was in addition to the home study charge, there is indeed something improper going on. You cannot have an EEG performed without electrodes being attached to your head to monitor brain activity.

Dude
10-08-2015 06:49 PM
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DariaVader Offline
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Posts: 1,818
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #8
RE: Help!
hmmm - they are not supposed to do that even when there *were* leads attached. Makes me wish I challenged that harder - even though my Insurance covered @ 100%

http://www.aasmnet.org/codingfaq.aspx
When billing for polysomnography, is it appropriate to also bill for EEG if the EEG is interpreted separately?

No. EEG and its interpretation is a required component of the polysomnogram service, billed as 95810. Billing for the EEG separately would be considered unbundling, which is incorrect coding.

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
10-08-2015 06:56 PM
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surferdude2 Online

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Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #9
RE: Help!
And in the case of the OP, they unbundled something that wasn't even in the bundle! Wink I doubt he hears any further from them about that charge.

I does make me wonder how many times they get away with it.

Dude
(This post was last modified: 10-08-2015 10:21 PM by surferdude2.)
10-08-2015 07:00 PM
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Ghost1958 Offline

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Post: #10
RE: Help!
If you do get billed for something not done tell them they can drop the bill or you will inform your insurance they are being billed for a procedure not performed.
They will drop the bill.
10-09-2015 01:47 AM
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