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Is 2nd hospital stay necessary?
#1
Ok guys, had the sleep study done in hospital. They determined I had 45 episodes an hour. Now they want me to come back for another night to determine pressure settings, but after getting the bill from the hospital today saying I owe nearly 600.00 after my insurance has paid and I have met my deductible for the year, I'm wondering if there is a cheaper way to do this. Any thoughts?
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#2
Hi Newbie Granny,
Most of the sleep clinics will do a split study, with the first 4 hours to determine if you have SA. And the second part of the night is for titration to determine pressure settings. A lot of times, the patient doesn't sleep enough during the first half to be able to do a titration during the second half, so they have to have you come back.

The only other way would be an overnight home study, but your insurance may not pay for that since you've already had the first sleep study done.

You need to call your insurance company and find out exactly what is covered for the titration.

OpalRose
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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.




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#3
First, ask for a copy of the first study report. Find out what type of apnea was observed.
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.
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#4
Hi Newbie Granny,
WELCOME! to the forum.!
When I first got started with my treatment in 2008, I had to go back for two sleep studies because I didn't get to sleep in time at the first one,so I had to go back for the second time to be fitted with a CPAP machine and mask.
They were able to tell me that I had moderate sleep apnea on the first study, though. The second night was for the titration.
Hang in there for more suggestions and answers to your questions and much success to you as you start your CPAP journey.
trish6hundred
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#5
Hi Newbie Granny and welcome

Depend on the diagnoses, for just obstructive apnea, doesn't matter whether severe or mild (not central or complex apnea) ... sleep lab titration is not necessary and at times they don't get it right

An auto PAP, example "AirSense 10 AutoSet for Her" or Phillips Respironcis System one Auto 560 can do the job
Clinical manuals/setup information/software are available

Having said that, doing it alone is for someone who is going spend a lot of time figuring things out and making adjustment
Not for the faint hearted

Good luck
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#6
If you are on Medicare or Medicaid and your sleep lab accepts assignment, not to worry, it will be covered and you will pay 20%. If it isn't covered, you will pay nothing since the error is theirs.

It doesn't sound like you have Medicare though since your portion of payment seems too high. My sleep lab cost me $3,453.00 and Medicare paid the lab $355.53 and I was billed for $90.70 for my portion. Since they accept assignment, the remainder is written off.


If instead you have conventional insurance, you should check with them to verify coverage of a titration session. They may consider your doctor to be able to provide that service without a sleep lab study.

Dude
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#7
(09-24-2015, 08:09 PM)Newbie Granny Wrote: Ok guys, had the sleep study done in hospital. They determined I had 45 episodes an hour. Now they want me to come back for another night to determine pressure settings, but after getting the bill from the hospital today saying I owe nearly 600.00 after my insurance has paid and I have met my deductible for the year, I'm wondering if there is a cheaper way to do this. Any thoughts?


Knowing what I know now, if your only issue is apnea, I think you would do just as well with an auto machine and Sleepyhead to determine a best pressure given the cost. In my case, it wouldn't have helped because I wouldn't have known that my oxygen stays only at 91% no matter what pressure is used - however, I knew going in that I had a slow heart rate. If you DON'T feel better after some months, you could always required a titration to relook at your situation. Talk it over with your doctor about options. I'm sure you aren't the only one who has a financial issue.
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#8
Without a Dr. writing a prescription you may have to pay all out of pocket for a machine and all that goes with it. Most insurances will not pay without the prescription and a machine and mask cannot be purchased without a prescription.
For free Medicare assistance for your state check out this page. http://www.seniorsresourceguide.com/dire...onal/SHIP/
or here http://www.medicareinteractive.org/
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#9
It's not really necessary, but it's not necessarily a bad idea anyway.

You're probably stuck because the medical mafia will probably refuse to write a prescription without an in-lab titration.

If instead of an in-lab titration, they sent home a fully data capable APAP machine, they could send in the SD card or use the wireless modem. They could then read the results, set a pressure, and monitor long time. If there are problems, they could always do an in-lab titration on those with inconclusive or problematical results.

It would save a lot of money, and probably work much better than the current standard of $leep te$t, in lab titration, ignore in-home data.

I also see little reason other than profit that they don't start every patient off with a split night study if you get enough sleep.

Unfortunately, the medical mafia protects their profits and hold you hostage for a second test before you can get a prescription.

BTW, be sure the $600 is right. Medical providers often send high initial bills that are then knocked down by the insurance company. Be sure you've got the final EOB statement from the insurance company before you pay the hospital. The medical providers almost never send you a note when they figure out they've been overpaid, and even when you catch them, it's like pulling teeth to get the money back.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#10
OP posted in another thread "Do my titration session in a couple of weeks", wishing her the best of luck

After I had my sleep study, they gave me options to to have titration done at the hospital or at home, I chose the hosp
Had I known what I know now, might done it home, but then, didn't knew a thing
When I learned few things, wondered what was the all fuss about
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