Sleep study charged my insurance SEVEN THOUSAND DOLLARS

[DougNichols 124]

That's gotta be a ripoff, but it's appearing in my insurance claims.

What did everybody else's sleep study charge their insurance providers?

[MINI-Me 196]

What's charged and what's allowed are completely different things.

Also - what was included in the charge? Was it the night in the clinic, the 8 hour monitoring, the equipment, the results and the reading?

[klus263 9]

The sleep study is crazy....I had to do 2 as the first one showed a mild case and then I had to do 2nd night to sleep with a machine. Each was $1600, insurance approved $1100 then the cost of the machine was extra. My insurance requires a rental over 6 months. I had it for the compliance for the doctor's office and had it at the hospital....surgery was done on Dec 1st. This machine goes back Monday.....I am not paying another deductible on this.

[DougNichols 124]

What's charged and what's allowed are completely different things.

Also - what was included in the charge? Was it the night in the clinic, the 8 hour monitoring, the equipment, the results and the reading?

That was the night at the clinic, alone. Doctor's consult afterwards was different. I think they tossed a high number at the insurance company, to see what they would pay.

[Becca 108]

The medical bills really are out of control. If you think that is bad, try a 20,000 bill for an emergency room visit I had earlier this year. When my lapband broke in half, the broken tubing settled in my right lower side and got infected. I didn't know that is what happened. The ER doc thought I had appendicitis and so he ran all these scans, bloodwork, and ultrasounds. I can't even imagine going to the ER without insurance. Very scary!!!

[TexasTeacher 7]

Hate to tell you, but that is accurate. Mine was 7-something, as well. I can't recall exactly what the insurance paid, but it seems like it was in the 5,000 neighborhood. It can be worse, though, my son is an insomniac and a pediatric sleep study is 10,500. Thank heavens for insurance!

[BlackBerryJuice 349]

That's ridiculous! I lived in the US for a while, and one time I got a doctor's bill by mistake (it was supposed to go to insurance) - was shocked to learn that my visit for a stubborn sore throat had cost $1200! That didn't include a SINGLE test, either! I think here we bill the government about $50 per visit, depending on the province.

I blame the lawsuit culture in the US. I was blown away when I found out how much docs pay in malpractice insurance there (upwards of $250,000/yr for a young doc with no lawsuits on record). Here it's only about $2000-3000 a year, no more than $25,000 in high-risk specialties like obstetrics. It's very hard to sue a doc frivolously here.

[Firefly2 9]

yep my place charged the insurance company $7000 too..... i was livid when it showed that my portion was going to be about $2500 but the manager at the sleep study place told me that they were writing off my portion and not to worry about it.

[DougNichols 124]

That's just insane.

[Brother J 11]

It is correct, insurance companies generally pay usual or customary fees instead of what is billed. I paid cash for my surgery and the hospital told me charges were $33,000. I dickered and finally paid about $12,000. The surgeon wouldn't dicker and I'm sure I paid more than what insurance would pay the surgeon. Since I have so many health problems, I was very picky about hospital and surgeon but it did cost a lot. If I didn't have so many problems from my obesity, I definitely would consider a foreign surgeon and location.

[Brother J 11]

It is correct, insurance companies generally pay usual or customary fees instead of what is billed. I paid cash for my surgery and the hospital told me charges were $33,000. I dickered and finally paid about $12,000. The surgeon wouldn't dicker and I'm sure I paid more than what insurance would pay the surgeon. Since I have so many health problems, I was very picky about hospital and surgeon but it did cost a lot. If I didn't have so many problems from my obesity, I definitely would consider a foreign surgeon and location.

[Cinderella 2]

Gee, why am I not surprised... I was just looking over my bills, and although my surgery itself was $15,000... the hospital charged my insurance company $34,500 for three days in the hospital (NOT including what the recovery room charges were).

This has to be the most expensive hotel on the planet! What do poor people do?

Cinderella

[ThatDudesMom 13]

My insurance was charged for $1600. And of course I had to go a second night (with a mask) so that was another $1600. I haven't seen what they charged insurance for the actual machine yet, but they say my part (20%) will be about $550.

[Bryn 3]

i just got the itemized bill and it was a total of $3,897 that was charged and sent to my insurance company. about the same price when i had another 3 years ago at a different facility. i ended up paying$120 copay

[Jeff Loughridge 1]

I think the whole sleep study requirement is a scam.

I fought having one, knowing I did NOT have OSA. The pulmonologist I saw argued with me, told me I didn't realize I had it, and was in danger of falling asleep at the wheel. Oh, really? I told him I drive 35,000 miles per year, including 18 hour drives to the Keys and have no problems. He balked. I told him I have no symptoms, other than snoring and he insisted I just didn't realize it. Ultimately, he gave me a pre-printed form with all of the symptoms of OSA listed, as if I had them and told me I needed the sleep study. I again told him I didn't have any of the symptoms listed, except snoring, and I was not going to have the study. He stood up, said, "Well then cancel your surgery because I'm not giving you clearance without the sleep study," and he WALKED OUT on me. My father always told me the most important thing a doctor can do to treat a patient is to get their history. This crackpot completely disregarded my history.

I left, called my primary care physician and asked who they would suggest I see. I made an appt, saw the second pulmonologist, and he completely agreed with me. He agreed there is no justification to require a sleep study on someone undergoing surgery to eliminate the underlying cause of any potential OSA, other than it is good for business. He said if post-op SA occurs, use empirical CPAP at a 6 or 7 and see if it helps.

I got my clearance and had surgery.

I specified before hand that I did not want the pulmonologist who walked out on me to treat me in any way post-op. As I'm coming out of anesthesia, who is there but that son of a bitch. The first thing he says to me is why did I walk out on him. I had enough presence of mind to repl, "I didn't. You walked out on me!."

He said I stopped breathing post-op, something not unusual given the quantity of anesthetics used. He put me in IMCU with a CPAP machine which I refused to use. My nurse, an absolute angel, told me the next morning that I had no apnea events all night, not a single one...and I was being monitored.

The morning of post-op day 1 I was moved to the general surgery wing. While my wife and kids were visiting me, his partner came in and spent 15 minutes arguing with me, telling me how irresponsibkle both I and the pulmonologist I got the clearance from were. He didn't examine me at all, just argued. That son of a bitch sent me a bill fot that visit. It isn't getting paid. Both my wife and I again told the hospital staff I did not want to ne treated by either of them.

Day 2 post op I went into Atrial Fib at about 5AM and was moved to ICU temporarily. While there, Who shows up there but the original SOB. He proceeds to tell me I am in ICU and have Atrial Fib because I have sleep apnea. This time I talked to the nursing supervisor and said he was fired. I would call the police if I saw him again. It was as if he was hovering waiting to blame every anomaly on OSA.

The fact of the matter is OSA is responsible for Atrial Fib about 3% of the time. General Sleep Apnea, such as that common after deep anesthesia but with no relation to OSA is responsible about 27% of the time.

I live in fear that this crackpot pulmonologist is going to show up at my front door and tell me my yard has crabgrass and my dog has worms because I have undiagnosed OSA.

I still have his pre-printed referral form with fraudulent symptoms as justification for a sleep study. I am fiing a complaint against him with the state licensing board and hospital administration, as well as notifying my insurance and providing them with his referral form.

As a point of interest, my father was a physician but is now retired and 92 years old. In 1960 he and 3 other physicians sold their private practices and started staffing the Alexandria Hospital Emergency Room full time. Their idea became known as "The Alexandria Plan" and slowly spread across the country. One of his group, Dr. Jim Mills was also a founder and first president of ACEP, the American College of Emergency Physicians. I have been very fortunate being around and knowing physicians all my life and absorbed quite a bit of knowledge. I also know BS when I see it and these sleep studies are BS for someone getting WLS.