Hello all,

As stated this is the first time I am having to deal with insurance companies, as I am 25 years old and have never needed to prior. Im severely freaking out because my surgery coordinator told me I had to do a sleep study and she reassured me after looking at my explanation of benefits that it would be covered under insurance. Well today I got the claim alert from Aetna saying for the two nights it cost $14,000 and the portion I owe is $11,000. I have a $500 deductible and $2000 out of pocket max. For $14,000 I would have gone to Mexico! Because I am young and naive I was hoping anybody with education or experience in the area could help me proceed to fight this claim. I am super scared right now because I have no idea how to come up with this kind of money.

Thanks

Whiskey Tango Foxtrot?!?!?!

My sleep study was only one night and was ($800) paid by Aetna. Something stinks in Denmark and it's not the cheese! I'd recommend investigating this further.

It sounds like something is incorrect on your statement. I wd def call your insurance. If you have a $2000 max annual then you should not have to pay no more than that period. I have a in network annual max out of pocket of $2000 and $4000 out of network. Even with your copay's and deductibles it should still be part of your max out of pocket amt. I have recvd similar statements in the past where it showed what was billed and showed the insurance did not pay anything and I start to freak out then see a tiny blurb on a different part of the statement reflecting the doctors office/ whoever is doing the billing did not get a preauthorization and therefore insurance nor I was responsible for the bill, it even went so far as saying I was not to pay that I did not owe the amt.

I paid the same $800 with cigna. I have had 2 sleep studies and a wakefulness maintenance test which entails staying up for 8 hrs in a lazyboy with no tv, watch, clock, or anything to keep you occupied. Also in a very coooold room with the lights really dim. Luckily I am not one of those kinds of people that sleep all the time.

I know that I have to go take one more sleep study in order to get off the machine. I been on it for 3 years and it has maybe 20hrs use total lol.

I am going to call the sleep center tomorrow and ask them how they justify that much. Im hoping since insurance paid them 1500 both times and I paid 500 deductible both times they decide to be nice and waive it lol.

Wow - my sleep study was 1400 and then the CPap was another 1700. Of course I hate the machine and while I try to sleep with it it always is off by the time morning rolls around. I do have to bring it to the hospital.

I have a Resmed auto vpap 25. I paid around that too. My insurance wanted me to rent it for $500 bucks a month for 5 months then they wanted me to pay the copay to purchase it. I asked them if they thought just cause I was from louisiana that they thought I was crazy. Its not logical to pay over 2500bucks for a 1600 dollar machine. I said that I will just pay cash thank you

LoL

Hi,

Oh gosh! I had the same problem and I freaked out. The claim is not a bill. I called my insurance company and they said I did owe the amount for the 1st sleep study which was $3800. So then I called the sleep study center and they insured me I wouldn't owe that much. I was still unsure about the whole situation until I got the actual bill in the mail. I ended up owing $230 and my insurance paid about $340. It was such a relief hope this is the same situation your in.

P.s. I have the cpap now and I hate it. I too always wake up to find its off my face and wonder how? And when? Lol.. just hope to get use to it because my insurance I monitoring it with a memory card in the machine.

I have Cigna and paid just over 200 for my sleep studies. I also have the same issue of when I go to bed the mask in on and when I wake up it's off. They are also monitoring mine with a sd card.

i just recieved my bill for my first night (sleep study). The office billed my insurance company 3500. The insurance copany paid all but $30.00. By the way I have Aetna. So I agree with everyone else that what you recived was just the insurance claim not your bill. Your bill will specifically state what was billed to the insurance company and what was paid by the insurance company, and of course what is remaining to be paid by you.

I am going to call the sleep center tomorrow and ask them how they justify that much. Im hoping since insurance paid them 1500 both times and I paid 500 deductible both times they decide to be nice and waive it lol.

Did you every get this resolved with your insurance company? I am dealing with the same problem myself. Just saw a claim come through for $6900, insurance says "You may owe provider $6900" on the claim listing so I am freaking out BIG time! I realize this isn't the final Explanation of Benefits but I am very concerned!

I was diagnosed with mild sleep apnea after having the initial study done. I'm supposed to go back this weekend for a second round to be fitted for the mask. I told the center they need to sort things out with insurance and find out what I'm going to pay out of pocket for everything in total before I go out there again!

Did you every get this resolved with your insurance company? I am dealing with the same problem myself. Just saw a claim come through for $6900, insurance says "You may owe provider $6900" on the claim listing so I am freaking out BIG time! I realize this isn't the final Explanation of Benefits but I am very concerned!

I was diagnosed with mild sleep apnea after having the initial study done. I'm supposed to go back this weekend for a second round to be fitted for the mask. I told the center they need to sort things out with insurance and find out what I'm going to pay out of pocket for everything in total before I go out there again!

Yeah, I got way too worked up! For me they accepted whatever the insurance company paid them and never billed me for anything! My total out-of-pocket expenses for the sleep study was just the gas to get there!!! Don't worry about it and just call the sleep center and ask them how they do their billing after they are paid from insurance.

Oh, and im going to take a wild guess and say you went to Mid Cities Sleep Center also. So no worries they rock!

Oh, and im going to take a wild guess and say you went to Mid Cities sleep Center also. So no worries they rock!

No, actually I went to Sleep Therapy of North Texas. It was OK but I was a little put-off by the tech who connected all the wires. He was a nice enough person but was a mouth-breather and had some serious halitosis! Not a pleasant combination to have when in close quarters to someone like that. Also, just a personal preference but as a female I would have preferred to have a female tech instead of a male!

BTW - Just saw an email from the scheduling person that after the second sleep study (this weekend) I'll have the option to purchase the CPAP/mask. It will be $322 and I can pay $25 up front and then I can pay the balance in 6 monthly installments. She also said the billing person should be contacting me to discuss the insurance claims. (Fingers crossed!)