sleep study last night..probably going to have to pay for it

KayleighsMommy · April 29, 2008

Oh, man...that sucks!!!! I thought I was the only one having problems with the sleep test issue. I was told that if I DO have apnea they will pay for it, though now I am wondering..... :cool2:

What kind of crapppy insurance (And isn't BC/BS supposed to be the best???) Won't pay for a test that is common (it's not like we are having some back room, off the wall test done) that can be potentially life saving???

Geez....:coolgleamA:

KayleighsMommy · May 1, 2008

They got my sleep study results back. They said I have mild sleep apnea. The only reccomendation was for 1 liter oxygen flow while sleeping <sigh>

Not only am I probably going to end up paying for the test (I'm just assuming..since I was only labled "mild") this in probably not going to help at all when it comes to my insurance (hereafter known as "those lousy cheap bastards") paying for the lapband.

I am so tired of worrying about this. :smile:

alegna242 · May 3, 2008

Well, I'm glad it is mild, however I am still puzzled on why your on O2? Are you anemic? did they mention anything about Pickwickian syndrome? Try to find out your AHI. and PM me. Thats your apnea hypopnea index. I am interested in knowing what it is. Where I work we would take care of the apnea first, even mild to avoid O2 every night.

Tamihott · May 3, 2008

I spoke to bc/bs il and asked them about the sleep study denial. They said it was billed out with a diagnosis of Hyerpsomnia not sleep apnea. I had to call the hospital dr office etc and have them write up a referral just in case, and change the diagnosis. They are also going to send a hard copy of the report just in case. Lets hope all goes well. The ins co told me if the diagnosis was sleep apnea it was covered. I would say mild or severe it should be covered. Good luck

KayleighsMommy · May 3, 2008

Well, I'm glad it is mild, however I am still puzzled on why your on O2? Are you anemic? did they mention anything about Pickwickian syndrome? Try to find out your AHI. and PM me. Thats your apnea hypopnea index. I am interested in knowing what it is. Where I work we would take care of the apnea first, even mild to avoid O2 every night.

OK...I'll see what I can find out. I am quite unhappy, not that I want to have severe apnea...I have all the symptoms. I tend to have a lot worse time on my back (as most people do, I know) and I was never observed that way. I wake up more often than not with chest pain...that leads me to believe there is an issue. I will PM you if/when I get the results. julie

Tamihott · May 4, 2008

Alegna,

Since my dr office has not called me yet to discuss what the actual test results mean, maybe you could help me figure it out. My hypopnea index was 33.9. Impression Considered positive for severe sleep apena with significant amount of oxygen desaturation and sleep disruption. The longest recorded hypopnea was 27.4 minutes in duration. The patient had 129 arousals. 120 were related to respiratory events. There were 125 hypopneas. I think it does not sound good, but maybe you could help. Thanks Tamara

Tamihott · May 9, 2008

I just found out that Bc/Bs il paid for my sleep study. My portion was 150.00 out of 3575.00! I am soo relieved. I just find it hard to believe that including the reading of the report the total is over $4000.00 no wonder insurance premiums are soo high!

alegna242 · May 13, 2008

good, but just to clarify the Doc makes the big bucks- not I :smile2:

Tamihott · May 16, 2008

Thanks alegna for your info I go tomorrow for my Cpap study. Dreading it! Wish me luck!

Weedwoman · May 16, 2008

Thanks alegna for your info I go tomorrow for my Cpap study. Dreading it! Wish me luck!

It was a sleep study and severe sleep apnea diagnosis that gave me my life back, about ten years ago. I had become so exhausted that I could only stay awake an hour or two at a time, and any sleep I had was useless to refresh myself. This went on for over a year before diagnosis!

I WELCOMED that diagnosis. It's great to have a name and a treatment for what had become my dreary life. When the tech brought a CPAP to my house and demonstrated it, me laying on the couch and feeling incredibly foolish to need this contraption with a mask, humidifier, and tubing, I wondered what was happening to my routine and tried to imagine the changes. I read somewhere that 80% succeed with CPAP and "tolerate" the treatment. And I was bound and determined to be one who succeeded! I was --desperate -- and was willing to tolerate almost anything to improve my life.

A few tips: try a meditation or relaxation tape while wearing the mask to fall asleep. Soft music is another alternative. Anything to ease you into a new pattern, and distract you from any discomfort. Consciously doing deep breathing helps too -- and a new nightgown and soft pillows.

My machine has gone around the world with me -- Nepal, Europe, England, all over the US and Canada, Equador, Costa Rica... in short, it's a big deal for my life, no big deal to travel with and fit into my life. It basically saved my life, and gave it back to me.

Good luck.

Weedwoman

KayleighsMommy · May 30, 2008

I have not seen the EOB yet, since I am in MI (we finally sold our house here), but my husband told me we got the EOB from BCBS/IL for my sleep study... and it appears they paid it. Yayyyyy. He said the hospital billed $3400.00, $1650.00 was paid and $1750 was not. It says amount you may owe: 0. I feel sooo much better about this. Now I just have to wait on the approval (or, I suspect , denial, for the lap band) I will go ahead and schedule the procedures (the hernia repair I badly need, and the lap band I will self pay for on that portion of the surgery) <sigh>.....We really can't afford $5500 out of pocket... but I am NOT going to go through 2 surgeries. :thumbup: