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

[KayleighsMommy 16]

I went last night for my "cosmetic" sleep study. I still can't get over the fact the insurance co may not pay for it because they consider it cosmetic (since it's being ordered pre lap band) Darn BC/BS IL.

Anyway, I barely slept. I had about a half hour of REM sleep at the end of the night, the rest of the night I just layed there like a log...an awake log :thumbup: The girl who did it would not tell me what the conclusion was (I fully understand, it's against policy, and she is not a doctor) but, the impression she gave me was that it was OK :sad:

I was really hoping it would show I had sleep apnea. Furst and foremost..it would really help my chances of getting the surgery OK'd (they are waiting on my study results, as well as 5 years weight documentation. Secondly...if the study is deemed medically necessary (I have apnea) the insurance co will pay for it too. Otherwise, I am on the hook for it.

I hope they call me back for another study if this one was inconclusive in any way (I fell asleep pretty quickly, though the tech had to come in and put 0xygen on me before I went into REM, so perhaps that is enough to show a potential problem?) I guess a girl can hope.

[Long2BFree 12]

Just because she said it went okay could mean that she got the results she needed so you won't have to come back a second time. They aren't allowed to tell us how it went as that is up to the doctor when he reviews your study. You will probably know in about a week what your results are.

[KayleighsMommy 16]

Just because she said it went okay could mean that she got the results she needed so you won't have to come back a second time. They aren't allowed to tell us how it went as that is up to the doctor when he reviews your study. You will probably know in about a week what your results are.

Yep...true. I just know she had told me she needs 3 hours of REM sleep (I had about a half an hour) I am just concerned that if she didn't see any problems it will be marked as "no apnea" I really want to be told I have apnea, for insurance purposes (sad, isn't it??? :thumbup:

Guess I'll just have to wait and see.

[Long2BFree 12]

Yep...true. I just know she had told me she needs 3 hours of REM sleep (I had about a half an hour) I am just concerned that if she didn't see any problems it will be marked as "no apnea" I really want to be told I have apnea, for insurance purposes (sad, isn't it??? :thumbup:

Guess I'll just have to wait and see.

I feel your frustration. Just be aware that if you have sleep apnea then you will probably be put on a CPAP machine. My insurance covered the test but not the machine. My machine is a rent to own machine and after I've paid for 10 months of rental it will become mine.

If it's not one thing, it's another.

[Tamihott 0]

I had my sleep study done two weeks ago, as you know I also have BC/BS il. I was like you and kind of wished something would show up. I was not even worried about them paying until I saw your posts. When it was confirmed that I have severe sleep apnea, I was in tears. It is a scary thing that I wish I did not have to deal with. In the long run I am glad that I know and I am sure it will not hurt my approval process, but I could do without. I go back for the CPAP study on the 16th. I dread that I have to wear that mask and have a machine to sleep, considering that I don't sleep well now. You have to have "clocked" soo many hours on it, before that surgeon and anesthesiologist will even do the surgery. Just another thing to wait for. Good luck. Tamara

[Long2BFree 12]

I had my sleep study done two weeks ago, as you know I also have BC/BS il. I was like you and kind of wished something would show up. I was not even worried about them paying until I saw your posts. When it was confirmed that I have severe sleep apnea, I was in tears. It is a scary thing that I wish I did not have to deal with. In the long run I am glad that I know and I am sure it will not hurt my approval process, but I could do without. I go back for the CPAP study on the 16th. I dread that I have to wear that mask and have a machine to sleep, considering that I don't sleep well now. You have to have "clocked" soo many hours on it, before that surgeon and anesthesiologist will even do the surgery. Just another thing to wait for. Good luck. Tamara

It's hard to get used to the CPAP but makes such a difference in how you feel. Make sure you ask the doctor to write a prescription for the humidifier as it will help cut down on dry mouth and also helps blow warm air when it's cold in your bedroom.

[KayleighsMommy 16]

I feel your frustration. Just be aware that if you have sleep apnea then you will probably be put on a CPAP machine. My insurance covered the test but not the machine. My machine is a rent to own machine and after I've paid for 10 months of rental it will become mine.

If it's not one thing, it's another.

How insane is that?????

[KayleighsMommy 16]

I had my sleep study done two weeks ago, as you know I also have BC/BS il. I was like you and kind of wished something would show up. I was not even worried about them paying until I saw your posts. When it was confirmed that I have severe sleep apnea, I was in tears. It is a scary thing that I wish I did not have to deal with. In the long run I am glad that I know and I am sure it will not hurt my approval process, but I could do without. I go back for the CPAP study on the 16th. I dread that I have to wear that mask and have a machine to sleep, considering that I don't sleep well now. You have to have "clocked" soo many hours on it, before that surgeon and anesthesiologist will even do the surgery. Just another thing to wait for. Good luck. Tamara

When I first went in, the tech had me try a couple of different masks (evidently at this place if they notice you have x number of occurances in a 3 hour period they come in and put a CPAP machine on you) There are quite a few different types/configurations of masks, hopefully you will find one that is comfortable for you.

My surgeon requires 2 weeks of CPAP usage before surgery. I am just concerned they will decide I do not have apnea when I do, and there will be an issue during surgery (since we all know that sleep apnea makes surgery more dangerous)

I guess I will just have to wait for the report to come back.

julie

[Tamihott 0]

I was just on the bc/bs il website and was reviewing my claims to see if they had billed out the sleep apnea test yet and was shocked to see that the pulmonologist had already sent in their bill to read the test and they charged $495!!! It is amazing since they were the last ones to call me about the test. I heard from the sleep center and my surgeon within two days of the test, but did not hear from the pulm until almost two weeks later. I asked them if the dr could talk to me and tell me what the test actually means (I have a copy) and she said well he is out of town for another week!!

[alegna242 1]

So the tech put Oxygen on you? not the CPAP but Oxygen? If they put O2 on you then you will come back for a CPAP titration. Unless you have some sort of Chronic Lung Disease (COPD ect.) that is causing your O2 to go down even without apnea.

[KayleighsMommy 16]

So the tech put Oxygen on you? not the CPAP but Oxygen? If they put O2 on you then you will come back for a CPAP titration. Unless you have some sort of Chronic Lung Disease (COPD ect.) that is causing your O2 to go down even without apnea.

Oh, OK...since I needed O2 (within probably a half hour of going to sleep...not even in REM yet), they are most likely going to consider that having apnea of some sort?? Will they still need to do the 3 hours of REM sleep (assuming I understood that properly) With the need for O2 will I most likely need a CPAP?

I am glad we have a trained professional here I can ask questions :smile2:)

[ladyT 0]

Oh, my stars -- I have tried to sleep using the machine, but I simply can't do it! Immediately upon putting the mask on my face to breathe, I suddenly begin to panic (rapid heart beats and fear that I will not wake up). I am going to continue trying to sleep with the mask on my face, as I know that it is there to help me while sleeping -- I just don't care for it. My son heard me snoring so loud and then noticed a long delay before snoring again. He stated that he shook me to wake up and insisted that I wear the mask -- but again, stubborn old me -- I put it on and took it right off. I have been diagnosed with the advanced stages of sleep apnea as a result of visiting the sleep center twice. I know that I am a good candidate for the surgery -- at least I think I am with a BMI of 39 at 5' 0", sleep apnea, and severe arthritis. However, I am no longer working -- do not have insurance at this time, but plan to pay cash for the procedure, as it is well needed. Perhaps I will wait until I have landed another job and then try going through my insurance. Thoughts?

[KayleighsMommy 16]

I was just on the bc/bs il website and was reviewing my claims to see if they had billed out the sleep apnea test yet and was shocked to see that the pulmonologist had already sent in their bill to read the test and they charged $495!!! It is amazing since they were the last ones to call me about the test. I heard from the sleep center and my surgeon within two days of the test, but did not hear from the pulm until almost two weeks later. I asked them if the dr could talk to me and tell me what the test actually means (I have a copy) and she said well he is out of town for another week!!

Wow...that's annoying.

[Tamihott 0]

Just now I was checking the bc/bs il website, as I have everyday to check the status of the sleep study charge and if and when they were going to pay for it. I was diagnosed with severe sleep apnea and they denied the claim stating "this is not a covered benefit", so tomorrow the fight begins. UGHGHGGH. They suck!!

[plain 12]

KayleighsMommy, I'm a registered sleep therapist. If the tech put oxygen on you, then something is going on with your sleep (It may not be apnea...there is a disorder called "Upper airway resistance syndrome" that is kinda like obstructive sleep apnea's lesser-known brother).

Second, If the tech says she needed 3 hrs of REM, she is either 1) lying to your face because she figures you won't know, or 2) an raving idiot. Because normal REM time is approx. 20-25% of total sleep time (the only way you could get 3 hours of REM is if your study lasted around 12 hours, which is a near-impossibility in sleep labs).

Probably, your tech was unregistered and didn't really know what she was doing. PM me if you have any specific questions.