Is this out of line?

[jonquiljo]

Hi all - I am new here, and I will start with the fact that I just received my bill for a "take home" (Respironics Stardust II) sleep test. I was billed $3200!!! You can buy the machine for that much money! I live in the USA, and I know our system rips us off, but this caused more stress than having sleep problems!

Has anyone heard about anything like this??? Thanks.

(once I get past this I have some questions about apnea and cpap, though I have used machines off and on since 1997)

[OutaSync]

Wow! That's crazy high. My overnight in the Sleep Center was $1200.

Bev

[jonquiljo]

I kind of thought so. I wonder about these people. They billed my insurance company for $3200 - which made my portion of it about $1000. But even $1000 seems a bit much for using 1 night of a machine that can be purchased for only $3200.

No wonder the US is such a mess with health care!

With a Dr. that bills like that I am not sure I can trust wast they want me to do. Maybe it's better if I took the study results and went to another sleep Dr.?

[LSAT]

The best CPAP machine can be purchased for A LOT LESS than $3200. Because they are billing your insurance for $3200 doesn't mean the insurance company will pay them that much. They may only get paid $1500.

[Tired Linda]

I had my sleep study and titration studies in July and August. They were about $2800 each, so I don't think your're really that far off.

Linda

[Tired Linda]

Whoops, I just re-read your post and see you had in-home. Both of mine were at a clinic.

[Sillyme]

If it was a 'take home test' I would imagine that the data was captured by the machine and read by a technician who didn't have to monitor you all night. Should have been way cheaper than an overnight at a sleep center. Guess we should ask about costs and co-pays but I didn't think to do it. I have Aetna and fortunately they covered it 100%. I never saw the bill. I was surprised that you can't buy a machine without a prescription, though I did see some on Craig's list.

[roster]

I kind of thought so. I wonder about these people. They billed my insurance company for $3200 - which made my portion of it about $1000. But even $1000 seems a bit much for using 1 night of a machine that can be purchased for only $3200.

No wonder the US is such a mess with health care!

With a Dr. that bills like that I am not sure I can trust wast they want me to do. Maybe it's better if I took the study results and went to another sleep Dr.?

Talk to your insurance company about this and then talk to the business manager of the medical practice.

One thing we need to learn in this country is to demand to know how much procedures cost before we agree to have them done. My family does it every time now, even for small things. It can be very frustrating because you will often be told, "We don't know until you have the procedure and the computer creates the bill." That bull crap does not fly with me anymore. When I get it, I immediately call the business manager and dig the answers out before I have the procedure done.

It works the same for prescriptions. I ask the doc, "How much does that drug cost? Is there a generic? Give me the prescription on paper because I will shop around."

We should not be letting these medical professionals off the hook. What other types of services (dry cleaning, house painting, lawn care, massage, wedding photographer, auto repair) do you agree to have done and wait until it is done to see how much they bill you??? None! Medicine should be treated the same.

[jonquiljo]

The sleep Dr. charged $3200 for the test and the insurance marked it down to $1000. I have a high deductible, so I owe the $1000. But even a $1000 seems a bit much. When I picked up the unit, the secretary said it would cost me $200 - but she was about 15 years old and I don't think she knew what she was talking about.

I will call them and ask them if they charged me for an "in-facility" sleep study or a home study. I bet they messed up and charged for the "in facility". If not, they are a rip off - and I don't think I could trust the Dr. who runs the place if that were true.

I mean I will live if I end up paying the $1000, but I don't think I could trust a Dr. who could try to charge that much. They also wanted me to use a DME company that they worked with, and it made me awfully suspicious. Since I have had cpap machines before I knew I could get one anywhere - especially since my insurance would never pay for it.

[Sillyme]

Since I have had cpap machines before I knew I could get one anywhere - especially since my insurance would never pay for it.

Where do you find a new unit for sale without a doctor's Rx? The ones I've seen online say they need one, though the masks don't seem to.

[kempo]

I got my bill yesterday. This is after paying $300 up front because I had not meet my $500 deductible.

Total Charges: $4,119.30 Payments Adjustments: $4,110.35 Balance Due: $8.95

I can't believe my insurance paid that much.

[chunkyfrog]

My sleep study and titration were in the sleep lab; and ran about $1100 to $1200 each.
My lab is also my DME. They sell ResMed products for about 20 - 30% above online pricing;
and complain that they don't make money except on the sleep studies.
It is good we are comparing prices.
It would be tempting to start talking spreadsheet;
but I suspect LOCATION is an overwhelming factor on price structure.

[Emilia]

LOL--- I just checked my account page on BCBS Health Options, and the sleep titration alone was billed for $5,034.01 (have no idea what the penny was for), and the amount allowed and paid was $1,468.50. The sleep study itself was billed $5,128.19, and the amount allowed and paid was $598.91!

I have no co-pay or deductible so this was all covered. I assume the hospital sleep center writes off the amount not covered.

These amounts are just crazy..... amazing.

[jonquiljo]

Where do you find a new unit for sale without a doctor's Rx? The ones I've seen online say they need one, though the masks don't seem to.

Oh no, the Dr wrote me a script - then the office "suggested" I go with the DME company they tend to work with. My insurance (as you can tell) is crap as I have an individual policy in California which is one step better than being uninsured (and I pay about $5K a month for the privilege) - but that's another story. So they wouldn't pay for a machine. I just didn't see an advantage going with a local DME charging twice the Internet price if all they gave you was easy service. I could buy another machine for the price I'd pay to get easy service. I therefore bought it on the Internet for a decent price. I didn't want to spend much because I was not yet sure I would do OK with cpap after my experience with it in the late 90's. Boy has equipment improved! I will get into that in a bit.

It does seem that if my insurance company "allowed" $1000 - then they were billed for an in house study. There is no way they would allow that much for a take home test. I'm definitely going to call the sleep center office tomorrow.

Grrrr. It gets me really jealous that you all seem to pay a few dollars for your sleep tests. You must have group coverage. Here in the San Francisco Bay Area they overcharge medicine just a little bit - not nearly to account for the differences I am hearing. I had a cardio stress test about a month ago (stress echocardiogram) and it was "allowed" at around $650 - so allowing $1000 for a take home ipod with a nose tube seems excessive.

[Janknitz]

Billed prices for providers, procedures, and DME are basically works of fiction. It makes it very hard to 'shop around and understand what your out of pocket costs will be before receiving medical services.

Insurance companies set the rates they will cover with each provider, and depending on their contract with you, you may only have to pay the difference up to and not above the rate set by the insurer. Sometimes you may have to pay over and above the allowable rate, so it's good to know this beforehand and find out if you can do better with a "preferred provider". Of course, you have to figure the deductibles in there as well. I'm not sure you can blame this physician or sleep lab, it's a game every provider plays. But it still stinks!

The real people who suffer are the uninsured. They don't have an insurance company to negoitiate for them and often have to pay the full amount the provider charges. Providers who will accept only 20% of the charged amount from an insurer will hold a private party's feet to the fire for the entire amount. This is so screwy!

It's important to check the bills carefully. Years ago I read an article that did an audit of hospital bills and 100% of the bills were WRONG. Not 90% or even 99%. One hundred percent!!!!!!!!!!!!!!!