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Switching Sleep Clinics


Posted by Michelle P on January 10, 2001 at 09:45:12:

I have an appt. later this month for my daytime sleep test. (I have already had my night sleep study and my titration and have been on CPAP now for 2 months.)

I just received stuff from my insurance company that has me freaked out. The ball seems to have been dropped three times resulting in much expense.

First, it seems our ins policy has changed, and we were not informed of the changes by my husband's step-father who takes care of all that for the family business.

Second, I dropped it by not talking to the insurance company myself. All I can say in my own defense (and stupidity) is that we have never been limited to particular doctors or hospitals in the past, only pharmacies. I also did not know about the changes, and was aware the sleep clinic would do a precertification prior to my sleep studies to make sure it would be paid.

Third, the ball was dropped by the sleep clinic. They conveniently forgot to mention after they had done the precert that the insurance company would only PAY 50%!!!! This is because their hospital is not on their list. (Definitely a new list, as there didn't use to be one, and I have used this hospital in the past with the same ins co. and no problems.) I think it was pretty low of them not to inform me of this.

There is a sleep clinic at another hospital that my ins co will pay 80%. I guess I'll need to switch. My question is this....are they likely to make me start all over, or is there a good chance they will just get my records and pick up where we left off? Has anyone else switched in midstream for reasons other than wanting a new sleep study from someone else?? Did they make you redo everything?

Obviously if I'm wanting to switch for financial reasons, it would be pretty stupid and expensive to start over. It appears that due to the 50% we are stuck paying, I am already in some very serious debt!!!!

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