[4Kate]

Hi I have had the 1st sleep study done and they said I needed to come back for another and to have a cpap machine set. I did what I was told and when I finished the 2nd one I was told that I would get a call from the home nurseing agency. They called today and said because my scores were so mild my ins co will not cover the machine as they do not feel I need it!. I asked her if people with my scores get a machine on there own and she said no. i was 88% before and 92 after. Its only 4 points different. There another score that I didnt understand and I have a 4 and the insurence co says you must be atleast a 5 to even be considered. The machine would cost me $111.00 each month out of pocket. I am waiting for my serg office to call me back but does any one think they will make me get one? The rule is that if you have sleep apnea you must wear the cpap machine during your hospital stay. Only the lab seems to think I have it.

So what do you all think, or has any one has this problem?

[Perfesser]

If the insurance company says you don't have it, then you probably don't meet the "definition" of sleep apnea. Your surgeon is the last word, though. Go with that, and if you have to rent one for a month, it's just another cost of getting your life back.

Good luck!

CT

[4Kate]

hmmmmmm, Now the WLS office returned my calling saying that , NO I have a score of 17 and not 4. The 17 is when I am on my back and since surgery is done on your back....... So now the office manager is calling the home care office to find out what the deal is and then the ins co to fight with them if need be.


Ok line up the hoops so I can start jumping!

[4Kate]

Ok I just called the home company again and they said that if they try and submit the claim to the ins co and they turn it down then I get a bill for $1200. Hmmmmm There has to be a way around this. I guess this is when I be glad I am at a good office for my WLS. I guess my WLS office already called them and now they are calling the sleep lab to discuess this.