Not everyone who snores needs this evaluation. What Gives: Sleep studies are somewhat controversial and have been flagged in the past as being overused. Service Provider: University of Miami Health System’s sleep medicine facility at Bascom Palmer Eye Institute in Miami. Mendoza owed the bulk of that: $5,157, including $262 in coinsurance and $4,895 to satisfy his deductible. Humana’s negotiated rate for the total was $5,419. Total Bill: $10,322, including a $9,853 outpatient charge for the sleep study and a $469 charge for the sleep specialist who interpreted the results. Medical Service: An overnight sleep study at a hospital sleep center to determine the type of mask and the proper levels of airflow and oxygen needed in Mendoza’s CPAP to treat his severe obstructive sleep apnea. (Nancy Mendoza, who works as a social worker, and their two teenage children are covered under her employer plan.) Once his deductible is satisfied, he owes 50% in coinsurance for other billed charges. It has a $5,000 deductible and an out-of-pocket maximum of $6,500 for covered care by in-network providers. The Patient: José Mendoza, 61, has a Humana HMO plan through the construction company where he works as a truck driver. Subscribe to KFF Health News' free Morning Briefing. The new CPAP was helping both Mendozas get a better night’s sleep - until the bill came. I’m not as tired as I was before,” he said. Despite the unfamiliar setting and awkward equipment, Mendoza slept that night.Īfter the study, Mendoza started using the same, more comfortable CPAP model he’d used during the study. The technician fitted him with a CPAP with two small cannulas for his nose. After he got into his pajamas, a technician attached electrodes to his head and chest to track his brain, heart, lung and muscle activity while he slept. one night in early February and was shown into a spacious room with a sofa, a TV and a bed. Mendoza arrived at the sleep center about 8 p.m. Mendoza’s pulmonologist said it was not detailed enough and ordered a visit to an overnight sleep lab to get extensive data. He needed a new CPAP machine, they said.īut first, he had an at-home sleep test. But after a battery of tests, clinicians concluded his obstructive sleep apnea itself was likely causing his headache and cardiac problems. He thought it was related to his high blood pressure, a condition sometimes linked to obstructive sleep apnea. Late in 2019, Mendoza, 61, went to an emergency department near the family’s Miami home with an excruciating headache. But the machine was noisy and uncomfortable. Submit Your Billĭiagnosed with severe sleep apnea 15 years ago, Mendoza was prescribed a continuous positive airway pressure (CPAP) device to help him breathe easier. Do you have an exorbitant or baffling medical bill? Join the KFF Health News and NPR ‘Bill of the Month’ Club and tell us about your experience.
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