NBC Charlotte is investigating a consumer complaint that he was surprise billed more than $1,000 for an in-lab sleep study that was not covered by his insurance (which indicated a home study was the diagnostic route to take).
The reason for the insurance company’s denial?
They say he should have done an in-home sleep study – that’s what was included in his coverage. Not the hotel, as he says his doctor suggested.
“They never mentioned an in-home sleep study?” we asked.
Rob responds, “Didn’t know that was possible.”
No news here, Insurance companies, who do not know the patient, are making medical decisions. Anyone with heart disease requires an in lab study. In addition, Home Sleep tests usually underestimate the severity of OSA, if present. The physician was trying to do the best thing for the patient.
that doctor will get $1000 worth of headache and i predict this will destroy the relationship between provider and patient–at the end this patient is not going to be helped
As we medical professionals all know their are several exclusions to a HST. Any non-medical insurance clerks will not understand nor care about this. This is concerning for me to see how the trend on patient care is a heading for diagnosing and treating the patient. I know for fact there are patients being tested in home that have not only one but more than one of the exclusions. Is this for the sake of saving money? Does it need to come to a major law suit of mis-diagnosing the patient before we all wake up. There is a place and time for HST however I know it’s being abused.