New Home Sleep Testing Option Benefits Patients

April 13, 2009

Last year, Medicare and Aetna , who together provide insurance coverage for nearly 60 million Americans, decided that patients could now be tested for obstructive sleep apnea (OSA) with a simple at-home test. Prior to this, home testing was only covered in limited situations by very few insurers.

"Medicare beneficiaries who have obstructive sleep apnea face significant risks for cardiovascular disease and other ailments," said CMS Acting Administrator Charlene Frizzera in announcing this landmark policy change. "This coverage decision establishes nationally consistent coverage and assures that beneficiaries who have sleep apnea can be appropriately diagnosed and referred for treatment."

Now, other insurance companies are starting to modify policies to allow this simpler, home-based approach for all patients suspected of having sleep apnea. Many others will now consider payment on a case-by-case basis.

This is great news for patients suspected of having sleep apnea, as well as those that have already been diagnosed and may need repeat testing. The cost of a home study can be anywhere from 1/3rd to 1/10th the cost of an in-lab study, depending on the provider. Since employers are shifting healthcare costs to their employees, many patients are now facing higher co-pays and deductibles.

Testing Option	Process	Time from Referral to Treatment	Key Difference	Billed Cost	Patient Cost (depends on plan)
In-Lab PSG	Spend the night at a lab with numerous electrodes on	3-12 weeks*,	Ideal for sicker, more complicated patients	$1,600-5,000*	$320-1,000
Home Sleep Test	Device delivered, you apply a few simple sensors before bedtime	1-2 weeks	Easier, less expensive option to rule out OSA	$300	$25-30

* Lab studies often involve seeing a specialist first, waiting for insurance approval, an initial diagnostic study in a lab, waiting for results and then a second in-lab study to determine CPAP pressure.

Learn more about home sleep testing.

Instant Diagnostic Systems (IDS), based in Decatur, Alabama, offers the most convenient and least expensive option for patients who simply want to find out if they have sleep apnea or not. Upon receipt of a signed order from your physician (forms available online or can be faxed to your physician upon request), IDS will contact you to arrange delivery of a device right to your home. The unit is shipped with an instructional video, as well as simple written & illustrated instructions on how to apply sensors under the nose and on a finger. Experienced technologists are available by phone 24/7 for questions. The following day, simply drop the device in your mailbox. In 2-3 days, your doctor will have the report.

“We're getting a lot of calls from patients who have been avoiding in-lab studies because of the inconvenience or they have high co-pays or deductibles in excess of $1,000. Even when their insurance company policies will not cover the home studies, patients would rather just not deal with the bureaucracy and will pay the $300 for a home test themselves,” says Laura Trout , Director of Home Sleep Testing Services for IDS. “We see the educated, resourceful patient being the ones to drive this market more than physician preference or insurance company policies, which will take longer to change.”

Not all home sleep testing options are the same. In some cases, you may go to a lab or other diagnostic service center to pick up a device and have someone explain how to use it. You will then need to bring it back the next day. Depending on how far away the center is, this may or may not be a great option for patients.

Other companies are bundling home sleep testing within an online or facility based sleep management program, which may have additional costs associated with them. For example, you may be asked to fill out some questionnaires that are reviewed by a sleep professional, and the cost of this is added to your bill. Or, you may still be directed to more expensive and unnecessary testing by someone at the company who tries to make your case seem more complicated than it is.

“When I was told I might have sleep apnea, I was forced to go to a sleep lab by my insurance company, even though I asked to have a home test.,” says Chuck Makarov, who was diagnosed with sleep apnea last year. “I had trouble working it into my schedule, missed work the next day, and had to pay $350 for my portion. And, it was really difficult to sleep at the lab with all of those sensors on. I would have much rather taken the test at home and the results would have been exactly the same.”

Home sleep testing has been commonly used in countries like Europe, Australia and Canada for many years with excellent results. As Americans struggle with higher costs for healthcare and less money in their pockets, home sleep testing could not have arrived at a better time!

If you know someone who has been avoiding a sleep study because of the cost, inconvenience, or inability to sleep in new places, let them know about this new option. Or, visit www.instantdiagnostic.com to learn more about this exciting new alternative for patients with sleep apnea.