That's a really frustrating situation — especially when two specialists already agree on your diagnosis. Here are some steps that may help when insurance pushes back on covering an MSLT:
- Appeal the denial — Ask your insurance company why it was denied. If it was coded incorrectly by your doctor's office, fixing that could Show Full Answer
That's a really frustrating situation — especially when two specialists already agree on your diagnosis. Here are some steps that may help when insurance pushes back on covering an MSLT:
- Appeal the denial — Ask your insurance company why it was denied. If it was coded incorrectly by your doctor's office, fixing that could change the outcome.
- Get the procedure and diagnosis codes — Before any appointment, ask your provider for these codes, then call your insurer directly to confirm what's covered and what your out-of-pocket cost would be.
- Negotiate with your provider — If insurance won't budge, let your doctor's office know the test isn't covered. As a self-pay patient, they may offer a discount.
- Ask about a standalone sleep center — Hospitals tend to charge the most. An independent or outpatient sleep facility may be significantly cheaper. If cost is still a barrier, there are programs that may help cover expenses:
- Medicare Savings Programs
- Medicare Extra Help
- State Pharmaceutical Assistance Programs
- Patient Access Network Foundation
- The HealthWell Foundation
Talking to a social worker or patient advocate could also help you find options specific to your state. You don't have to navigate this alone!
October 22
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