Private health insurance plans pay for a large portion or even all of many types of medical equipment used in the home. This type of equipment is referred to as durable medical equipment or home medical equipment. Most health insurance plans have similar rules to Medicare, but you should know that all private health insurance plans vary and the specific rules of your plan may differ from these Medicare guidelines. We accept most of the major health insurance plans.
We work as hard as we can to make sure we know your test that is ordered by your doctor is covered before we perform the test as well as explain to you what your out of pocket costs should be. Almost every insurance plan has a deductible as well as your co-pay. Your deductible is the dollar amount you must pay each year BEFORE your insurance company starts paying for your equipment. They usually run between $500 and $2500 each calendar year. Your insurance company and your employer set that we don't. At times the insurance covers the test with only a co-pay. Other times it goes against your deductible that must be met every year by you.
In addition to your deductible, some plans have a co-pay ranging from 10%-30% you will be responsible for. We verify that information up front but feel free to contact your insurance company to ask them what the deductible and co-pay are for your plan for your sleep test. We would be happy to work with you and your insurance company to help you understand how your plan works as it relates to home medical equipment needed by you or a loved one.
After we bill your insurance you will receive an EOB (Explanation of Benefits) from them describing what test was billed, the billed amount (what we charge) and the contracted amount (what they pay). We do not set the amount your insurance pays, they do. You will then receive a bill from us for any deductible that has not been met for the year as well as your co-pay amount.
We cannot write off your deductible or co-pay without documented financial hardship. If that is the case please contact us and one of our accounts receivable specialists in our billing department will be happy to work with you. If you have any questions about this process please don't hesitate to contact us at either of our offices.