Insurance Updates

HEALTH INSURANCE UPDATE

During a medical visit, your healthcare provider recommends an over night sleep study.  The first thing that may come to mind is, “Will my health insurance cover this procedure?”  The answer is probably yes.  The majority of insurance carriers recognize the need for sleep disorders medicine, and they should since 1/3 of the population has some type of sleep problem. Currently, there are 86 clinically documented sleep disorders including Obstructive Sleep Apnea, Insomnia and Narcolepsy. 

I highly recommend that you take the time to call your insurance company to make sure sleep disorders services are a covered benefit in your plan.  Once we receive an order for sleep testing from a medical provider, we automatically pre-authorize insurance benefits.  It still doesn’t hurt to check for yourself incase there is conflicting information related to benefits, co-pays or deductibles. 

It is a good idea to see if your insurance company requires you to stay at an American Academy of Sleep Medicine (AASM) accredited facility.  Blue Cross and Blue Shield of Montana for example, does require sleep disorders centers to be AASM accredited for quality assurance measures amongst many other purposes and pay less for sleep services performed in non-accredited facilities.  This leaves individuals with considerably more out of pocket expenses which shouldn’t have to happen. 

We’re pleased to let you know that we’re AASM accredited in Great Falls, Helena and Butte.  Some other large cities in Montana such as Billings and Missoula also have AASM accredited centers, so access shouldn’t be too much of a problem.  We offer assistance for those who do not have, or cannot afford health insurance.  When scheduling your sleep study, please let the receptionist know that you would like a hardship application sent to your address.  Once this is completed and reviewed, our administrative department determines the amount of reduction if eligible and establishes a payment plan.  Our goal and intent is to serve you to the best of our abilities any time you need sleep medicine care. 

For more detailed information about this topic, please call us at 453-7570 Monday through Friday between 8:00am and 5:00pm.  For those living in the Butte and Helena areas, please call us toll-free at 866-715-7570.  Sleep Well!      Other insurance companies may also require AASM accreditation so be sure and ask your customer service representative when inquiring about coverage.  This may save you hundreds of dollars, or worse, total out of pocket expenses.  It’s also important to remember that the outcome of your sleep study has a significant reflection on what your insurance company will cover for medication{s}, supplies and/or Durable Medical Equipment if indicated.  The good news is that every major city in Montana has an AASM accredited sleep disorders facility.   For those of you who utilize insurance provided by the hospital in Great Falls, we still provide discounts so your sleep study will not cost anymore out of pocket than if you had it done at their facility.  Please keep in mind that we have the only board certified and fellowship trained sleep medicine specialists in the area.  If you have any questions regarding your health insurance coverage for sleep study services, please give us a call.  We’d be happy to help you!

 

We are preferred or participating providers with the following health insurance organizations:

  • Blue Cross & Blue Shield of MT

  • New West Health

  • TriWest/Tricare

  • Medicare

  • Medicaid

  • First Choice Health PPO Network

  • Allegiance

This is not an all inclusive list.  If you are concerned if our facility is covered by your insurance please contact your insurance company.