Billing FAQ's

1) I just had a sleep study done, but it is not showing as being applied to my deductible. Why is this?

It takes up to 30 days for most insurance companies to process claims. If you had a recent sleep study done, it may not have been applied to your insurance.

2) Am I purchasing or renting this equipment?

You will be purchasing the equipment. However, depending on your insurance policy, your insurance company may require that your sleep apnea equipment first be rented. For example, Aetna first requires a 10 month rental of the equipment before purchase, for UHC (United Healthcare) a 1 month rental is required before purchase (on some cases UHC will allow a straight purchase), for most BCBS (Blue Cross Blue Shield) plans, equipment is generally set for a straight purchase (on some cases BCBS will require a few months rental).

3) Why is it taking so long to get my machine?

Some insurance companies require a preauthorization, which means we have to send all of the patient’s clinical information to the insurance company for review before the patient can be scheduled for an appointment. This preauthorization is to verify that it is medically necessary for the patient to receive their sleep apnea equipment.

4) How often will my insurance cover for a new CPAP/BiPAP?

This will vary depending on what insurance you have. A patient care coordinator will have to verify your insurance benefits.

5) Why am I getting a bill?

The reason can be one of the following:

  • Your deductible or co-insurance amounts are not paid by your insurance company(s).
  • The insurance company requested information from the patient, but did not receive information from the patient.
  • The out of pocket amount exceeds the estimated uninsured amount paid at the time of service.

6) I have a secondary insurance; why am I still getting billed?

The secondary insurance did not pick up 100% after the primary insurance paid.

7) What is an EOB?

EOB stands for Explanation of Benefits. It is a statement from the insurance company giving a breakdown on how charges were paid.

8) I thought I purchased the equipment at my time of set up; why am I still getting an EOB?

Monitor Medical has to bill your equipment according to the insurance requirements. If your insurance plan requires several months of rental before purchase, we must bill accordingly.