Sleep Techs Need to Understand How Insurance Works
Many sleep technicians don't know how insurance works. They don't understand what insurances cover and which insurances need authorizations before giving equipment or performing tests. To them, this is an issue just for the billing office and the scheduling desk. I have found that the more I understand about our field and the way we are paid, the better I am able to help the lab be profitable.
The difference between a job and career is that in a career we understand as much as possible in all aspects of our field. This makes us an important part of the business. We are then able to contribute more to the lab. A person who has a job comes in, does what's required, and goes home at the end of his or her shift. There is a place for both types of people. However, the best way to help our patients is to understand how everything works so we can educate them.
Insurance reimbursement is something most patients do not understand and so they do not see why we can't do a split night study on everyone, why we do not send them home with a machine, and why they may have to pay a separate deductible when they get a piece of sleep equipment. If we have a better understanding in the sleep lab, then we're able to educate them. The more education you give a patient, the more successful you will be when you're selling them on the need to use a PAP device.
I will admit it is hard to keep up with competitive bidding and changes in policies by insurance companies and managed care programs. But if we at least keep up with Medicare reimbursement policies, then we have a basic idea of what patients need to know. We can tell them that they need to make a follow-up appointment 30-60 days after the delivery of their PAP device. And we can explain when they should get new masks and filters for the machine. This information will then be reviewed again when the machine is delivered. The more times people hear something, the more likely they are to remember it. This will help to contribute to compliance, which is the ultimate goal of testing and treating sleep apnea.
A little research goes a long way in helping you to grow the lab. When you have successful patients, your referring physicians will be happy. The more tests ordered, the more beds are filled and the less likely you are to be cancelled. All in all that is a good deal for everyone.