sleep study denial

I was all set to get my sleep study done this Friday, turns out my insurance denied it for a 2nd time. Now my pulmonilogist is going to try an appeal it... What's the chance that'll happen? Just so incredibly frustrating, that was my last step of the puzzle before I got a date, and now it's setting me back and Idk how much it's setting me back :(

Do you have symptoms of sleep apnea? Some surgeons consider it standard, but if you don't have symptoms the insurance company may not. My pulmonologist  didn't make me get one. Even though the surgeon's nurse who goes over the charts (not the actual doctor) balked a little, he sent clearance and that was that. Good Luck.

Why did the insurance deny it?

My insurance company believes it's not medically necessary 

Is it medically necessary?  Do you have symptoms of sleep apnea or something?  Or is it just something your surgeon wants done on all patients, whether it's medically necessary or not?

I do not have any symptoms of sleep apnea no. It is a requirment from the surgeon. So I would expect my insurance company to fight it, and after the appeal, I assume it still wont be covered

OK.  I'd talk to your surgeon about it, about why he wants you to have one if it's not medically  necessary.  If he feels it is medically necessary, he should be able to explain that to the insurance company.  If he agrees it's not medically necessary, maybe he will waive the requirement.  Not all surgeons require a sleep study of all patients.

Thank you, I will talk to my surgeon as well. I know that the pulmonologist is trying to appeal it, and hopefully it will help. For now, the waiting game :) Whats a few more weeks.

I think you'll probably be able to get it worked out.  After all, you can't be the first person with no signs of sleep apnea whose surgeon wants a sleep study before surgery.  I imagine your surgeon is pretty good at getting things covered by insurance.  But also do talk to him because maybe it's not absolutely necessary to have one anyway.  Even if insurance does pay for it, who wants to mess with that if they don't have to?

What was their reason for the denial? 

With your pulmo doctor appealing it, that will be more persuasive than you doing it on your own.

Best of luck to you!