Skip Navigation LinksHome > Services > HME Suppliers > Home Sleep Testing > FAQ

Frequently Asked Questions by HME Providers

What type of device does IDS use?

IDS uses the ResMed ApneaLink Plus, Type III device. This device has a nasal pressure cannula to record airflow and snoring, and a finger sensor to record oxygen saturation and pulse. To learn more, visit our Home Sleep Testing Equipment Detail page linked here:

http://www.instantdiagnostic.com/ids/(S(pbfkn245qkhnsq55i1rlqgrh))/content.aspx?content=dme_home_sleep_testing_device

Many of my referrals now come from the sleep lab; I’m afraid I’ll anger them if I start promoting Home Sleep Testing. How should I address this?

IDS offers an anonymous option where your comapny name and contact information will not appear on forms, test reports, or correspondence with the ordering physician. As an option, we can include a unique ID number that identifies your company and allows us to send a medical release form to the patient. The form will allow you to review test reports after they have been interpreted and sent to the treating physician. This process gives you the opportunity to promote a Home Sleep Test (HST) option to primary care physicians (PCP). 

There are several other ways to handle these important relationships as well. First of all, increased access to HST will increase the overall awareness of sleep disorders. Therefore, the number of patients tested, and the overall size of the pool of patients being diagnosed with other sleep disorders or with more complex cases will still require testing in a sleep lab. Next, a negative HST result would still likely refer that patient to a sleep specialist and the patient would eventually undergo attended sleep studies to look for more complex apnea, or other sleep disorders. Finally, some physicians may still opt to have patients that are diagnosed through HST go to the sleep lab for the titration study. In this case, you will have actually brought new business to the sleep lab.

If marketed properly and carefully, HST could be utilized to strengthen your relationship with the sleep lab.

One of my competitors is doing the testing themselves. Can they do that?

Medicare has made it very clear that they do not want the HME participating in the HST process. Other insurers seem to be following Medicare’s lead. It can be a very dangerous play for HMEs.

Because IDS services are so efficient and effective, it doesn't make sense to invest the time, money and risk to perform the HST yourself. Reimbursement rates are extremely low for most insurers and equipment costs and labor are very expensive. In low volume, it is impossible to make a profit. IDS Sleep is free and you gain all the advantage without the time, cost, or risk.

What benefits should I be promoting to the primary care doctors?

Healthier patients, better acceptance: HST is typically preferred by patients over in-lab studies. They appreciate being able to sleep in their own bed with no one watching them, as well as the convenience of not having to schedule an appointment with a sleep lab. There are no long drives to a sleep lab, and no waiting for an appointment.

Cost is also a very big concern for patients, particularly those with high co-pays and deductibles. The full cost of an IDS HST is typically less than the co-pay of a lab visit. See the patient education section of this website for more benefits to patients. 

Patient Services Overview  

More revenue and better relationships per patient: Medicare requires at least two office visits for all Obstructive Sleep Apnea (OSA) patients now: one prior to testing (HST or PSG in a lab) to confirm the patient is a candidate; and a second follow-up between the 31st and 91st day of PAP treatment to determine if the patient is showing clinical improvement. In a sleep lab situation, these visits are typically handled by the sleep physician; but PCPs prefer to keep their patients in their office. Therefore, IDS provides the PCP with easy-to-read, board certified sleep physician-interpreted IDS test reports and simpler treatment and titration when utilizing today's auto-titrating PAP equipment with their built-in compliance and efficacy reporting. There may even be additional CPAP initiation codes that can be billed depending on the situation (speak with your CPAP supplier for more information) and insurer. These extra office visits are great opportunities for the PCP to learn more about their patient and strengthen their doctor-patient relationship.

'Turn-key' testing includes interpretation by a board certified sleep physician: Our panel of board certified sleep physicians reviews each study and makes treatment recommendations. No need to worry about finding local sources; simply order the test and wait for the results.

Faster results: Many hospital-based and free-standing sleep labs require a consult with the sleep physician prior to testing. They also have a liminted number of beds, making appointment scheduling a long, drawn-out process. IDS not only allows PCPs to refer directly, but provides results in as few as 5 days, and typically less than 10, from the date the PCP orders the test. Patients will likely be treated, on therapy, and getting relief in a week, rather than months later as in many sleep lab programs.

Less hassle: The IDS HST referral form and process is extremely simple. IDS handles insurance verification when needed, allowing their staff to save time by not having to get approval for a specialist referral. As an HME, you can help them learn how to identify patients and provide excellent care once patients are qualified.

Who can order a Home Sleep Test?

According to Medicare: (Rev. 1506; Issued: 05-16-08; Effective/Implementation Date: 06-16-08)

20 - Ordering of Test

All procedures performed by the IDTF must be specifically ordered in writing by the physician or practitioner who is treating the beneficiary, that is, the physician who is furnishing a consultation or treating a beneficiary for a specific medical problem and who uses the results in the management of the beneficiary's specific medical problem. (Nonphysician practitioners may order tests as set forth in CFR 410.32(a)(3).)

Keep in mind that ordering practitioners must have an NPI number. Also, Alabama state law requires the person ordering the test be a licensed physician.

From the Federal Register regarding Non-physician Practitioners that can order tests:

(3) Application to nonphysician practitioners.

Non-physician Practitioners: (that is, clinical nurse specialists, clinical psychologists, clinical social workers, nurse-midwives, nurse practitioners, and physician assistance) who furnish services that would be physician services if furnished by a physician, and who are operating within the scope of their authority under State Law and within the scope of their Medicare statutory benefit, may be treated the same as physicians treating beneficiaries for the purpose of this paragraph.

Will the HST patients appear in my IDS account like my oximetry patients?

Yes. If the order form from the physician indicates your company is the treatment provider, you will see the patient name and status of the test in your IDS browser. However, to ensure CMS guidelines are met you will have no interactions, ability to edit information, or have any involvement whatsoever in the process. IDS handles everything: scheduling; shipping and receiving the device; interpretation of the test report; and sending the report to the ordering physician.

NOTE: If your name is not on the form but your IDS account ID number is (i.e. the IDS Anonymous option discussed above), a medical release authorization with your company ID number is sent to the patient with the equipment. If the release is returned and signed you will be provided the patient name and HST report when available.

What is the cost to the patient?

It will vary depending on insurance. The patient responsibility for regular Medicare patients who have met their deductible and without a secondary insurance for 2012 was is 20% of the medicare allowable for participating providers. Deductible also applies.. Other copays and deductibles obviously vary depending on the patients plan.

As of January 1, 2010, our published fee for an HST was $295 for a Type 3 (subject to change). There are also discounts available for patients paying in advance of equipment delivery. We make every attempt to validate insurance coverage up front for the patient if they request that we do so. We also let patients know what their responsibility is likely to be and give them the choice to continue.  

To put it in perspective, an IDS HST will typically be between 1/3rd to 1/10th the fee of an in-lab study and often the full cost of the HST is less than just the co-pay amount of a lab study.

Will our older patients be able to follow instructions?

IDS provides very easy to follow, illustrated and printed instructions as well as a video that includes step-by-step instructions through the whole HST process. These instructional pieces have been developed by our technical staff, supervising physician, and the device manufacturers and are based on knowledge gained from instructing and testing hundreds of thousands of patients in home overnight pulse-oximetry. We also provide a toll-free, 24/7 support line staffed by qualified technicians for patients who still experience difficulties. Our success rate of 97% easily exceeds industry standards.