Friday, June 27, 2008

Running A Sleep Lab

A key part of running a sleep lab is keeping on top of the constantly changing regulatory environment, on both the federal and state levels. This link does a good job of describing the new federal regulations for independent diagnostic and testing facilites (IDTF's) that went into effect January 2008 (though for pre-existing IDTF's, many of the provisions do not apply until January 2009). Every February the AASM gives a course on sleep lab management that is very useful for anyone running a sleep lab.


Maria said...

The problems of sleep labs are not just compliance with regulations. Sleep lab operators need to run good facilities which are tolerable for patients. It took me a long time to recover from the emotional torment of lousy techs who answer every question "you would have to ask your doctor." Insurance companies pay through the nose for the testing, but there is never a doctor available to help the hapless patient. When I couldn't fall asleep during titration and asked for sleeping pills, the tech said he would ask a supervisor, the supervisor hummed and hawed "What kind of meds did you bring with you?" "None, " I said, "never needed any." "Then I will call the doctor, maybe we can get some presecribed for you for tonight." When the doctor did not call back, she said "He hasn't called, but actually you were sleeping beautifully for nearly 3 hours you just woke up a few minutes agao and began calling out for help, which is why I came in!"

David Szabo said...

I just found your blog. I was a presenter the February AASM meeting in Clearwater--I'm glad you think the program was worthwhile!

Sleepalee said...

I have a quick question for you if you don't mind! I am in the beginning process of opening an IDTF in a rural area of Mississippi. I have been told by several "professionals" in this industry that I will not be able to bill Medicaid for the services provided at this Sleep lab, due to the fact that I will be billing as an IDTF. I can only find one policy from the Medicaid policy Manual online, dated from 2000, that actually states the above. I have been told that there is an updated policy, but I cannot find anything about it on the MS Medicaid website and I have gotten very little help with the department via the phone! Before I decide to move forward with this lab, I need a definitive answer from someone!! Because this lab will be located in a rural area,obviously one of my main payor sources will be Medicaid. Do you know where on the website I can locate their updated policy that states an IDTF can bill??

Thank you so much, your blog is awesome!!


Michael Rack, MD said...

thanks for your comments, Maria. I plan on addressing them on a separate post towards the end of August.

David Szabo: I enjoyed the AASM course and plan to attend it again in 2009. thanks for reading.

Sleepalee: The MS sleep center that I am a part-owner of is an IDTF. We bill Medicaid, Medicare, and most other insurance companies on a global basis for sleep studies. The sleep center then pays me a fee for each study that I read (that's the simple version of how I am paid for reading sleep studies- there is a complicated formula for my compensation to avoid violating the antikick back rules). I also read sleep studies for a few small hospitals. For the hospital-associated sleep centers, I bill the professional component (-26), and they bill the technical component (-TC)

FPsleep said...

Great Blog!
I have a question. I am BC in family medicine/psychiatry and sleep medicine. How are you credentialled with insurance plans?. The reimbursement for psych is better than for FP but due to the mental health carve out visits are limited. Sleep medicine is not accepted as speciality by most payers and your primary speciality has to be used. Are you credentialled as IM or Psych.

~~PSI~~ said...

I work at the Only IDTF pediatric sleep lab in Texas, do you know of any agency who can handle our insurance credentialing? I looked around and only found groups who handle physicians and NOT IDTF

kylerpatience said...

Sleepdocotor you addressed that you bill for the professional component for some of the places that you read. Do you indicate place of service as each indivual location when billing Medicare. I.E. POS on the CMS 1500 indicates hospital A, not your practice location? Thanks

TeaJay's Blog said...

I read your above comment. I am rounding up my sleep fellowship and looking to set up a sleep lab. Where would I get comprehensive information or a step-by-step guide as well as potential pitfalls?

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