Insurance & Coverage
We accept Medicare and most major commercial insurance plans. Our team handles prior authorization for sleep studies and coordinates with DME providers, surgeons, and dentists who manage authorization for CPAP equipment, Inspire/Genio implantation, and oral appliances.
Hate Phone Calls? Text Us Instead.We Reply Fast
We know you're busy. Text us your questions during business hours and we'll reply in minutes-not hours. No phone tag, no waiting on hold.
Text: (214) 308-1525Mon-Fri 8am-5pm | Average response: 3-5 minutes
Insurance Plans We Accept
Medicare
We are Medicare participating providers. Medicare covers:
- In-lab and home sleep studies (with prior authorization)
- CPAP equipment and supplies (80% after Part B deductible)
- Inspire therapy (approved 2017, requires documented CPAP failure)
- Genio therapy (approved 2024, coverage expanding)
- Oral appliance therapy (with medical documentation)
Commercial Plans
We participate with major commercial insurers:
- Blue Cross Blue Shield (BCBS) of Texas
- United Healthcare (UHC)
- Aetna
- Cigna
- Humana
- Many other PPO and HMO plans
Coverage varies by plan. Contact us to verify your specific benefits.
Out-of-Network Benefits
If your insurance plan is not in our network, you may still have out-of-network benefits. Many PPO plans offer partial reimbursement for out-of-network care. We provide detailed receipts (superbills) for you to submit to your insurance for reimbursement.
Self-pay option: We offer competitive self-pay rates for patients without insurance or with high deductibles. Contact our office for pricing information.
Prior Authorization Process
Many insurance plans require prior authorization for sleep studies and treatments. Our team handles prior authorization for sleep testing, while our partnered DME providers (for CPAP), surgeons (for Inspire/Genio), and dentists (for oral appliances) manage authorization for their respective services. We coordinate this process to minimize delays.
Initial Consultation
Dr. Jain evaluates your condition and recommends appropriate testing or treatment (sleep study, CPAP trial, Inspire candidacy evaluation, etc.).
Insurance Verification
Our billing team verifies your insurance benefits, checks for prior authorization requirements, and confirms coverage details.
Prior Authorization Submission
We submit all required medical documentation to your insurance company, including clinical notes, sleep study results (if applicable), and evidence of medical necessity.
Approval & Scheduling
Once sleep study authorization is approved, we schedule your testing. For CPAP equipment, surgical procedures (Inspire/Genio), or oral appliances, your DME provider, surgeon, or dentist handles their respective authorization process. Typical approval timelines: sleep studies (3-7 days we handle), Inspire/Genio surgery (2-4 weeks surgeon handles), CPAP equipment (1-3 days DME handles).
Denial Management
If your insurance denies authorization, we handle the appeals process, provide additional documentation, and work with peer-to-peer physician review when necessary.
Sleep Studies
3-7 days approval
Inspire/Genio
2-4 weeks approval
CPAP Equipment
1-3 days approval
Important Insurance Information
- •Deductibles & Co-insurance: You are responsible for any deductibles, co-pays, or co-insurance required by your plan. We collect estimated patient responsibility at time of service.
- •Coverage Verification: While we verify benefits in advance, insurance coverage is ultimately determined by your insurance company. We recommend calling your insurance to confirm specific coverage details.
- •CPAP Compliance: Most insurance plans require documented CPAP usage (typically 4+ hours/night for 21 of 30 days) before covering advanced therapies like Inspire or Genio.
- •HSA/FSA Eligible: Sleep apnea diagnosis and treatment expenses are typically eligible for Health Savings Account (HSA) or Flexible Spending Account (FSA) reimbursement.
Verify Your Insurance Coverage
Contact our billing team to verify your specific insurance benefits for sleep studies, CPAP equipment, or Inspire/Genio therapy. We'll provide a clear breakdown of your estimated out-of-pocket costs.