Theta Sleep Clinic
Benefits of Direct Pay Care
Why We’re a Direct-Pay Sleep Clinic
At Theta Sleep Clinic, we believe you deserve transparent, personalized care. Many of our clients come to us exhausted—not just from poor sleep, but from trying to get meaningful care through the insurance system. Long wait times, rushed appointments, denied claims, and limited access to specialists are all too common.
We’ve structured Theta Sleep Clinic to be different:
- You know exactly what you’re paying for—up front.
- We spend more time with each client (appointments are 30–90 minutes).
- We’re free to focus on what actually works, not what insurance will approve.
- You don’t need a referral, pre-authorization, or to “fail” treatments first.
This model gives us the freedom to provide care that is flexible, thoughtful, and personalized—the kind of care we believe everyone deserves.
Out-of-Network Reimbursement
If you have a PPO or another plan with out-of-network benefits, you may still be able to get reimbursed for all or part of your visit cost.
We’ll give you a superbill (an itemized receipt with proper medical codes) and guidance on how to submit it. Many clients receive at least partial reimbursement—often between 40–80%, depending on your plan.
Tip: Check with your insurer to see if your plan includes out-of-network coverage for outpatient visits.
Does Insurance Cover Sleep Testing or PAP Equipment?
Yes! While our consultations are self-pay, we frequently refer to sleep labs and providers that accept insurance for testing (like home sleep studies or in-lab polysomnography).
If CPAP therapy or other treatment is recommended, we’ll collaborate with those providers to support your care while keeping it affordable.
Top 10 Benefits of Direct-Pay Care
- No surprise bills or deductibles
- Transparent, upfront pricing
- Longer visits with time to really listen
- Personalized, unhurried care
- No insurance gatekeeping or denials
- Flexible visit types (virtual or in-office)
- Direct access to your provider
- Ability to tailor treatment around your values
- Easier communication and follow-up
- Less stress—more sleep
What If I Can’t Afford Self-Pay Visits?
We understand that healthcare costs can feel overwhelming. Here’s how we try to help:
- We offer a range of appointment lengths and pricing options
- Free 20-minute discovery calls to see if we’re the right fit
- We’re happy to refer you to in-network providers when needed
- Superbills may help reduce your out-of-pocket cost through reimbursement
If cost is a concern, let’s talk. We’ll do our best to work with your needs and connect you with helpful options.