AASM requesting members complete private payer preauthorization survey
May 23, 2013
Recently private payers have changed coverage policies for sleep services to include stipulations for utilization management review and preauthorization. These changing requirements have created concern among sleep medicine physicians as these implemented preauthorization policies result in increased administrative work associated with ordering sleep studies.
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AASM demands that MVP contract with qualified local OCST providers
May 16, 2013
In June 2012, New York payer MVP announced a new Sleep Study Benefit program that requires preauthorization for sleep testing and encourages the use of out of center sleep testing (OCST) in many patients. Recently, MVP announced a revision to its medical policy for OSA.
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HHS publicizes data on hospital charges
May 08, 2013
On May 8, the department of Health and Human Services (HHS) announced an unprecedented initiative to provide consumers with nationwide data on what hospitals charge. HHS explained that by providing this data it hopes that “business and consumers alike can use these data to drive decision-making and reward cost-effective provision of care. In addition to making the data available, HHS is also planning to fund data centers to review and publicize reimbursement data in the future.
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AASM demands changes to Cigna’s sleep testing policy
April 19, 2013
Recently, Cigna Healthcare announced an update to its national medical policy for sleep testing. The new policy, which took effect February 15, 2013 requires preauthorization for all sleep related services.
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CMS to implement edits on ordering-referring providers
March 21, 2013
Effective May 1, 2013 the Centers for Medicare & Medicaid Services (CMS) will implement edits that will result in claims denial if the ordering or referring provider is not enrolled in Medicare. To prevent denials, claims submitted on or after May 1 must include the name and national provider identifier (NPI) of the practitioner who ordered or referred the service.
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Visit the recently updated AASM Practice Management page
March 21, 2013
This week, the practice management section of the AASM website was expanded to include new frequently asked questions (FAQs) about coding and billing. New FAQ categories include out of center sleep testing and actigraphy. For updated content, please visit the AASM Practice Management website.
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