Sleep and Private Payers
AASM members have experienced significant change in the way private payers cover sleep services over the past year. Through preauthorization requirements and utilization management review, many private payers are requiring the use of home sleep testing for many patients suspected of obstructive sleep apnea. The AASM is aware that members need new resources to understand, and in some cases fight these new policies.
Descriptions for important terms such as OCST, Utilization Management and Preauthorization
The key shifts in private payer coverage for in-lab sleep testing for obstructive sleep apnea to home sleep testing and treatment for the sleep disorder.
The steps the AASM has taken in response to new private payer requirements for preauthorization and utilization management review. Actions include:
Resources members can use when contacting payers on this important issue:
- Template letters to payers
- Links to key AASM Practice Parameters and Clinical Guidelines
- Submit your practice management questions to the AASM at firstname.lastname@example.org.