In early August, AASM members across the country were contacted by UnitedHealthcare (UHC) regarding their new process for Advanced Notification and Prior Authorization Requirements for Polysomnography and Portable Monitoring for Sleep Related Breathing Disorders. The new process promotes the use of out of center sleep testing (OCST) and establishes an advance notification and/or prior authorization requirement for all in-center sleep testing.
In communications with staff, AASM members have expressed concerns about whether UHC will limit the provision of OCST to four nationally contracted IDTFs. The AASM has reached out to UHC for clarification on their new process. UHC has confirmed the following:
- Sleep centers and physicians interested in becoming contracted providers of OCST are encouraged to contact their local UHC contract representative for requirements and additional information.
- UHC has contracted with national IDTFs and local providers to offer OCST.
- A list of locally contracted providers of OCST is available at UnitedHealthcareOnline (login required).
The AASM supports the use of OCST as an alternative to in-center polysomnography for appropriate patients and when performed according to AASM guidelines. AASM members are encouraged to incorporate OCST into their sleep medicine practice in order to stay competitive in the changing landscape of sleep medicine. In 2011 the AASM began accrediting providers of OCST who meet an established set of standards. Many AASM accredited sleep centers already have become accredited providers of OCST, which puts them in an excellent position to share their expertise as local providers.