Payer Policy Scorecards

Payer policy scorecards were created to evaluate how effective payer policies are at establishing appropriate coverage for diagnostic sleep testing services. The intent of the scorecards is to encourage insurers to adopt evidence-based policies that support patient safety and delivery of high-quality care.

The following scorecards for several major payers are based on the careful review of their policies by the AASM Payer Policy Review Committee, were approved by the AASM Board of Directors, and sent to each payer in advance for comment before posting online.

Diagnostic Testing for Obstructive Sleep Apnea

The AASM Payer Policy Review Committee based the Diagnostic Testing for Obstructive Sleep Apnea (OSA) scorecard on the AASM’s 2017 clinical practice guideline on diagnostic testing for OSA. The scorecard’s nine criteria correspond to the clinical practice recommendations contained in the guideline. The Committee also developed a Template Policy, intended to serve as an additional resource, which exemplifies a policy that is in alignment with the AASM guideline on Diagnostic Testing for adult OSA.

Aetna

AIM Specialty Health

Blue Care Network and Blue Cross and Blue Shield of Michigan

Blue Cross and Blue Shield of Florida

Blue Cross and Blue Shield of Minnesota

Blue Cross Blue Shield of North Carolina

Blue Cross Blue Shield Federal Employee Program

Blue Cross Blue Shield of Arizona

Blue Cross Blue Shield of Massachusetts

Blue Cross Blue Shield of Wyoming

Blue Shield of California

CareFirst Blue Cross Blue Shield

Cigna

eviCore

Excellus Blue Cross Blue Shield

Harvard Pilgrim

Highmark Blue Cross Blue Shield Pennsylvania

Horizon Blue Cross Blue Shield of New Jersey

Humana

Independence Blue

Premera Blue Cross

Priority Health

UnitedHealthcare