Patient Acceptance Fact Sheet 2018-01-03T22:15:01+00:00

Patient Acceptance Fact Sheet

Patient Acceptance Policy

Explicit acceptance criteria for defining the patient population evaluated at the sleep facility ensures all patient evaluations are within the scope of the professional expertise, technical competence, capability of the staff and appropriate for the facility.

Requirements for Both In-center and HSAT

The policy should be comprehensive and describe:

  • Types of patients accepted.
  • Accepted patients adhere to the current AASM clinical guidelines and practice parameters
  • Age limitations.
  • Explanation of how referrals are received.
  • What information is required from referring physician for direct referrals.
  • The process of how patient information is reviewed and approved, to ensure the test is appropriate for the patient.
  • Evidence based criteria that may exclude a patient. (e.g. infectious disease, etc.)

Requirements Specific for HSAT

The HSAT policy should clearly define:

  • Only to be used for patients with high pre-test probability of OSA.
  • Not appropriate for patients under the age of 18.
  • Evidence based criteria for exclusion. This may include:
    • Limited co-morbidities, such as: moderate to severe pulmonary disease, neuromuscular conditions, congestive heart failure. Other sleep disorders such as: central sleep apnea, periodic leg movement disorder (PLMD), circadian rhythm disorder (CRD), narcolepsy, parasomnias.
    • HSAT should not be used for general screening.

Applicable Accreditation Standards

Written policies are required that indicate acceptance that adhere to the current AASM clinical guidelines, practice parameters and minimally include and define:

  • Age limitations.
  • A mechanism for acceptance.
  • Evidence based criteria for exclusion.
  • Information required from the referring provider prior to all sleep testing.

Facilities are to demonstrate their acceptance and testing of the full spectrum of sleep diagnoses.

A written policy is required that indicates adherence to the AASM clinical guidelines and must include and define:

  • Age limitations.
  • A mechanism for acceptance.
  • Evidence based criteria for exclusion.
  • Information required from referring provider prior to testing.

HSAT should adhere to high pretest probability for adults. In cases of insurance mandate or medical exception, the protocol should explain the rationale and follow up procedure on negative and positive tests.

The facility director or appropriately licensed medical staff member must review the information provided for each patient and determine if the test meets criteria for acceptance. Evidence of communication from the referring clinician should be recorded in the medical record for every test. This should include communication that the H&P was received, and the report was returned to the clinician.

Key Things to Keep In Mind

  • It is acceptable to have one Patient Acceptance Policy for both in-center and HSAT if all elements of the standard are defined for each program.
  • The criteria for acceptance for HSAT patients may be described and defined in the HSAT protocol if the facility chooses.
  • A licensed medical staff member must review the information provided from the referring physician, prior to testing, and evidence must be documented or noted in the medical record for direct referred patients.
    • Review your state professional practice acts to determine who is an appropriately licensed medical staff member (e.g. PAs, APRNs) that can review the information prior to testing.
  • Patient Volume form is to include the diagnose of all patients seen within the previous six months regardless of whether a study was performed. This should include all patients tested in the sleep lab and those seen in the sleep clinic.
    • A sleep clinic is an outpatient location where patients with sleep disorders pursue treatment, arrange diagnostic testing and patient management/follow up care is provided. The location can be within the sleep facility, or in a separate location.
    • A sleep lab is where the diagnostic testing is performed as ordered by the sleep physician.
    • A sleep facility is considered the lab and clinic collectively, even if they are in separate location/space.
      • Clinics and the sleep lab may be in separate physical locations, however statistically they are to be reported as one.
    • Satellite locations or additional facilities are not accredited as one entity. Each individual location must independently meet all standards and apply for individual accreditation.
    • For direct referrals, the medical record must include communication from the referring clinician, (H&P, physician order) with an indication/documentation that the final report was returned.