There once was a time a sleep study could be scheduled without consideration of the insurance carrier. Patients could be scheduled that night or the next day. Times have really changed as we have moved into an age of pre-authorizations and longer wait times for patients to have an overnight sleep study.
Have we lost quality of care for the patient as insurance takes over and the request for a sleep study is denied? Regulatory and economic pressures are changing the way sleep disorders patients are diagnosed and treated. Private insurers are requiring pre-authorization for laboratory sleep studies and are incentivizing home sleep testing for most patients suspected of obstructive sleep apnea. Reimbursement for home testing will be lower than for laboratory testing, and further reductions in overall reimbursement are anticipated.
What can you do to assure your patients receive appropriate care?
In the Q3 issue of A2Zzz, Eva Lisa Alegria, RCP, RRT, RST, RPSGT, shares information and tips to assist sleep centers with the authorization process, in hopes of minimizing denials, obtaining reimbursement for the study, and improving quality care for our patients.
Alegria provides our readers with a detailed process to support sleep centers to successfully navigate the authorization process.
This article is one of four designated CEC articles in this issue of A2Zzz. AAST members who read A2Zzz and claim their credits online by the deadline can earn 2.00 AAST Continuing Education Credits(CECs) per issue – for up to 8.00 AAST CECs per year. AAST CECs are accepted by the American Board of Sleep Medicine(ABSM) and the Board of Registered Polysomnographic Technologists (BRPT). To earn AAST CECs, carefully read the four designated CEC articles and claim your credits online. You must goonline to claim your credits by the deadline of November 30, 2017.
To earn AAST CECs, carefully read the four designated CEC articles and claim your credits online. You must go online to claim your credits by the deadline of November 30, 2017.
After the successful completion of this educational activity, your certificates will be available in the My CEC Portal acknowledging the credits earned.
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