Effective Nov. 1, 2012, UnitedHealthcare (UHC) now requires providers to receive advanced notification and/or prior authorization for sleep testing performed in a sleep center. Providers will not need to obtain advance notification or prior authorization for patients evaluated with out of center sleep testing (OCST). UHC will review requests for in-center polysomnography according to the new UHC policy for sleep testing.
UHC contacted their providers regarding these policy changes in July and August. There has been some confusion as to who can now provide OCST under the UHC policy. UHC has contracted with four national IDTFs to provide OCST: NovaSom, Lifewatch, Virtuox and WaterMark. However, in addition to these IDTFs, UHC is contracting with local providers of OCST, including many sleep centers. Sleep centers that provide OCST are encouraged to contact their local UHC contract representative about becoming an approved OCST provider.