Frequently Asked Questions
SLEEP STUDY
APPROVAL PROCESS
How will I know if my patient is approved for a sleep study?
If my patient is approved for an HST, who provides the testing?
What are my options if my patient is denied for a sleep study?
What if I order a titration study and the payor approves an auto-PAP?
HOW WILL I KNOW IF MY PATIENT IS APPROVED FOR A SLEEP STUDY?
Both the patient and the physician will be notified by the insurance company by fax/letter. Patients approved for in-lab studies will be contacted by Neurocare to schedule an appointment. If Neurocare is the assigned HST provider, the patient will be contacted to schedule. Neurocare will notify the referring physician if HST is assigned to another sleep testing provider.
IF MY PATIENT IS APPROVED FOR AN HST, WHO PROVIDES THE TESTING?
Neurocare Center for Sleep is accredited by the American Academy of Sleep Medicine for Home Sleep Apnea Testing and is contracted with most payors, including:
Harvard Pilgrim Health Care, Blue Cross Blue Shield, United Healthcare, Aetna, Medicare, Fallon, Cigna, Tufts, Neighborhood Health Plan, and Unicare/GIC
Some of our hospital sites provide HST testing and Neurocare will coordinate scheduling with the appropriate provider
WHAT ARE MY OPTIONS IF MY PATIENT IS DENIED BY THE INSURANCE PAYOR FOR A SLEEP STUDY?
If an in-lab study is denied and if the order did not permit Home Sleep Testing, then Neurocare will provide referring physicians with the information to appeal the outcome determination with the payor
Consider referring to a Sleep Specialist for consultation and management, including order of testing and justification of medical necessity/precertification
WHAT IF I ORDER A TITRATION STUDY AND THE PROVIDER APPROVES AN AUTO-PAP?
Please contact the durable medical equipment (DME) company listed on the authorization sent to your office in order to provide them with the authorization number and initiate the process to obtain APAP for your patient. Neurocare is not a DME provider and cannot facilitate the process further.