This portal is intended to support providers in requesting authorizations for sleep services and managing your patients sleep service needs across the sleep management continuum. The program is a prior-authorization program designed to improve the overall quality of sleep related services from diagnosis to therapeutic
A Medical Necessity approval will be required prior to performing a sleep
study, initiating sleep therapy, and ordering sleep therapy supplies in order to receive claim payment. All requests for sleep services will be reviewed and assessed for medical necessity and site of service using evidence based and industry accepted medical criteria. Please refer to the Sleep Management Programs medical criteria prior to submitting your authorization request for sleep services.
In addition will provide a comprehensive support program for patients who require treatment for Obstructive Sleep Apnea and are prescribed a Positive Airway Pressure (PAP) device. The sleep therapy adherence program, iComply is intended to assist patients in adapting to their therapy and maintaining a level of therapy adherence in order to ensure that members achieve the maximum therapeutic benefits of the prescribed treatment.
This secure portal will allow contracted providers to:
Check member eligibility
Request authorization for sleep related services
Report sleep study interpretation results
Report PAP therapy adherence for continued benefit coverage
Importance of Providing Correct Ordering Physician Information June 22nd, 2013
This is to remind you about the importance of providing current and correct ordering physician information with each authorization request and to introduce new provider portal functionality relating to ordering physician information