Used in accordance with FDA guidelines<\/li>\n<\/ul>\n\n\n\nIf you have a patient who does not meet all the criteria above, you should still submit the paperwork for the preauthorization or predetermination. If United HealthCare denies it, ask for a peer-to-peer review. This is a way for the insurance company to receive feedback on opportunities to tweak the policy in future updates.<\/p>\n\n\n\n
Looking Ahead and How Fuel Can Help<\/h2>\n\n\n\n
In the coming months, it will be interesting to see if other insurers will follow suit with oral devices as a treatment option before considering surgery for OSA. Also, will the UHC medical necessity criteria be a roadblock for adolescent Down syndrome patients to access needed OSA surgical intervention? Time will tell. Need help keeping up with the latest insurance policy changes so that you can make your billing and coding as accurate as possible? Michelle Netoskie, Fuel Medical\u2019s Billing and Coding Specialist, offers revenue cycle management support to ensure your practice is compliant and profitable. Get in touch with her by completing the form on this page.<\/p>\n","protected":false},"excerpt":{"rendered":"
On March 1, 2024, United HealthCare (UHC) revised its commercial and individual exchange medical policy for obstructive and central sleep apnea (OSA) treatment, introducing new patient eligibility requirements that could impact your practice. The revisions are primarily for the surgical treatment of OSA and include the following: Including a failed trial of an oral appliance…<\/p>\n","protected":false},"author":1,"featured_media":12818,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_seopress_robots_primary_cat":"none","_seopress_titles_title":"","_seopress_titles_desc":"","_seopress_robots_index":"","header_content":"","schema":"","fname":"","lname":"","credentials":"","position":"","tenure":"","department":"","location":"","apply_url":"","placeID":"","no_match":false,"name":"","company":"","review":"","address":"","city":"","state":"","zip":"","lat":"","lng":"","phone1":"","phone2":"","fax":"","mon1":"","mon2":"","tue1":"","tue2":"","wed1":"","wed2":"","thu1":"","thu2":"","fri1":"","fri2":"","sat1":"","sat2":"","sun1":"","sun2":"","hours-note":"","footnotes":""},"categories":[120],"tags":[],"article_type":[12],"_links":{"self":[{"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/posts\/12815"}],"collection":[{"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/comments?post=12815"}],"version-history":[{"count":6,"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/posts\/12815\/revisions"}],"predecessor-version":[{"id":12824,"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/posts\/12815\/revisions\/12824"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/media\/12818"}],"wp:attachment":[{"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/media?parent=12815"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/categories?post=12815"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/tags?post=12815"},{"taxonomy":"article_type","embeddable":true,"href":"https:\/\/fuelmedical.com\/wp-json\/wp\/v2\/article_type?post=12815"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}