UHC: No Change in Sleep Reimbursement Policies

A CPAP code was incorrectly added to an earlier policy update; AAHomecare seeking clarification on reprocessing any denied claims.

UnitedHealthcare (UHC) has not altered its reimbursement policies for sleep therapy claims, and an earlier notification of denial for PAP supply claims from DME providers was due to a system error, according to UHC.

“We have not made any changes to our reimbursement policy for CPAP/PAP supplies,” said Tracey Lempner, director of communications for UnitedHealthcare. “We did discover that a CPAP code was incorrectly added to a policy update. As soon as we were aware of the error we corrected it and we are adjusting claims.”

Last week, there had been reports that providers had received the UHC update stating that the organization would no longer pay for PAP supplies while the unit is on rent.

When it comes to appealing any incorrect denials, the American Association for Homecare reported that some providers have been told to submit denials as a claims project to UHC while others are being told not to resubmit and that UHC will be reprocessing the claims automatically.

“The Association is still waiting for a response from national contracting at UHC to confirm this information and to obtain clarification on how providers should proceed for claims reprocessing,” a statement from AAHomecare read. “We will confirm the information from the national contracting team and let providers know as soon as we receive further guidance.”

About the Author

David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.

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