Facility-based Sleep Studies
Facility-based sleep studies, also known as polysomnography (PSG), are used to diagnose sleep disorders (sleep apnea, narcolepsy, parasomnias, etc.). Preauthorization of facility-based sleep studies will be administered by Humana's Clinical Intake Team (CIT). Please note that precertification, preadmission, preauthorization and notification requirements all refer to the same process of preauthorization.
Preauthorization for Facility-based Sleep Studies
Health care providers can facilitate an authorization or provide notification for facility-based sleep testing by contacting CIT via one of the following methods:
- Humana.com/providers (registration required)
- Availity.com (select markets only, registration required)
- Humana's interactive voice response (IVR) line at 1-800-523-0023, 8 a.m. to 8 p.m. Eastern time, Monday through Friday
Please note: Exclusions from this requirement include the following members and providers:
- ASO: Groups not utilizing the standard PAL
- MA: PFFS, Risk Groups, Medicare Advantage Prescription Drug (MAPD) plans
- Other: HumanaOne®, Puerto Rico, Medicaid
Submitting Preauthorization Requests
Humana requires that facility-based sleep studies (PSG) ordered for a Humana-covered patient be administered through CIT by phone or Web.
Phone: 1-800-523-0023
Submitting a request online
Physicians may submit an online request via Humana.com/providers (registration required) or Availity.com (select markets only, registration required).
Additional Resources
Home sleep studies do not require preauthorization.
Questions
Questions about submitting a preauthorization request for facility-based sleep studies may be directed to Humana at 1-800-523-0023.
