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Sleep Management Tools and Criteria


Program Overview | Utilization and Quality Management | Sleep Portal Login | Program Tools and Criteria

Criteria
CareCore National Sleep Management Criteria V1.1.2012
For health plan specific criteria please see below
                                                                                                            
Programs Managed by CareCore National in conjunction with Sleep Management Solutions

Fallon Community Health Plan
For prior authorization
Telephone: 1-800-630-3493
Fax: 1-866-999-3510

Criteria
Fallon Community Health Plan Criteria V.1.0.2012

Forms
Sleep Study Certification Request
Sleep Therapy Request
Fallon Community Health Plan SMS Home Sleep Test Order Form

Tutorials
Fallon Community Health Plan Sleep Management Provider Module
                                                                                                           
Tufts Health Plan
For prior authorization
Telephone: 1-888-511-0401
Fax: 1-888-511-0403

Criteria
SMS Sleep Management Criteria- Tufts Health Plan
SMS Sleep Management Criteria- Tufts Health Plan: Medicare

Forms
Sleep Study Certification Request
Sleep Therapy Request
Tufts Health Plan SMS Home Sleep Test Order Form

Tutorials
Tufts Health Plan Sleep Management Provider Module
                                                                                                           
Programs Managed by CareCore National
Aetna
For prior authorization
Phone: 1-888-622-7329
Criteria
Aetna Health Plan Criteria V1.0.2012

Tutorial
Sleep Management Provider Overview

Helpful Information
Aetna FAQ
New Polysomnography requirements -  effective March 1, 2012
For Aetna HST providers
                                                                                                          
Harvard Pilgrim Health Care
Phone: 1-888-511-0401
Harvard Pilgrim Network Participation
Phone: 1-800-918-8924 Ext: 10190

Criteria
Harvard Pilgrim Health Care Criteria V1.0.2012

CPAP Compliance Policy Change- Effective June 1, 2012
Letter from Harvard Pilgrim to DME Providers, dated March 28, 2012
PAP Compliance Fax Cover Sheet

Forms
Harvard Pilgrim Registration Form

Helpful Information
Harvard Pilgrim FAQ
Harvard Pilgrim Performance Standards and Expectations

Tutorials
Harvard Pilgrim Sleep Management Program Provider Overview
Harvard Pilgrim Health Care PAP Compliance Program
                                                                                                           
WellCare

Criteria
WellCare Sleep Management Criteria- Effective 4/1/2012








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