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Sending Orders to Sleep Source

Clinical documentation for PAP equipment referrals can be faxed to 888-307-2154. See below for a list of required items for different types of referrals:

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Newly diagnosed patient - PAP machine referral:

  • Prescription with pressure and setting details for PAP

  • Sleep study report (insured requirement only - preferred for cash pay)

  • Chart notes prior to the sleep study (insured requirement only - preferred for cash pay)

  • Letter of medical necessity - unsigned form sent by Sleep Source after the patient receives their PAP

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CPAP supplies renewal (new patient to Sleep Source):

  • Prescription for CPAP supplies

  • Chart notes not necessary but appreciated

Replacement PAP order (must be 5 years since previous device to qualify for insurance coverage):

  • Prescription with pressure and setting details for PAP

  • Sleep study report (insured requirement only if patient is new to Sleep Source - preferred for cash pay)

  • Chart notes with details regarding the reason for replacement (insured requirement only - preferred for cash pay)

  • Letter of medical necessity - unsigned form sent by Sleep Source after the patient receives their PAP

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CPAP supplies renewal (annual insurance requirement):

  • Prescription for CPAP supplies

Insurance Guidelines FAQs

We cannot locate our patient's past sleep study, can they still receive a new PAP device?

  • Insurance companies will typically require Sleep Source to have documentation on file of a sleep study in order to provide a replacement device. Sleep Source can assist in locating an older study, but if one is not found then we would recommend providing a home sleep test. This is not a requirement for cash pay patients.

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We cannot schedule our patient for their 31-90 day follow up within the timeframe required, is this going to be an issue for them?

  • It would be ideal to schedule them within this timeframe, but they can still receive insurance coverage if the appointment is outside of this timeframe.

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Does the insurance require that compliance is met when our patient completes their 31-90 day follow-up?

  • Yes. In order for the follow-up to qualify for most insurances, it must occur after the patient has achieved compliant use of their PAP. We recommend scheduling them again or rescheduling if this appointment occurred prior to meeting the usage requirement. The follow up should document that the usage requirement is met and that the patient is benefitting from its use.

What is the requirement for extending the 90 day trial period for meeting compliance?

  • If your patient is non-compliant and requesting an extension, they should have an appointment with the physician to discuss the reasons. Most insurances require the completion of an in-lab sleep study to extend compliance. The sleep study and notes for the visit are needed by Sleep Source, and the patient will have another 90 days to achieve compliance once these are sent. Patients will be charged and expected to pay that balance unless they achieve compliance in the extension period.

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Our patient spoke with their insurance company and ________

  • Sleep Source compiles and documents insurance guidelines for many insurances and has staff skilled in dealing with insurance agents to get correct information. The quality of information provided by insurance reps is very variable, and it is not uncommon for patients to be given inaccurate or incomplete information. We do our best to take these inquiries seriously but with a grain of salt, and may ultimately have to provide counter-information that contradicts what a patient was told by an insurance rep.

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