Obstructive sleep apnea (OSA) is a growing concern in the U.S. In 1990, the incidence of OSA in adults 30–70 years old was 11%.¹ By 2014, it had risen to 26%² and is now estimated at more than 30%.³ Sleep studies are key to identifying the condition, but getting insurance approval can be a barrier.

It's incredibly frustrating to assess your patient, determine the need for testing, and then have your patient's insurance company deem the service not necessary based on a technicality or miscommunication. It causes delays in care, as well as the extra administrative burden of going through an appeals process. But these denials can often be avoided. As two physicians who have experience working within the prior authorization process, we will attempt in this article to highlight the most common reasons for denials and provide best practices to make the process go more smoothly.