Insurance & Billing
The following information is provided for reference by former patients who may need to reconstruct billing records or respond to unresolved insurance correspondence from the period during which Somnatek was operational.
Insurance Accepted
During its operational period, Somnatek Sleep Health Center accepted coverage from the following insurance carriers. This list reflects the payer mix at the time of closure and is provided for reference only.
| Carrier | Network Status | Authorization Required |
|---|---|---|
| BlueCross BlueShield of Georgia | In-network | Yes — in-lab PSG, MSLT |
| Aetna | In-network | Yes — all diagnostic studies |
| UnitedHealthcare | In-network | Yes — in-lab studies only |
| Cigna | In-network | Yes — all diagnostic studies |
| Humana | In-network | Yes — in-lab PSG, MSLT |
| Medicare (Parts A & B) | Participating provider | No — medical necessity documentation required |
| Medicaid (Georgia) | Enrolled provider | Yes — all services |
| Tricare | In-network | Yes |
| Self-pay / Uninsured | Accepted | N/A — payment plan available at time of service |
Research study participants enrolled under Protocol 7A were billed separately under a clinical research billing track. Research participant billing was handled through Wexler University. Former research participants with billing questions should contact Wexler University’s Office of Research Administration.
Prior Authorization
Somnatek required prior authorization from most major carriers before scheduling in-lab polysomnography or MSLT procedures. The authorization process typically required a referring physician letter documenting clinical indication, a completed sleep questionnaire (ESS and STOP-BANG or equivalent), and a signed patient consent.
Authorization numbers were documented in the patient record and on the Explanation of Benefits (EOB) returned by the insurer. If you received a denial and need to reconstruct the authorization record, contact Dorsal Health Holdings LLC for a copy of your clinical file.
The prior authorization request form used by Somnatek is available on the Patient Resources page.
Billing Codes
The following procedure codes were in use at Somnatek for common diagnostic services. This information may assist former patients in verifying EOB records or resolving insurance disputes.
| Procedure | CPT Code | Notes |
|---|---|---|
| Polysomnography, unattended — 6+ hours | 95808 | In-lab standard study |
| Polysomnography with CPAP titration | 95811 | Split-night or full CPAP titration |
| Multiple Sleep Latency Test (MSLT) | 95805 | Narcolepsy/hypersomnia evaluation |
| Home sleep apnea test (Type III device) | 95806 | Unattended, portable monitoring |
| Sleep medicine interpretation | 95810 | Physician read and report |
Outstanding Balances
Somnatek Sleep Health Center transferred all open accounts receivable to Dorsal Health Holdings LLC as of November 3, 2014. Patients who received a billing statement dated after this date should contact Dorsal Health Holdings LLC directly. Somnatek is no longer able to process payments, issue adjustments, or respond to billing disputes.
If you believe you received a statement in error or have documentation of a payment that was not reflected in your account, contact Dorsal Health Holdings LLC in writing at the address on your statement.
All former Somnatek patient correspondence should be addressed to:
Dorsal Health Holdings LLC
c/o Records Administration
465 Upper Riverdale Road, Suite 4
Harrow County, GA 30274
This office does not accept walk-in inquiries. Written correspondence only.