Early this month the AADSM notified members about what appeared to be a policy change set by Aetna. Members across the country received denials from Aetna for oral appliance therapy and were told that Aetna would no longer cover oral appliances for the treatment of obstructive sleep apnea. We are relieved to tell you that this issue has been resolved.
On May 18, AADSM staff connected with the Aetna Clinical Policy Unit, which discovered that oral appliance claims were being denied as of early April due to a system error. Aetna agreed to fix this system error and reprocess all oral appliance claims that had been denied. As of Monday May 23, the Aetna system has been fixed. Reprocessing of claims will occur over the next few weeks - there is no need to resubmit claims that Aetna denied during the period of non-coverage. We appreciate that our members informed us of the Aetna coverage problem allowing us to act quickly to resolve this issue on your behalf.