Best Medical and Billing Practices for Dental Sleep Medicine

Navigating the medical insurance maze can be difficult for dentists and staff and you won’t need to reinvent the wheel! We will share our hard earned knowledge and experience with you and save you time and money. We will hold your hand and teach you the process and tricks of the trade in a step by step format complete with forms and templates so that you can effectively bill medical insurance and receive maximum reimbursement. Mastering this process will give you the edge you need in this wide open and growing market.

Evaluation / Management (E/M) Coding and Recording Keeping for Dental Sleep Medicine

All dentists that bill CPT codes for consultations / office visits must follow E/M coding guidelines set forth by the American Medical Association. E/M coding guidelines require very specific documentation in the patient medical record. This is very different than dental record keeping and billing for dental codes.

If a dentist who bills CPT codes is audited by a medical insurance company and does not have all the documentation to meet the specific CPT code in the patient medical record, he/she will be required to give back fees paid to him/her by the insurance company. It is a fact that dentists who practice dental sleep medicine have been audited. And auditing of dentists will expand as billing for dental sleep medicine services becomes more prevalent.

Health Insurance Companies - Navigating the Maze

Insurance companies have very specific guidelines and requirements that must be followed when billing for oral appliance therapy. We will help you work within each individual company’s guidelines for timely and consistent processing and payment of claims to your office or directly to your patients. Before a patient begins treatment you will be able to present them with a detailed plan of care that will show them what they can expect their medical insurance will cover and what their estimated out of pocket will be. Effective treatment planning will lead to more patient acceptance.

Insurance reimbursement for oral appliance therapy varies from region to region throughout the U.S. You will become an expert in your area. And you can market your expertise to physicians and patients.

How do I get started?

We work with each office (dentist and up to 2 staff members) via webinar and teleconferences so that you do not have to incur the costly expense of travel. You will receive ongoing support as you learn your way through the medical health insurance protocols. Special onsite programs are available for an additional fee. Programs will begin the fall of 2008.

Upon completion of our program BEST BILLING PRACTICES FOR DENTAL SLEEP MEDICINE

You will be able to:

• Understand and implement required E/M c• Understand and implement required E/M coding and medical record keeping to maximize reimbursement and minimize risk
• Know how to collect the medical documentation you need for treatment
• Develop comprehensive treatment plans
• Work with health insurance companies to confirm benefits, and preauthorize treatment
• Understand exactly what the health insurance companies in your area require for payment of dental sleep medicine services
• Negotiate payment with insurance companies
• Submit clean claims for treatment
• Understand your options with Medicare
• Understand how to correspond with physicians
• Understand effective follow up your best marketing tool