Successfully billing medical insurance in a dental practice depends on several factors.

First and foremost, the procedure has to be covered under the patient’s specific medical plan and policy.

Second, there must be proper documentation showing that the procedure was medically necessary. Depending on the written policy, some insurance companies may require additional information in order to be approved, such as a physician’s written order or prescription.

Third, the medical claim form needs to be filled out properly, with the correct ICD diagnosis codes, and CPT procedure codes.

Below is a list of the most common dental procedures covered under medical insurance, however other procedures can also be covered if they meet the above requirements:

Sleep Apnea Appliance Therapy (Dental Sleep Medicine)

TMJ Disorder Therapy (TMJ Appliances)

Medically Necessary Dental Implants and Oral Surgeries

Infant Frenectomies

Mucositis Treatment

Oral Cancer Screening

Accident Cases

Botox for Painful Bruxism

Exams, CBCT and Radiographs for the Above Procedures

Dental sleep medicine billing is the process of submitting medical claims for oral appliance therapy that treats obstructive sleep apnea (OSA).

Medical insurance and Medicare typically reimburses for oral appliance claims when claims are submitted with the right documentation.   In fact, there are no dental codes for OSA, leaving medical insurance as the appropriate billing source for dental sleep medicine services.

Dental practices can bill for a custom oral appliance, exams, and radiographs related to the treatment.

In order to receive medical insurance reimbursement in dental sleep medicine, you need several pieces of information to complete the puzzle. Medical billing for dental sleep medicine is not difficult once you figure out the proper protocols.

• The diagnosis of obstructive sleep apnea by a physician.
• A written order or prescription for an oral appliance from physician.
• Patient questionnaire that includes medical history, Epworth Sleepiness Scale, and sleep history.
• Detailed documentation or narrative report of questionnaire data and exam findi/ngs.

Dental Sleep Medicine Billing is made easy with DentalWriter software. Our clients report over a 95% success rate when billing for sleep apnea appliances.

The key to successful medical billing in a dental practice lies in detailed documentation and narrative reports building your case of medical necessity.  Dental practices can combine DentalWriter with a medical billing service to successfully implement medically necessary services, or do the medical-billing in-house.

The narrative reports that DentalWriter™ generates from each patient visit serves as your documentation and your communication to physicians, which greatly increases your referrals and help grow your dental sleep medicine and TMJ disorder services.

In addition, DentalWriter™ simplifies and streamlines the workflow with the electronic questionnaire and exam forms, and the library of Quickletters over 150 template letters and forms for all of your communication needs.

Our development team typically releases 2 major software updates a year. These updates include changes to medical billing codes or protocols, new features, such as our benefit checker and ledger, and enhanced technology integrations, such as our Secure E-Fax add-on.

The Desktop version of DentalWriter is only compatible with a Windows operating system. However, The DentalWriter Private Cloud version is compatible with Mac operating systems since it is accessible through an internet browser.