Dental Sleep Medicine Billing
Dental sleep medicine billing is the process of submitting medical claims for obstructive sleep apnea (OSA) treatment using oral appliance therapy.
Oral appliance therapy for OSA is covered under most major medical insurance policies and Medicare. In fact, there are no dental codes for OSA, leaving medical insurance as the appropriate billing source for dental sleep medicine services.
Dental Sleep Medicine has become one of the fast growing services in dentistry in the last decade mainly because of one reason – Medical Billing Reimbursement.
So what’s the big deal about obstructive sleep apnea treatment covered by medical insurance?
It can make dental sleep apnea treatment easily accessible to the patients who need it. Out of pocket expenses becomes much less of a factor when the patient knows their medical insurance would cover it, making them much more likely to accept treatment.
How do I bill medical insurance for dental sleep medicine?
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.
What are the dental sleep medicine medical billing codes?
You can find the medical billing codes for dental sleep medicine here, and how to use the billing codes to maximize your dental sleep medicine billing success.
Should I bill for dental sleep medicine in-house or hire a 3rd party medical billing service?
There are two main routes your dental practice can take in order to have success in dental sleep medicine billing.
1. Dental Sleep Medicine Billing In-House
•Keep the entire percentage and amount of medical reimbursement for each dental sleep medicine claim.
•Stay in complete control of your data and claims status.
•Extra work for your team.
•Adds another element to the dental sleep medicine implementation process.
Choosing this method can be more profitable, but can be more of an upfront investment in your team. Once the billing protocols are implemented and streamlined, billing in-house has several advantages that can be sustained long-term.
2. 3rd Party Dental Sleep Medical Billing Service
•Free up your team members’ time calling insurance companies.
•Doesn’t require as much training for team members.
•A percentage or fixed amount is taken per claim.
•Not as much control over your status claims and data.
Utilizing a 3rd-party medical billing service can be beneficial for dental practices that don’t have a team member they can designate the medical billing to. Although you won’t keep as much of your medical reimbursement, using a dental sleep medicine billing service can allow dental practices to begin implementing dental sleep medicine faster and efficiently.
Whichever solution you choose, it is important to ensure you have an efficient system in place to streamline your questionnaire and exam intake, generate the proper documentation, letters, and communications to referring providers.
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