Why Medical Billing for Dental Sleep Medicine Doesn't Have to Be Scary
By: Jon Nierman
For dental practices implementing obstructive sleep apnea treatment, the topic of medical billing almost always comes up, and with that, many questions.
- Should we bill medical insurance?
- How complicated is it?
- Can we remain fee for service and bill?
- How do we start?
Like most things in life, a one-size-fits-all answer doesn’t apply.
There are several ways to structure your model, but ultimately offering reimbursement helps add value to your services and creates a win-win situation for both the patient and the practice.
3 Ways Incorporating Medical Billing Benefits a Sleep Practice
1. Obtain Higher Case Acceptance
Medical billing makes treatment more accessible to your patients. With the help of medical insurance, many patients can move forward that otherwise wouldn’t. A benefit check makes it easy to determine the patient’s medical coverage. Tapping into their medical benefits to cover part of their treatment lowers their out-of-pocket costs and creates a great patient experience they will be raving about, increasing loyalty and referrals.
2. Establish Better Referral Networks with Physicians
Billing medical insurance not only makes it easier for patients to accept treatment but also for physicians to refer patients to you. Physicians want to feel great about where they send their patients. If a patient has an incredible experience with you, they will thank the referring provider for sending them your way. That will facilitate additional referrals and a strong partnership. Additionally, by sending follow up narrative reports to the patient’s other providers, word will get out to the medical community that you are your area’s go-to dental sleep provider.
3. Maximize Medical Benefits for Other Services
In addition to OSA appliance therapy, other dental office services are often considered medically necessary by insurance, including TMJ therapy, oral surgeries, frenectomies, & even Botox (for pain). You can leverage the same medical billing systems you use for sleep, multiplying the value it adds to your practice and patients.
So, the real question shouldn’t be IF you should add medical billing to your practice, but HOW.
The difference between medical billing success and frustration comes down to 2 factors:
- Repeatable Systems
Medical insurance success revolves around having the proper documentation and correspondence in a “medical model.” A system to create SOAP reports of medical necessity is crucial to show the patient’s subjective complaints, objective exam findings, assessment, and plan. Implementing a system designed for dental sleep medicine eliminates guesswork, reduces denials, shortens turnaround time, maximizes reimbursement and efficiency, and fosters happiness for your team and your patients.
Team members and dentists who are educated in the reimbursement requirements and dynamics in billing medical are the most successful. Even when using a 3rd party medical billing service, knowledge is power!
Finally, an expert support network can make the difference when getting started.
Nierman Practices Management specializes in providing the key training, systems, and support a dental practice needs to implement medical billing stress-free. Their core solution, DentalWriter Plus+, is a dental sleep medicine cloud software and integrated medical billing service and support network that streamlines the dental sleep medicine and medical billing workflow to facilitate easy reimbursement, referral building, team efficiency, and practice growth.