ARNOLD L CHASSANOFF, DMD
Diplomat, American Board of Dental Sleep Medicine
|
INSURANCE COVERAGE
Very few, if any, dental plans provide coverage for oral appliance therapy. Without exception, oral appliance therapy should be billed to medical insurance carriers. Most medical insurance companies today will cover oral appliance therapy if they are assured that they are paying for something that the patient needs. There must be a diagnosis and a sleep study to justify the diagnosis. Medical necessity for the treatment must be established and a prescription signed by a physician is required. The cost, durability and probability of success are considered as well as the dentist's experience and qualifications. A substantial amount of information is usually required to be submitted to the insurance carrier to establish a benefit. The medical code for treatment of obstructive sleep apnea syndrome by oral appliance therapy is E0486. Your insurance company can advise you if this is a covered procedure before we evaluate you and submit the necessary paperwork. STANDARDS OF CAREMedical insurance companies are expected to adhere to the American Academy of Sleep Medicine Practice Parameters. The Practice Parameters state that oral appliances are indicated for use in patients with mild to moderate obstructive sleep apnea who prefer oral appliances to CPAP, or who do not respond to CPAP, or are not appropriate candidates for CPAP, or who fail treatment attempts with CPAP or behavioral measures such as weight loss or sleep position changes.FEE ARRANGEMENTSOral appliances are custom made for each patient and because of this, they must be paid for in full at the time of delivery. Our insurance specialists will work with your insurance company to determine your coverage. We will submit all necessary paperwork from our office as well as your physician's office to ensure that your benefits are maximized.MEDICARE COVERAGEWe do not accept or process Medicare. Medicare currently covers oral appliances and coverage is considered on a case by case basis. A large percentage of our Medicare patients have insurance coverage.FINANCINGFinancing is available for oral appliance therapy at no interest thru the CARE CREDIT PROGRAM. You can apply on line for approval by clicking here.
|
|