When a dentist adds Dental Sleep Medicine to their practice, they are going into it to save lives and make money, typically in that order.  But somewhere along the lines, they’re not quite making the money they were planning on making and they realize there are some frustrations they must deal with since they are now dealing with medical insurance. I believe that’s one of the biggest obstacles dentist face, leaving the “familiar” world of dental insurance and entering the “wonderful”, “frustrating”, and “ever changing” world of medical insurance. But keep in mind, your first purpose of adding Dental Sleep Medicine is to save lives. Alright, let’s be honest, if the money isn’t coming in, it’s easy to get side-tracked that the main purpose is saving lives. That is where utilizing a trusted third party billing service or hiring an insurance “guru” in your office comes into play.

Your third-party billing service or insurance guru have learned some tricks of the trade when it comes to medical insurance. It doesn’t mean there won’t be errors along the way but it means you, the dentist, can take a breath and know that someone else has your best interest in mind, it will make you more relaxed and excited about doing what you love, saving lives. We want you to succeed at both saving lives and making money.  If you’re not making money, you’re going to save less lives and that really is not an option. So, what can “WE”, the provider’s office and the third-party billing service do “TOGETHER” to see you succeed?

  1. Open communication, both parties need to let the other know what their expectations are.
  2. Both parties need to realize, the other is an ‘expert’ in their area and in realizing that, come to have a mutual trust and respect for the other.
  3. Always, always, always obtain an authorization before beginning services.
  4. Recognize that sometimes the insurance company will lie. I know, shocking, right? But, it’s true, the same representative will tell you or your billing coordinator two different things. Let’s not blame each other, let’s coordinate our efforts to get the “truth”.
  5. The fault lies with the insurance company, if they told you or your third-party billing service one thing but does another. That’s where disputes and appeals come in.
  6. Always keep things in proper perspective. Saving lives is the goal and making money is the benefit “WE’ all receive for saving lives.
  7. The estimated patient responsibility is just that, an estimate. Even when a predetermination is done, we will not be informed of the allowable amount, unless you are an in-network provider but we can provide a good estimate.

We are in this together. This is a rapidly growing service and more medical insurance companies are getting involved and recognizing the necessity for the Mandibular Advancement Device. There are twists and turns in this journey we are all on, but in the end, it will be worth it!

Please do not hesitate to let me or your third-party billing service know if you have any questions.


Lori Skipper

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