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How Does Medicare Actually Work with Sleep Apnea Treatment?

November 7, 2018

Dental and medical insurance policies can seem to be purposefully complicated, but Medicare coverage can be especially challenging. If you’ve made the decision to offer oral appliances for sleep apnea sufferers, you may need to understand how Medicare policies cover these devices. You may be thinking, “I already accept regular medical insurance, and that’s a hassle. How much worse is Medicare going to be?” The truth is, it can be a big challenge and take up a lot of your time during the application process. In this post, we’ll discuss the process for becoming a Medicare provider for oral appliances and why it’s worth the challenge.

Durable Medical Equipment (DME) Coverage

Medicare insures oral appliances for sleep apnea and snoring as part of the Durable Medical Equipment (DME) coverage. These Medicare benefits cover all kinds of equipment necessary for medical purposes like wheelchairs, shower seats, hand rails, and other products. Oral appliances and CPAP systems for snoring and sleep apnea also fall into this Medicare category.

Participating & Nonparticipating DME Supplier Status

In order for your patients to be able to receive thesebenefits from Medicare, your dental office needs to be established as a participatingor nonparticipating DME supplier. Otherwise, your patients will likely bedenied their reimbursement from Medicare. Your office should apply for “nonparticipating”supplier status unless you also accept Medicare dental insurance benefits. Ifyou do take Medicare dental benefits, you may qualify to apply as a “participating”supplier. To apply for DME supplier status, you’ll need to complete the Medicare855s application. It can be a bit of time commitment to complete the fullapplication process, but for most dental sleep medicine practices, the increasein patients is well worth the time it takes to complete and file your 855s application.

How Brady Billing Can Help

At Brady Billing, our team of professionals offer a variety of services to make billing, insurance, and Medicare easier for those dental offices that are offerings sleep apnea services. In fact, we exclusively work with dentists who provide sleep dentistry services. That means our team members really understand the specific challenges you’ll be facing. We can help with your medical insurance, billing, and application to become a nonparticipating DME supplier for Medicare coverage. Best of all, we offer customized service options that meet your specific billing and insurance needs. Our goal is to help you spend your time where it belongs – with your patients. To learn more, call the Brady Billing team today. Located in Frisco, Texas, we are happy to provide billing services for dental offices across the US.

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