{"id":121,"date":"2019-01-07T18:47:57","date_gmt":"2019-01-07T18:47:57","guid":{"rendered":"https:\/\/www.bradybilling.com\/blog\/?p=121"},"modified":"2019-02-07T19:02:29","modified_gmt":"2019-02-07T19:02:29","slug":"3-year-rule","status":"publish","type":"post","link":"https:\/\/www.bradybilling.com\/blog\/3-year-rule\/","title":{"rendered":"Are You Taking Advantage of the 3 Year Rule?"},"content":{"rendered":"\n<div class=\"wp-block-image\"><figure class=\"alignleft is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.bradybilling.com\/blog\/wp-content\/uploads\/2019\/02\/AdobeStock_4004091-1024x672.jpeg\" alt=\"Woman on phone looking at calendar\" class=\"wp-image-122\" width=\"338\" height=\"221\" srcset=\"https:\/\/www.bradybilling.com\/blog\/wp-content\/uploads\/2019\/02\/AdobeStock_4004091-1024x672.jpeg 1024w, https:\/\/www.bradybilling.com\/blog\/wp-content\/uploads\/2019\/02\/AdobeStock_4004091-300x197.jpeg 300w, https:\/\/www.bradybilling.com\/blog\/wp-content\/uploads\/2019\/02\/AdobeStock_4004091-768x504.jpeg 768w\" sizes=\"auto, (max-width: 338px) 100vw, 338px\" \/><\/figure><\/div>\n\n\n\n<p>Most insurance providers and even Medicare make it possible\nfor patients suffering from obstructive sleep apnea to receive a new oral\nappliance every three years. This ensure the ongoing function of their\nappliances. However, many patients don\u2019t know about this, and many dentists\nfail to touch base with their patients to ensure they\u2019re coming back for a new\nappliance at least every three years. Keep reading to learn more about the\nthree year rule and how you can put it to work in your dental office. <\/p>\n\n\n\n<!--more-->\n\n\n\n<h2 class=\"wp-block-heading\">What is the 3 Year Rule? <\/h2>\n\n\n\n<p>Most <a href=\"https:\/\/www.bradybilling.com\/in-network-medical-insurance-coverage.html\">medical\ninsurers<\/a> and Medicare consider three years to be the reasonable life-span for\ndurable medical equipment (DME) like sleep apnea appliances. Thus, they offer\ncoverage every three years for a new oral appliance for those suffering from\nobstructive sleep apnea. For traditional insurance, you will likely just need\nto keep track of the three years and contact the insurer for preapproval as necessary.\nNot surprisingly Medicare has some additional standards that need to be met,\nincluding: <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The appliance needs to be used to serve a\nmedical purpose<\/li><li>It should not be used in the absence of illness<\/li><li>Appliance must be safe for home use<\/li><li>Criteria specified for oral appliance\nmanufacture and materials must be met<\/li><li>All documentation requirements for Medicare\ncoverage by the provider must be met<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">How Can You Let Patients Know About this Option? <\/h2>\n\n\n\n<p>Most providers will meet with patients periodically to check\nthe efficacy of the appliance. If the patient who receives sleep apnea\nappliances in your office is one of your regular dental patients, you will\nlikely see them twice a year for checkups, and you can use this time to make\nsure they\u2019re not having any issues with their appliances. If they are not a\nregular patient in your office, make sure you have a recall appointment set for\na few months after initial use of the appliance to ensure compliance and\nefficacy. After the initial recall, you should keep in touch at least once a\nyear to ensure they are still having success with their treatment. Some\npatients will prefer to just meet their sleep physician for these checkups, so\nyou\u2019ll need to make sure you have a good relationship with these providers. When\nit comes time for the three year appliance, have a system in place to contact\nthe patient directly or through their sleep doctor. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What if They Need a New Appliance Sooner? <\/h2>\n\n\n\n<p>Medicare only covers new appliances every three years, but\nother insurers are more flexible. You\u2019ll need to review coverage limits, and\npartner with your patient to find the best option to minimize out of pocket costs.\nIn some cases, contacting the insurer directly and applying for\npre-authorization is enough to override the three-year limitations. If the\npatient needs a new appliance due to damage from teeth grinding or clenching,\nyou may want to do some research to find a more durable option to avoid the\nneed for early replacement. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Meet the Brady Billing Team <\/h2>\n\n\n\n<p>At Brady Billing, we always do our utmost to simplify these\nprocesses, and we can help your dental office make sure patients are making the\nmost of their available benefits. If you\u2019re ready to get started working with\nour knowledgeable team of billing professionals, <a href=\"https:\/\/www.bradybilling.com\/contact-us.html\">call<\/a> today. We look\nforward to discussing all of your billing needs and our available options. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Most insurance providers and even Medicare make it possible for patients suffering from obstructive sleep apnea to receive a new oral appliance every three years. This ensure the ongoing function of their appliances. However, many patients don\u2019t know about this, and many dentists fail to touch base with their patients to ensure they\u2019re coming back [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,17],"tags":[8,9,10,6,13,3,4,33,21,22,14,39,34],"class_list":["post-121","post","type-post","status-publish","format-standard","hentry","category-medical-insurance","category-sleep-dentistry","tag-medical-billing-for-dentist","tag-medical-billing-for-dentists","tag-medical-billing-for-sleep-apnea","tag-medical-billing-training-for-dental-offices","tag-medical-insurance","tag-medical-insurance-billing-for-dentist","tag-medical-insurance-billing-for-sleep-apnea","tag-medicare-benefits","tag-oral-appliance","tag-oral-appliances","tag-sleep-apnea","tag-sleep-dentistry","tag-snoring"],"yoast_head":"<!-- This site is optimized with the Yoast SEO 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