Re: [ACEsthetics] 3rd party reimbursement

Range is between $900 and $8000, depending on the insurance company and employer. Yep, about 85% Somnodent Flex and 5% G2s - others are SUAD, Herbst, TAP and OASYS

Kent Smith DDS, Diplomate-ABDSM
www.21stCenturyDental.com
www.SleepDallas.com
Dental Sleep Medicine Facility Accredited
2-day Sleep course: Wasted Days and Sleepless Nights (2013 dates March 22/23, May 17/18, July 12/13, Sept 13/14, November 8/9 )
Developer and President FindCE.com and Find-Speaker. com
Twitter - @theSleepDentist
Linked In Sleep Dentist

At 02:15 PM 2/3/2013, David R. Boag, DDS wrote:

Kent,

What is the range of your net income? After Nierman et al take their %? I'm sure it varies a good bit.

And are you still predominantly doing SomnoDent Flexes? What others do you use now? Moses? TAP3?

DRB

Sent from my iPad

On Feb 2, 2013, at 10:52 PM, Kent Smith < kentsmith@21stcenturydental.com> wrote:

I impress and take the bite, collecting the patient's copay at that time. I then "file the claim" to insurance at appliance delivery, as insurance companies require. Then when we receive the insurance check, we write off any difference, and do not charge the patient more. Medicare is different, BTW.

Kent Smith DDS, Diplomate-ABDSM
www.21stCenturyDental.com
www.SleepDallas.com
Dental Sleep Medicine Facility Accredited
MySecretBraces - Shhhhh!!!!!!!!!!!!
2-day Sleep course: Wasted Days and Sleepless Nights (2013 dates March 22/23, May 17/18, July 12/13, Sept 13/14, November 8/9 )
Developer and President FindCE.com and Find-Speaker. com
Twitter - @theSleepDentist
Linked In Sleep Dentist

At 07:10 PM 2/2/2013, safariandmd@aim.com wrote:
Kent can you explain what you do in your office. In other words do you take the bite and submit the claim or do you charge patient and have them be reimbursed directly.
Sent from my Verizon Wireless BlackBerry
From: Kent Smith < kentsmith@21stcenturydental.com>
Date: Sat, 02 Feb 2013 18:32:00 -0600
To: <safariandmd@aim.com>; <schminsk@bellsouth.net >; <toothpick44@gmail.com >
Cc: ACEsthetics group< ACEsthetics@googlegroups.com>
Subject: Re: [ACEsthetics] 3rd party reimbursement
There are about 5, including Dental Writer, who do this for you, and I strongly encourage that. Saves a lot of headaches. I run two sleep rooms all day long (10-20 patients a day), and still use an outside service.

Kent Smith DDS, Diplomate-ABDSM
www.21stCenturyDental.com
www.SleepDallas.com
Dental Sleep Medicine Facility Accredited
MySecretBraces - Shhhhh!!!!!!!!!!!!
2-day Sleep course: Wasted Days and Sleepless Nights (2013 dates March 22/23, May 17/18, July 12/13, Sept 13/14, November 8/9 )
Developer and President FindCE.com and Find-Speaker. com
Twitter - @theSleepDentist
Linked In Sleep Dentist

At 06:17 PM 2/2/2013, safariandmd@aim.com wrote:
Not trying to hijack this thread but there was discussion on OSA reimbursment groups a couple of weeks ago. Does Rose Niermans company do this for dental offices. I am thinking to have an agency do this for us. Guessing they charge 8-10 % on what they collect for us. Might just be worth having them deal with this for us. Any feedback would be appreciated.
Sent from my Verizon Wireless BlackBerry
From: John Highsmith DDS <schminsk@bellsouth.net >
Sender: acesthetics@googlegroups.com
Date: Sat, 2 Feb 2013 16:54:37 -0500
To: <toothpick44@gmail.com >
ReplyTo: schminsk@bellsouth.net
Cc: ACEsthetics group< ACEsthetics@googlegroups.com>
Subject: Re: [ACEsthetics] Medicare nails CPAPs
Unfortunately the majority of home studies are only oximetry. My understanding is that oximetry only shows severe OSA, the type that can kill you. Nice to know, but there are a myriad of ways OSA can make your life miserable and can exacerbate any co-morbidities the patient has, so these screenings seem totally inadequate. Ironic that a patient will often get better medical care in this regard walking into Kent Smith's office than going to their physician.


John Highsmith DDS
Clyde, NC
AACD Accredited Dentist
LVI Clinical Instructor
Diplomate, ICOI
Fellow, Misch Implant Institute
DrHighsmith.com




On Feb 2, 2013, at 4:40 PM, Guy Moorman wrote:

Don't know if this hit everyone but got a message from sleep society that Medicare is cutting CPAP reimbursement by 47% for full mask devices.  Nothing was said about MADs.  I worked on the nurse practitioner for the local big shot sleep guy who got me to take Kent's course (thank goodness) and asked her if they were doing any ambulatory sleep studies.  I'd heard that Medicare and the Blues were going to move almost totally to ambulatory over the centers.  She angrily told me that the Blues had just about made them go totally to ambulatory sleep studies because they were essentially as accurate as those being done in docs' offices or centers rather than hospitals.  She said she hated the ambulatory sleep studies because patients did not know how to use them.  We've had not one problem other than one clerical error and a temp loss of one test.  They just hate the lower reimbursement. 

I'm sure all of this is due to abuse of sleep studies and CPAP sales by Home Health Companies.  Kent that 47% I know you've seen but I did not know if the Blues in Texas had moved on the sleep centers like they have here.  If we could come up with a cheaper device than the CPAP we've be doing most of the sleep devices.  This will push the average Home Health fee to about 100 bucks for the lower end CPAPs which is what the government is going to mandate.  I'm betting fewer and fewer people will tolerate that mask and will want to pay for an oral appliance or more expensive CPAP.  Guy

--
Guy W. Moorman
The Swamp
Douglas, Georgia

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