Medical Insurance

OSA is a medical condition and Oral Appliance Therapy should be submitted to medical insurance rather than dental insurance. You will need to submit the following with your claim:

1. Medical Claim formed filled out with the proper medical codes.
2. Letter of Medical Necessity (this is the diagnosis from the sleep MD and recommendation to treat with Oral Appliance Therapy)
3. Copy of the most recent PSG supporting the diagnosis.
4. Copy of the "Parameters" document which you can download from this site. This supports the "standard of care" treatment, based on the diagnosis.
5. Copy of Dental Exam and Airway Exam including medical history, history of current condition, review of findings, and a recommendation for Oral Appliance Therapy.
6. W-9 form with all your information filled out.
7. If the patient is abandoning their CPAP machine, you should enclose an Affidavit that they were unable to tolerate wearing it and why.

Nierman Practice Management software ( "DentalWriter" and "Cross Code") will help organize these tasks. 800-879-6468.



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