Case Summary: Sleep Appliance and Exam
Amount Billed: $2600
Amount Paid: $2110.97
Insurance Carrier: Regence
This patient was seen by her dentist after she was diagnosed with sleep apnea, and was told an oral appliance might be an option for her. After a thorough exam was completed, it was determined that the patient was an ideal candidate for appliance therapy.
A VOB was completed, and it showed medical coverage was available. A pre-authorization was submitted and approved, giving the patient a $2100 savings due to medical insurance.
Billing medical insurance for sleep appliances is a simple process once you know all the documentation requirements, and it can save patients thousands and thousands of dollars. These savings, and the confirmation that the treatment is medically necessary, are key factors in increasing case acceptance for oral appliances.
The total amount billed was $2600 for the appliance and exam. Medical insurance paid $2110.97, leaving the patient a much more manageable portion of only $489.03. Comparably, had this office not been set up to bill medical insurance, the patient would have been responsible for the full amount of $2600.
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