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1) Students and Sleep Apnea
2) NPM Study Groups with Dr. Mayoor Patel
3) NPM Team Member Highlight: Justina Karciauskaite
4) Are you still billing medical claims on paper?
5) Tip of the Month: How to know what is required for medical coverage
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Recipe of the Month
Hot German Potato Salad
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Ingredients
1 pound potatoes, not peeled (about 4 cups, cubed) 3/4 cup chopped onion
1/2 teaspoon celery seeds
1/4 teaspoon salt (optional)
1/8 teaspoon ground black pepper
3/4 cup water
2 tablespoons unbleached all-purpose flour
1/3 cup cider vinegar
1 tablespoon granulated sugar or the equivalent in artificial sweetener
1/4 cup bacon-flavor soy bits
Scrub potatoes and cube. Place in medium saucepan and cover with water. Bring to a boil. Cover, reduce heat, and simmer 12 minutes or until potatoes area done. Drain.
Spray a skillet with nonstick cooking spray. Sauté onions until done. Add celery seed, salt (optional) pepper, and water. Simmer on low.
In a covered container, shake flour with vinegar to prevent lumps. Add to onions and cook, stirring constantly, until bubbly and thickened. Add sugar or artificial sweetener and stir. Carefully stir in potatoes. Serve hot, sprinkled with bacon bits.
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ABOUT US
Rose Nierman laid the foundation for dentists billing medical insurance when she wrote the first medical billing for dentistry manual, Successful Medical Insurance in Dentistry, 25 years ago. Over the last quarter century, Nierman Practice Management has led medical billing in dentistry with DentalWriter™ and CrossCode™ software and exceptional continuing education. Contact Rose at 800-879-6468 or visit www.DentalWriter.com.
Nierman Practice Management
221 Old Dixie Hwy #5
Tequesta, FL 33469
www.dentalwriter.com
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Students and Sleep Apnea
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With finals approaching and the frenzy of the school year ending, students tend to pull all-nighters, creating stress and causing sleep deprivation.
It is estimated that roughly 4% of college students suffer from sleep apnea, which can have a direct effect on their cognitive performance for learning, memory and overall health. Sleep apnea causing sleep deprivation in students is sometimes overlooked as common behavior of ‘being a student”. The repercussions of sleep apnea and poor sleep for students are vast. When students do not get the sleep they need, they are at risk for health, performance and safety problems; difficulties in school are often the result. However, sleep deprivation is also common mistakenly attributed to attention-deficit or behavior disorders. Sleep apnea often can be treated with continuous positive airway pressure, or CPAP, machine. Treatment with a CPAP machine sometimes isn’t a good fit with college students who are self-conscious or embarrassed about sleeping with a CPAP - also jokingly referred to as the “DarthVadar Mask”. An oral appliance for obstructive sleep apnea can be a great alternative option to the CPAP machine, if prescribed by the patients doctor.
Do any of your patients or loved ones exhibit any of the follow signs and symptoms of sleep apnea in students?
Nighttime:
- Snoring
- Breathing pauses during sleep
- Restless sleep
- Mouth breathing
- Difficulty getting up in the morning, even after getting the proper amount of sleep
Daytime:
- Hyperactivity
- Inattention
- Behavior problems
- Sleepiness
Want to find and help more sleep patients? Check out NPM's patient awareness and marketing solution Snoring Isn't Sexy: www.snoringisntsexy.com
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NPM Study Groups with Dr. Mayoor Patel
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NPM’s Director of Clinical Education, Dr. Mayoor Patel, has taken the NPM study group to a new level with engaging sessions such as interactive case presentations! Many of you were able to join the live sessions with Dr. Patel, but if you were not, or if you would like additional team members in your practice to view them; the great news is we record all of our study group sessions here at NPM and they are available 24/7, on demand to all active DentalWriter clients these are session you don’t want to miss!
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View the recording of Dr. Mayoor Patel's study group: "Differential Diagnosis of Orofacial Pain - Case Studies"
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View the recording of Dr. Mayoor Patel's study group: "Managing Side Effects of Oral Appliances for OSA"
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NPM Team Member Highlight: Justina Karciauskaite
Justina has been a part of the NPM team since July 2013, focusing on Nierman’s unique patient awareness and marketing resource Snoring Isn’t Sexy (SIS). You will often find her setting up new, and updating existing SIS member websites, creating and posting press releases for SIS members, creating and refining SIS promotional and branding materials, and tracking all the stats for incoming patient requests! When asked about her work with Snoring Isn’t Sexy, Justina commented “I feel lucky to be in this position and do whatever I can to help get patients to our website for them to get help. Our members are dedicated to offer a service that not many dentists do and that makes my work even more important. I feel proud to work with all of them and respect them for their hard work to help the people in their community.”
In her time outside of work, Justina attends a local community college full time and is in her second year. She is working towards a Bachelor’s Degree in Chemistry to complement her love of science. In her personal time, she enjoys taking her puppy to the beach, watching movies, spending time with loved ones, and eating good food. Justina commented “I absolutely love South Florida and will always want to live on the coast of an ocean and in 90 degree weather”.
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 Are you still billing medical claims on paper?
As the medical community is moving toward being paperless, paper claim forms are taking longer and longer to process and track the status.
Did you know?
Medicare DME will place a 28 day hold on a claim submitted on paper before they even begin processing it!
For a paper claim, you can expect approximately 90 days (or more!) for turnaround for Medicare DME. However, if you file electronically you can expect approximately 2 week to 30 days. If you are a participating DME supplier, the reimbursement check can even be directed deposited using EFT (electronic funds transfer). If you are a non-participating DME supplier, the reimbursement check will be sent to the patient.
DentalWriter Software is integrated with APEX Clearinghouse for electronic billing, allowing you to send your medical claims straight from DentalWriter to the clearinghouse with just a few clicks. You can then track your claim every step of the way, from the time the claim is submitted, to when it is accepted and completed. In addition to the claims tracking you are able to run daily, weekly or monthly reports for outstanding claims.
So what do other DentalWriter users have to say about electronic claims through DentalWriter?
“I wanted to let you know what a great experience I had with Julie at Dental Writer and Krystal at Apex. I am new to billing out Medicare and it was a foreign language to me. They both remoted in to my computer and walked me through every step of the way. They made a scary and intimidating experience a great one. The resources made available to me through them are amazing. I would highly recommend them and their services.” – Belinda, Ventura, CA
For most offices electronic billing can be set up and ready to use in under 2 weeks.
The NPM team and APEX teams are available to assist with setting up your payor ID’s along with answering questions on how to complete your claim for Commercial Insurance and Medicare DME.
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View video: using electronic claims with APEX through DentalWriter
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Tip of the Month
How to know what is required for medical coverage
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Want to know what coverage criteria an insurer requires before even getting on the phone with them? Good news is - most medical insurers will post their medical policies right on their website!
A medical policy is intended to provide guidelines and coverage criteria for:
- Services
- Equipment
- Technology
- Procedures
Examples of information you may find in a medical policy are:
- What services are covered, and not covered
- Coverage criteria to meet medical necessity
- CPT & HCPCS codes covered, and not covered by policy
- Diagnosis codes covered, and not covered by policy
- Additional billing/coding information – i.e. modifiers, appliance guidelines
- Definitions & Resource
- Example documentation
A medical policy is different that a patient’s coverage policy
- The medical policy is criteria and guidelines set by the insurer
- The patient’s coverage policy is what specific benefits that patient’s policy carries
To find the medical policy for the treatment you are looking for:
- Start with the insurer’s main website (or website on patient’s medical card if you have it!)
- Locate the “providers” section (you will generally also find “members”, “employers”, investors”, etc sections of the site)
- Locate the medical policies section (sometimes labeled “policies procedures & guidelines”, “practice resources”, “coverage policies”, “clinical policy bulletins” (CPB’s), local coverage determinations” (LCD’s)).
- Search for the subject you are treating! i.e. sleep apnea, temporomandibular disorders, pain, accident, oral surgery, etc
- If a policy is not available online, you can call the insurer to request a copy be faxed/mailed/e-mailed to you
You can view our study group over how to find and read medical policies!
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Below is an example of language you may find in a medical policy (the example below is a policy related to oral appliances for obstructive sleep apnea):
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