There is always excitement and some fear when the New Year is upon us. The same can be said about the medical insurance landscape as well. Medicare recently issued a development notification that will specifically affect dentists that provide Medicare DME services..

On November 28 a notification was mailed to all Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) providers.

The big question is why does this matter and how are you affected?

Dentists must now carry a Surety Bond in order to provide DME services to Medicare beneficiaries.   Below are additional important details that require your timely action:

  • Surety Bond must provide $50,000 coverage minimum per practice location.
  • You will have 60 calendar days from the date on the notification letter to obtain the Surety Bond.
  • You can obtain a DMEPOS Surety Bond from your current general liability insurance company.
  • If the information is not provided within the allotted time frame your Medicare PTAN will be DEACTIVATED. Once deactivated you will not be able to provide Medicare DME services, and you will need to reapply.

If you are in the process of the Medicare application process you should receive an email from your Medicare Analyst requesting the need of the Surety Bond documentation.  Please review the email notification to ensure that you are adhering to the time frame to produce the request.

This has been a topic of conversation on many different forums. The National Supplier Clearinghouse (NSC) issued an article outlining the change.  The regulations have yet to be updated in 42 CFR § 424.57(d)(15)(i)(C). The notated reason for the update is as follows:  “In recent years the NSC has seen a spike in the enrollment of Dentists for DMEPOS services. Dentists were initially allowed the exemption for the surety bond requirement”. Think about that for a moment! Dentists have impacted Medicare’s DME significantly enough to be defined as a “spike”.  This means that Dental Sleep Medicine is moving the needle! That is a testament to your continued pursuit in providing options to ensure that people do not go untreated.

Medicare can be difficult to navigate.  Your billing service provider will be well versed in the updates and will be a your valuable resource.  They will be the GPS for your practice and get you to the correct place without re-routing. We are always available to provide assistance as needed.

Questions? Contact Lisa Herdt, Director of Billing Services, 4 Pillar Billing.

Overcome Dental Sleep Medicine Obstacles

Setting goals is a part of life. Obstacles on the path are a part of life, too.  Let’s just face it. It’s how we choose to view and deal with these obstacles that will determine how and if we overcome them.  When a dental practice makes a commitment to add Dental Sleep Medicine (DSM) to its list of services it’s important to understand that will obstacles might surface, and there are ways to move past them.  There is no obstacle large enough that it should prevent any dental practice from offering this life saving treatment. Control what you can control and minimize barriers. There will likely be enough of them with insurance or difficult patients.

Here are a few tips to help prepare a team in advance of encountering DSM-related obstacles.

  1. Education: Do this together as a team. It is essential to provide everyone with a foundation on which they can grow together. Understanding the clinical aspects of DSM is just as important as understanding all the processes involved with a successful DSM practice.  Before the team starts talking about Oral Appliance Therapy (OAT) with patients, an education plan needs to be established.. This education can be done remotely or live in person. Or both. It just needs to be done TOGETHER.
  2. Coaching: Ongoing coaching and support for the dental sleep team is vital to success. If the dentist is solely responsible for DSM in the practice, it will create a road block. DSM is largely team-driven. It takes a village. Be sure to team up with an organization that provides continual, ongoing coaching to help with everything from clinical aspects of DSM to case presentation and medical billing.
  3. Software: DSM has a lot of moving parts. Using a software developed especially for DSM in a dental practice will allow streamlining of all the processes and allow the team to stay organized so nothing falls through the cracks.  From screening tools to electronic medical billing, make sure the software is cloud-based, simple and easy for the team to use.
  4. Support: This includes utilizing a 3rd party medical biller to manage the medical billing process. Let the experts handle the medical billing. The nominal fees most charge are worth your team’s sanity and time.  Who better to help overcome DSM medical billing obstacles than an experienced medical biller who specializes in billing for DSM for dental practices?

To get started on the right path, contact me at 877.95.SNORE x2.  Our industry experts are available to provide all the education, coaching, software, and support to dental practices committed to making DSM a priority.