FAQ'S FOR PRACTITIONERS
If by workup you mean Sleep Screening Visit (first Dr. Form), then the answer is that
1: You have to have a diagnosis and medical necessity (Rx. for Oral Appliance Therapy - OAT) bc in the sleep study report will be other sleep disorders and co-morbidities codes besides OSA that you'll need for the pre-determination call.
2: Let's assume the patient has had a sleep study and a diagnosis os OSA. You still have to have a documented face to face consultation visit, which is the Sleep Screening visit (which could be at the time of your hygiene visit) prior to preauthorization call bc you'll need the evaluation code form the bottom of the form at the end of the visit.
3: You have to make sure that the patient is a candidate for OAT, i.e. no existing Perio, decay, dental disease/pathology that would preclude from OAT. Perfect opportunity to get all that dentistry done ASAP and you will only know that if you do that face-to-face consult (Sleep Screening)
You can still do all of the data gathering and the MAD-FIT workup in the same visit. Assuming the patient has a diagnosis and you have their sleep study that documents OSA then it's simple. Do the Sleep Screening and establish candidacy for OAT, Do the Firm Financial (Financial Agreement Form) and there you will define the total cost of the all of the procedures you will be doing. That form is not a legally binding agreement if the patient doesn't move to treatment. The patient has to be prepared to be responsible for the entire fee in the event the insurance co. decides to not pay anything towards their care even after you go through the pre-determination (no different than dental insurance where a pre-determination is not a guarantee of payment). You want to know that upfront if a patient owns their condition and values the treatment they will be receiving before your admin team spends the 10-15 mins on the phone doing the pre-determination.
Let's say they insist that they know what the insurance benefits will be, then simply leave that form blank and leave their signature field empty in the Financial Agreement Form and "SAVE and CONTINUE" and the Pre-determination form appears next. Then when you know what that benefit will be, simply go back to the financial agreement form and have them sign it and then "SAVE AND CONTINUE".
3 Visits to delivery of appliance from initial screening w/o a diagnosis
Let's assume your patient has a diagnosis of OSA and has had a sleep study within the past 3 years then the workflow is Visit 1: Add them as a patient "ADD Patient +" and have them complete their pre-examination form or at a computer terminal chair-side.Then you complete your sleep screening form, establish candidacy for OAT and if they are not a candidate bc of existing dental disease then you have to take care of that.. Same visit: Financial Agreement followed by Medical Insurance Pre-Determination call followed by MAD-FIT workup, Bite registration and Rx. for OAT
Visit 2: Appliance delivery visit 1 week later patient completes their "Post Insertion Followup Visit" forms prior to visit 3
Visit 3: Appliance Insertion followup visit and referral for efficacy sleep study
Visit 4: follow up visit as soon as you receive results from that sleep study.
Visit 5: Annual follow up if they are not a patient of your hygiene practice and if they are a hygiene recall patient, then at their recall visit.
Let's assume you identify a pt. during their hygiene visit, having high probability of suffering from OSA and not diagnosed, in need of a diagnosis then the workflow is
Visit 1: Add them as a patient "ADD Patient +" and have them complete their pre-examination form (paper as described above) or at a computer terminal chair-side.Then you complete your sleep screening form, establish candidacy for OAT and refer for sleep study.
Before the next visit you have to have a positive diagnosis of OSA.
Visit 2: Financial Agreement followed by Medical Insurance Pre-Determination call followed by MAD-FIT workup, Bite registration and Rx. for OAT
Visit 3: Appliance delivery visit. 1 week later patient completes their "Post Insertion Followup Visit" forms prior to visit 4
Visit 4: Appliance Insertion followup visit and referral for efficacy sleep study
Visit 5: follow up visit as soon as you receive results from that sleep study.
Visit 6: Annual follow up if they are not a patient of your hygiene practice and if they are a hygiene recall patient, then at their recall visit.
Once done, then on the same iPad or desktop, still logged into the patient's chart, Access "Doctor Forms" and access "Sleep Screening Form" which should take about 5 mins mx to complete and then complete the "Financial Agreement Form" which your BA's can complete in a few minutes and then your You and your DA's can complete the "Referral for Sleep Study Form" in another few minutes.
The other way is to simply "ADD PATIENT +" in your dashboard and the patient get's an email with link to complete their Pre-Examination Forms and once they have completed it, you get an email notification of that and to schedule an appointment or "Sleep Screening" and then you can schedule a patient for 20 mins max for completing the "Sleep Screening Form", "Financial Agreement Form" and "Referral or Sleep Study"
I would also recommend that you NOT take the insurance check the patient gets and signs over to you, because that cancelled check will go back to the insurance company and they can argue that it was equivalent to you accepting assignment of benefits.
We also provide all of your patients specific letters and tools for management of medical claims and there is no extra charge beyond the per patient fee of $495 for the entire workflow.
The alternative is to hire a 3rd party billing service and pay them 12-15% of billing.
Please note that all fields that are marked with a red colored asterisk are mandatory to fill and complete. The data shall not save till such time all these marked fields are completed.
Please have a look at this video to know more about how to access MAD-FIT Workup Form.
Wash, Rinse and Dry the appliance completely before storing in a container.
Keep your oral appliance out of the reach of children and animals.
Some tooth and jaw tenderness is normal when beginning treatment and usually in the morning and for that reason, we have given you a Morning Repositioner (AM Aligner). The Repositioner/Aligner is to be used every morning for 5-20 minutes immediately following removal of the oral appliance. If these symptoms persist or become painful, contact our office immediately.
Follow up care is important, please be sure to make it to your scheduled follow appointments!
Please feel free to contact us with any questions regarding your oral appliance for Obstructive Sleep Apnea
You also have the option to generate a claim form after each follow up visit after the insertion but insurance cos do global payments so all follow up for OAT visits for up to usually 3 years is included in the payment for the appliance.
- • Memory Issues - during sleep, your brain forms connections that help you process and remember new Information. Lack of sleep can negatively impact both short and long-term memory.
- • Mood Changes - sleep deprivation can make you moody, emotional, and quick-tempered. Chronic sleep deprivation can affect your mood and lead to anxiety or depression, which may escalate.
- • Weekend Immunity - too little sleep weakens your Immune system's defenses against viruses like those that cause the common cold and flu. You're more likely to get sick when you're exposed to those germs.
- • Trouble with Thinking and Concentrating - Your concentration, creativity, and problem-solving skills aren't up to par when you don't get enough rest.
- • Accidents - being drowsy during the day can Increase your risk for car and work accidents and injuries.
- • Poor Balance - lack of sleep can also affect your balance and coordination, making you more prone to falls and other physical accidents.
- • Risk of Diabetes - lack of sleep affects your body's release of insulin. People who don't get enough sleep have higher blood glucose levels and an increased risk of type 2 diabetes.
- • High Blood Pressure - If you sleep less than five hours a night, your risk for high blood pressure.
- • Weight Gain - with sleep deprivation, the chemicals that signal to your brain that you are full. As a result, you're more likely to overindulge even when you've had enough to eat.
- • Low Sex Drive - people who don't get enough sleep often have lower libido. In men, this decrease in sex drive may be due to a drop in testosterone levels.
- • Risk of Heart Disease - Sleep deprivation may lead to increased blood pressure and higher levels of chemicals linked to inflammation, both of which play roles in heart disease.
- • Impaired Daytime
- • Alertness and Function
- • High blood pressure
- • Impaired Immune System
- • Morning Headaches
- • Dry Mouth upon awakening
- • Impaired Memory Consolidation
- • Impaired Physical Performance
- • Depression
- • Severe Anxiety
- • Impaired Executive and Cognitive Functioning
- • Short term memory loss
- • Intellectual and Cognitive deterioration
- • Mood changes
- • Shortened Lifespan
- • Temperamental behavior
- • Excessive Daytime Sleepiness
- • Snoring
- • Poor job performance
- • Witnessed Apneas
- • Restless Sleep
- • Impotence
APP-NEA is a Cloud-Based EMR and i-PMS that provides doctors with Guided Work Flow and Predictive Treatment Planning for Optimal Treatment Outcome.
APP-NEA provides a comprehensive End-to-End Dental Sleep Medicine (DSM) Practice and Patient Management Systems powered by Computational Data Analytics-driven by Machine Learning and Artificial Intelligence.
APP-NEA also provides its family of doctors with:
- • Education: Doctor Certification and Team Training
- • Marketing and Networking with Physicians, Dentists, Sleep & Dental Labs
- • Predictive and Accurate Patient Screening - Sleep SWOT
- • Guided and Automated Clinical and Administrative Workflows
- • Predictive Analytics: MAD-FIT for maximum Oral Appliance Therapy Efficacy
- • Medical Billing and Regulatory compliance solutions and support