Medical Insurance Billing for Oral Appliance Therapy - The MYSTERY of Dental Sleep Medicine Billing REVEALED - By Jenni Spencer

Sep 19, 2026

Uploaded by Mali

Medical Insurance Billing for Oral Appliance Therapy presents a billing-focused guide for dental sleep medicine teams, explaining claim processes, pre-authorization, coding fundamentals, and payer-specific workflows. It walks through setup tasks such as obtaining an NPI, selecting and preparing HCFA/CMS 1500 forms, using acronyms and ICD-10/CPT/HCPCS concepts, and determining whether to bill medical or dental. The book then covers patient and claim flow, pre-auth verification, submitting and appealing claims, and Medicare basics including jurisdictions and common patient-billing questions.

LanguageEnglish

CategoryPresentations

FormatPDF

Pages106

Reading Time37 min

AccessFree to download

Table of Contents

The Prep Work

Getting the Flow of It

Perfecting the Pre-Authorization

Submitting a Claim

Medicare Basics

Medical Insurance Billing for Oral Appliance Therapy The MYSTERY of Dental Sleep Medicine Billing REVEALED (for smart, ethical and moral dental teams who want to help lots of people and keep their dentist out ofjail) By Jenni Spencer With Rose Mary Milnerand Foreword by Dr. Jamison Spencer Copyright 2016 by Jennifer R. Spencer All rights reserved No part of this book may be reproduced in any form whatsoever, whether by graphic, visual, electronic, film, microfilm, voice recording, or any other means without prior written permission of the author. For information or questions about Spencer Study Club or the content in this book, please email jenni@jamisonspencer.com or go to www.JamisonSpencer.com. Published by Spencer Study Club 1201 Falls Bridge Dr., Raleigh, NC 27614 Printed in the United States of America All rights reserved ISBN: 978-0-9977655-0-2 Illustrations by MikoArc Graphics and charts are used with permission and are the sole property of Dr. Ellen Crean Cover Design and Layout by Lisa May ([www.lisamaystudio.com](www.lisamaystudio.com)) Table of Contents Legalese ......................................................................................................................................v Acknowledgements ......................................................................................................................v [Foreword ....................................................................................................................................vi](Foreword ....................................................................................................................................vi) [Introduction ...............................................................................................................................](Introduction ...............................................................................................................................). 1 The Prep Work .............................................................................................................................3 Your “Get Started” Checklist…........................................................................................................... 3 Obtaining your NPI (National Provider Identifier) ............................................................................ 3 Order/Purchase HCFAforms ............................................................................................................. 3 Download a HCFA/CMS 1500 Form Template ................................................................................ 3 To Contract or not to Contract (With Insurance) ................................................................................ 3 Acronyms & Definitions ..................................................................................................................... 6 ICD-10, CPT, Dental & HCPCS (DME) Codes .............................................................................. 9 Which do I bill…Medical or Dental? ............................................................................................... 11 What’s Your Variety of Insurance Company? .................................................................................... 12 Getting the Flow of It ................................................................................................................ 17 Patient Flow Chart ............................................................................................................................ 17 Flow Chart Steps ............................................................................................................................. 18 Insurance Claim Flowchart ...............................................................................................................20 Perfecting the Pre-Authorization............................................................

FAQs

What is covered in the book’s billing preparation steps?

It covers prep work such as obtaining an NPI, preparing/order HCFA forms, downloading a CMS 1500 form template, and deciding whether to contract with insurance.

How does the book explain the billing workflow for patient and insurance claims?

It provides patient flow chart guidance and insurance claim flowchart steps, including how to manage the flow before submitting claims.

What topics are included in the Medicare section?

It explains Medicare basics, Medicare jurisdictions, the Medicare patient flow chart for OAT, Medicare flowchart steps, and common Medicare questions about billing requirements for dentists.

Sep 19, 2026

Uploaded by Mali