An Overview of Electronic Solutions for Practice Management of Dental Sleep Medicine

Just like DSM, e-solutions for DSM are in their infancy stage

PD_Varga_600x300As a dental sleep medicine (DSM) consultant I have been asked by several dentists what system, software and medical billing company I recommend. My reply… That’s a great question! It depends on several factors and what’s best for you.
Before I break down my logic of analyzing which e-solution is best for my dentist friends I want to list some of the e-options available to dentists today. Dental practice management software, DSM designed practice management software/systems, DSM designed analytics and patient tracking, Electronic Medical Records (EMR), Electronic Health Records (EHR), medical clearing houses for electronic submission of medical claim forms, physician portals, cloud technology solutions, signature pads, secure and encrypted email, HIPPA complaint patient intake transfer, patient education/contact solutions, and soon telemedicine are just a few that come to mind. If you are like most dentists you may be scratching your head at this list and only identifying with dental practice management software. This is because just like DSM, e-solutions for DSM are in their infancy stage.
Evaluating options for e-solutions for DSM and determining what’s best for each dentist takes some research. First, I feel it’s important to know what is required for efficacious DSM. Second it’s best to analyze if oral appliance therapy will be added into an existing dental practice as additional therapy to general dentistry or is the practice planning to become DSM exclusive? Last, will the dental office be billing medical insurance for the patient and or participate with the patient’s medical insurance policies? Once these three factors are established the options are easier to evaluate.
What is required for efficacious DSM? In order to answer this we need to define the term. Efficacious is “successful in producing a desired or intended result.” This is a broad statement when it comes to DSM. What is deemed success – a patient accepting therapy, improving a patient’s overall health, physician interpreted before and after treatment sleep study results with at least a 50% improvement in breathing, receiving a check from a medical insurance company, or working with community physicians in a multi-disiplinary approach to therapy? Dentists will have different answers to these questions and most will say yes to all of the above. Most dentists I’ve encountered get involved in DSM to help patients breathe better during sleep and improve overall health then become aware of medical billing and clinical practice guidelines, which add a layer of actions and the need for electronic solutions.
I interviewed several of my professional colleagues, educators and dentists regarding this topic and it became very apparent that dentists offering patients oral appliance therapy are using 1 of 3 e-solutions for practice management:  Dental software with an integration of DSM, Electronic Health Records (EHR) revised for DSM or practice management systems specifically designed for DSM. The majority of dentists I have encountered are looking to add DSM to an existing general dental practice. They already have dental software such as Dentrix, Eaglesoft or Carestream to complete the fundamental tasks and functions including a scheduler, ledger, medical history, encounter notes and patient recall tracking. These systems also allow importing documents such as sleep study reports and written prescriptions. However, in my opinion they fall short as an e-solution for medical billing, DSM patient tracking and physician outreach. The need to add an ancillary software/system will manifest.
Let’s evaluate an overview of e-solutions for DSM.
Most dental software can be customized to accommodate DSM management but only to a certain extent. For example, custom codes can be entered for scheduling and posting completed appointments. Dental medical histories can be revised to ask questions like; Do you snore? Have you ever had your sleep evaluated? Have you ever been prescribed to use Positive Airway Pressure (PAP or CPAP) therapy? Template notes can be created for DSM appointments and patients can be filtered into a recall system for sleep, like hygiene schedules are tracked. Documentation such as sleep study reports and written prescriptions can be scanned into document storage. However, all of these tasks take work. Most dental practice management software companies have not fully caught onto DSM and have no pre-designed templates within their systems to accommodate it. Since this is the case the more customizable your dental software, the better. MacPractice has built-in DSM capabilities courtesy of pioneering DSM dentists who use it – you need to request it, since it is not automatically installed. As DSM becomes more main stream we will see dental software systems possibly accommodate for it.
A dentist also can consider a practice management system specifically designed for DSM. The three predominate DSM systems today include DentalWriter, Dental Sleep Solutions (DS3) and SleepConnect. All three can be used in conjunction with dental software. DentalWriter and DS3 are complete practice management systems including a scheduler and ledger for those dentists who want to keep DSM patient transactions separate from dental. Although SleepConnect does not have a scheduler the color coded patient management feature gives a visual overview of patient tracking. All three systems are built on the fundamental strategy of proper documentation to support medical billing, physician outreach and DSM support. Each are unique with special features and functions. DentalWriter has been on the market for 25 years helping dentists navigate medical billing for all medically necessary procedures such as TMD, oral surgery and accident cases. In the past 10 years DentalWriter has focused on DSM and added a medical billing service option and a marketing campaign through Snoring Isn’t Sexy.  DS3 has been developed by dentists working exclusively in DSM and have expanded to offer a wide range services including online study clubs, community education outreach and marketing materials. SleepConnect is amazing for patient tracking and analytic reporting along with secure physician portal to view mutual patient records.
What is the difference between an EMR and an EHR? An electronic medical record (EMR) is a digital version of a chart with patient information stored in a computer. An electronic health record (EHR) is a digital records of health information that can be shared instantly with authorized providers across practices and health organizations. There are several of both EMR and EHR systems available on the market designed for physicians. Most are customizable to accommodate DSM. For example PracticeFusion, AdvancedMD or CureMD are the top 3 I encounter among DSM dentists. These systems are nice because they are designed for medical intake and evaluation. The downfall is currently the same as it is with dental software these EMR and EHR systems are not automatically ready for use with DSM patients and they do need customization to accommodate DSM.
A medical clearing house is used to submit medical claims electronically. This is something I have all my clients consider. Dentists are not required today to file a claim form electronically to medical insurance, although electronic submission makes the process easier and the claims processing time is much shorter. Dental-Writer, DS3, SleepConnect, MacPractice and all EMR/EHR systems work with medical clearing houses to submit claims electronically. Some will also allow the printing of a claim if necessary. A dentist can register directly with medical clearing houses for electronic claims submission. If hiring a medical billing entity is your goal, chances are they are using medical clearing houses to submit your claims and will set that up for you. However, discussing options for electronic documentation transfer is a must because without that there will be a lot of faxing documentation back and forth unless a HIPPA compliant secure email system can be used between parties. Physicians are slow to adopt even secure email systems.
Like any big decision when adding something new a dental office it is imperative to do your homework. Research options by reaching out and scheduling demos or trial period to evaluate what works best for your goals with DSM and what you are comfortable using. Evaluate pricing structures as they are all different depending on the level of capabilities you strive for. Maybe even survey the physicians you work with closely and see if what they use can connect with what you are considering. E-solutions are our future! Embrace them and find what works best for you!

glennine-vargaGlennine Varga is a certified TMD assistant and educator with an AA of sciences. She is a certified TMD assistant with the American Academy of Craniofacial Pain. She has been employed in dental education for over 19 years. Glennine is certified in radiology, electrodiagnostics, expanded duties dental assistant in the treatment of temporomandibular disorders. She has been a TMD/Sleep Apnea trainer and speaker with emphasis on medical billing and documentation for over ten years and has tried the use of electrodiagnostic equipment for five years. Glennine is CEO of Dental Sleep Medicine Boot Camp. She has trained and assisted hundreds of dental offices on practice management, TMD/Sleep Apnea concepts, medical billing and team training. For more information visit www.dsmbootcamp.com or email g@dsmbootcamp.com.

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