In this edition, I continue our journey into the tangled maze of Medicare. In our last article, Courtney and I looked at the Medicare regulations associated with opting out, in this article we will explore the use of Advance Beneficiary Notices (ABN’s) and Dental Sleep Medicine (DSM) practitioner’s enrollment in Medicare Part B. Again, I want to thank Courtney for her amazing … [Read more...]
Medicare DMEPOS: Friend or Foe? Part 1
Best practices with the rulemaker I have avoided writing on Medicare. It is a bottomless pit of questions. Many of the questions that pertain to Medicare are complicated because we are dentists providing & monitoring a medically necessary treatment for a diagnosed medical condition, but functioning as Durable Medical Equipment (DME) suppliers. However, over the next three … [Read more...]
Short Stuff II: E-Codes
In this edition, I continue with the discussion of questions posed to me at the American Academy of Dental Sleep Medicine (AADSM) annual meeting last June. I admit that I have struggled with the questions pertaining to “E” codes, so I asked Rose Nierman of Nierman Practice Management to help me write this very important article. E codes are level II Healthcare Common … [Read more...]
Short Stuff
As I write this article, I have just returned from the AADSM meeting. I enjoyed reconnecting with old friends and making many new ones. However, it was challenging to find adequate time to answer all the questions which came rapid fire from every direction. Not that I mind answering questions, obviously that is not the case or I would not be writing this column. However, I … [Read more...]
Stark Law and Anti-Kickback Statute: Key Issues You Should Consider to Protect Yourself and Your Practice
In this issue, I have asked Jayme Matchinski, Attorney at Law, to join me in writing this important article. Jayme has many years of experience in healthcare law and is considered an expert in the field. I am truly grateful for her input and expertise in researching and writing of this article. Investigations, audits, and indictments related to the Stark Law and … [Read more...]
Insurance Fraud: Part III
I know! By now you are tired of hearing about insurance fraud. Three articles on insurance fraud is a lot. For those who have not read the other two articles, the first contained definitions of insurance fraud and insurance abuse with examples. The second article in our last edition, gave instructions for the dental practitioner if an auditor were to show up at your front door. … [Read more...]
Insurance Fraud: Are You Guilty? – Part 2
In the last edition, I explored the issue of insurance fraud in Dental Sleep Medicine and the response has been enthusiastic, as anticipated. While I am aware that insurance audits and inspections in dentistry have been rare, it is my personal opinion that this may change in the near future as more and more dentists are filing Medical Insurance and Medicare. Additionally, … [Read more...]
Insurance Fraud – Are You Guilty?
Morning Repositioning – Is This Therapy the Standard of Care?
by Ken Berley, DDS, JD, DABDSM Standard of Care (SOC) is defined as: “What a reasonable and prudent practitioner would do in the same or similar circumstances.” SOC is a curious concept among medical professionals. Frequently, I discover that health care professionals do not understand that Standard of Care is a legal concept and is ultimately determined by a … [Read more...]
TMJ-“Don’t Take That Risk”
As you know by now, this issue is dedicated to TMD complications secondary to Oral Appliance Therapy. I have resisted writing on this subject because it is so complicated and difficult to adequately cover in a short article. However, upon request and hereby and forever under protest, I will attempt to cover this subject as efficiently as possible in the space I have … [Read more...]
