Editor’s Intro: Knowledge of Reasonable and Useful Lifetime federal regulations can be of tremendous help in the complicated process of Medicare billing. by Ken Berley, DDS, JD, DABDSM, and Jan Palmer In writing this article, I have partnered with my dear friend, Jan Palmer. Hopefully, together we can shed some light on the complex subject of Medicare “same or similar” regu … [Read more...]
HSAT Usage: Are We There Yet?
by Ken Berley, DDS, JD, DABDSM The turf war continues and sadly, nothing has been decided. Almost daily I’m asked by a dental client why a dentist cannot diagnose OSA or Snoring. Many of my clients want to be able treat their patients who complain of chronic snoring without referring that patient to a sleep physician. Many dentists believe that an in-lab sleep study is u … [Read more...]
Sleep Medicine Malpractice Negligent Failure to Refer
by Ken Berley, DDS, JD, DABDSM I write this article out of concern for Sleep Medicine. The treatment of Sleep Disordered Breathing is undergoing a revolution. As with any revolution, passionate patriots are taking up arms to defend their turf. On one side of this conflict we have dentists who are now screening for SDB and wishing to participate in the treatment of their … [Read more...]
ADA Policy Statement on Sleep Disordered Breathing From a Lawyer’s Perspective by Ken Berley, DDS, JD, DABDSM
ADA policy statements have historically guided the evolution of our dental standards of care. The ADA House of Delegates adopted a policy on Sleep Disordered Breathing recently. Whenever the ADA publishes a policy statement, it is quickly discovered by plaintiff’s attorneys and becomes a resource for litigation. Therefore, it is vitally important for all dentists to understand t … [Read more...]
Need to Know Medicare Guidelines for Oral Appliances for OSA: Friend or Foe? Part 4
by Ken Berley, DDS, JD, DABDSM and Courtney Snow, Medical Insurance Consultant In this edition, I have asked Courtney to outline the Medicare rules and guidelines that dental offices MUST know in order to file Medicare. This is vital information! I encourage you to keep copies of this article for a quick reference for you and your employees. I want to thank Courtney for her … [Read more...]
Medicare DME/TELEMEDICINE: Friend or Foe? Part 3 by Ken Berley, DDS, JD, DABDSM
Medicare DMEPOS: Friend or Foe? Part 2
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 he … [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 Pro … [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...]
