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...]
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...]
