Dental Sleep Medicine Insider January DSM Insider 2018 | Page 8
SAY
YES!
TO BECOMING A
MEDICARE DME PROVIDER
I
clearly recall attending a Den-
tal Sleep Medicine CE course and
the subject of Medicare was ad-
dressed toward the end. At this
point we were all friendly and
comfortable with each other and
the question was, “Is this covered
by Medicare?” The instructor of
the course said, yes, its covered
but I do not suggest anyone be-
come a Medicare provider be-
cause of all the regulations and
the lack of profitability. There
was one dentist way in the back
of the room who piped up and
said with confidence “We treat
Medicare patients” and his of-
fice manager said, “someone has
to service these patients and we
LOVE Medicare!”
I am not kidding when I say there
was an audible gasp. Attendees
took turns chiming in with com-
ments like “you can have it!”,
“yeah, good luck with the au-
dit!” and “I can’t afford to treat
Medicare patients.” Unfortunate-
ly, these naysayers were misin-
formed in their assumptions and
misguided by the instructor.
Let me tell you about the WOW
moment I recently had which
was the impetus of this article.
One of my clients asked for a year
end report detailing their Medi-
care payments. Do you know
what we found?
LESIA CRAWFORD
follow them. When GoGo Billing
clients become Medicare DME
approved as non-participating
providers, I personally provide
training and review of the Medi-
care guidelines and required
documentation as well as advice
on case presentation with finan-
cial agreements and how to en-
sure maximum reimbursement
for you and your patients.
If you would like a copy of the lo-
cal coverage determination (LCD)
for oral appliances, please email
me a request and I will send you
the rules. Keep in mind the FIRST
RULE of Medicare billing is you
must be approved by Medicare
and have a PTAN number issued
to your office.
INTERESTED?
JOIN ME AT THE
NADSM SYMPOSIUM.
REGISTER NOW
The average payment per Medi-
care claim was $3762, and this
doesn’t even factor in the addi-
tional patient payments. So, tell
me again why we should not all
take Medicare??
Here’s the breakdown. This office
treated 40 patients with Medicare
coverage throughout the year.
Medicare paid approximately
$41,000 and supplemental or sec-
ondary plans paid an additional
$109,000. Another common mis-
conception is that practices have
to accept the Medicare allowed
amount. However, as a non-par-
ticipating provider you can actu-
ally bill patients your full fee.
Yes, there are rules with Medi-
care, and yes, there are some
rules that are exclusive to Medi-
care. My advice is, do not be afraid
of the rules. Just learn them and
Lesia Crawford,
CEO of GoGo Billing
GoGo Billing offers help with
Tricare registration for no
charge and Medicare creden-
tialing services for DME, Part
B and Ordering and Refer-
ring. Enter code DS3100 for
$100.00 off DME and Part B
credentialing. Contact me at
[email protected]
or call (877) 874-4646 ext.1