Medicare Program Enrollment Package


The Medicare Program

Medicare is the largest health insurance carrier in the U.S. and the number of Medicare beneficiaries is expected to grow.  Medicare covers sleep apnea oral appliance therapy for beneficiaries if clinical criteria are met, and if the provider of the appliance is a contracted Medicare supplier.  Providing oral appliance therapy to your patients who are Medicare beneficiaries is a great way to improve your patients' overall health and build your practice revenue.  Medicare pays 80% of the Medicare allowable amount for services; the other 20% is the patient responsibility.  Many Medicare beneficiaries purchase a Medicare supplemental insurance plan; these policies pay the 20% Medicare co-insurance so these patients have zero out of pocket financial liability.  Medicare patients often have little or no out of pocket expense and are generally very receptive to going forward with oral appliance therapy, especially when the costs are substantially or totally covered by Medicare.

However, in order to get Medicare reimbursement for treatment, you must enroll as a Medicare provider.  If you enroll as a participating provider with  Medicare, payments for oral appliance therapy from Medicare and from any supplemental insurance carriers will be made directly to your office.  If you are not enrolled, no benefits will be payable; the claim will be denied because services were provided by a non-contracted provider.

Provider Enrollment Service

It can be challenging for a dental office to become a participating provider with Medicare.  The sleep apnea oral appliance can only be provided by a licensed dentist, yet it is considered medical equipment for treatment of sleep apnea, a medical condition.  The Medicare application process can be confusing, time consuming and difficult for all providers, especially dentists.

Better Sunrise offers a Medicare Enrollment Service to make the process of becoming a Medicare participating provider much easier.  Rather than struggling through the process on your own, trying to figure out what is required by Medicare, and how best to set up your practice as a provider, we will consult with you and your staff, and offer support, guidance and recommendations.  We complete all required forms; submit all supporting documentation and track the status of the application with Medicare.  At the conclusion of the enrollment process, your office will have received a Medicare billing provider number and will be ready to begin treating Medicare patients and receiving payments directly from Medicare.

Purchase our Medicare Program Enrollment Package today and take a big step towards helping your patients and building your practice.