Customer Close-Up
In this Customer Close-Up, we are sharing an in-depth discussion that we had with the Slide customer, Dr. Terry Gordon, on an important set of topics impacting the successful practice of dental sleep medicine.
Dr. Terry Gordon
- American Board of Sleeping and Breathing
- Academy of Clinical Sleep Disorders Disciplines
- American Board of Dental Sleep Medicine
- American Board of Craniofacial Dental Sleep Medicine
Dr. Gordon serves as a mentor to dentists nationwide, particularly those seeking to specialize in snoring and sleep apnea treatment. His efforts are geared towards empowering both practitioners and patients in navigating available resources for comprehensive sleep-related healthcare.
Overview
We will take a close-up look into four areas that Dr. Gordon shared from his successful sleep-only practice, as well as how his use of the Slide changed his assessment of oral appliance performance for the better.
“Sleep apnea is a medical condition and patients expect treatment to be covered by their medical insurance. This impacts device choice.”
Dr. Gordon has made MEDICAL INSURANCE reimbursement a key part of his long-standing sleep-only practice through a successful partnership with Dedicated Sleep, a nationwide medical specialty group of sleep physicians and sleep dentists, that participates with the various insurance plans.
Recommendations shared by Dr Gordon include:
- Recognize that insurance coverage is key to patient acceptance and sleep-only practice growth. Fee-for-service alone limits the number of patients that can be successfully treated with oral appliances.
- Start by understanding the patient’s insurance coverage and reimbursement requirements. This is easier than you might think. Dedicated Sleep has looked at what is required to be paid by the insurance companies, so as their partner you can be ahead of the curve.
- Practice a “MEDICAL CONDITION” mindset because sleep apnea is a medical, not a dental condition. SOAP Notes (Subjective, Objective, Assessment, Plan) are essential treatment and billing documentation.
- Know that it’s the front-end work, understanding the requirements and getting insurance pre-authorization, that makes the difference.
“I am receiving “K1027 Code” insurance payments for the Slide and some insurers are paying more than the “E0486 Code.”
It was Dedicated Sleep that let Dr. Gordon know that the “K1027 Code” was paying, in some cases, even better than the “E0486 Code.” He is successfully billing and receiving reimbursement for the Slide from PRIVATE MEDICAL INSURANCE, as well as from MEDICARE ADVANTAGE PLANS, but NOT Traditional Medicare yet (as of July 2024).
“The Slide is a good fit for my patients and my practice. The success I have seen with my patients led me to use the Slide to treat my own sleep apnea.”
Dr. Gordon was pleasantly surprised by the lack of complaints from his patients using the Slide. His experience has been that devices with any components on the cheek side are very uncomfortable for the patient, and indicated that the Slide is a real improvement because the adjusting components are placed over the biting surfaces of the teeth.
Additional reasons Dr. Gordon prefers the Slide include:
- Ease: The Slide is NOT complicated. Also, it is well priced.
- Patient Comfort: He does NOT get discomfort complaints from his patients.
- Patient Adjustments: If it is difficult for patients to travel, then they can do the adjusting themselves, extending the range of patients that can be served.
- Retention: He likes that he can adjust the retention of the Slide in the patient’s mouth by dipping the device in warm water and then inserting and adjusting it during the initial fitting. No need to send it back to the lab.
- Extended Adjustment Range: The longer a patient wears the device they may need to have their jaw further extended. The Slide enables adjustment up to 8mm, significantly more than other devices he has used. This means immediate adjustment can be made without having to send the device back to the lab, so the patient DOES NOT have to go without their device.
“The Slide has given me no reason to look at any other appliance.”
Dr. Gordon’s overall view of oral appliances changed as a result of using the Slide. Other oral devices are difficult to adjust, they break and/or they do not hold the jaw together at night. The Slide has changed his assessment of oral appliance performance for the better.
In closing, Dr. Gordon’s suggestions for other dentist considering or practicing dental sleep medicine include:
- Look at Dedicated Sleep: Sleep and insurance are inextricably linked. Dedicated Sleep has cracked the code for getting paid by insurance.
- Just try it: Don’t be afraid to try the Slide. Don’t be afraid to bill the “K1027 Code.” The worst case is you do a trial for free in order to learn. The best case is you get paid more than the “E0486 Code.”
- Choose who you serve: Don’t do both general dentistry and sleep. If you want to do sleep – do it! Insurance savvy will make your slice of the business pie larger.
We extend our thanks to Dr. Terry Gordon for sharing his valuable time and insights with us.
The Slide® is an FDA cleared Oral Sleep Appliance used in the treatment of mild to moderate sleep apnea and snoring, as well as for people that cannot tolerate CPAP. The Slide places all of the adjustable components over the biting surfaces of the teeth, away from all the oral tissue, providing comfort by design. The Slide is the latest in oral sleep technology and a patent-pending device.