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Sleep Apnea: Payment, Insurance and Providers
How is treatment provided, and how is it paid for?
Obstructive Sleep Apnea is a very dangerous syndrome leading to drastic problems with quality of life and even to early death. Happily, however, the dental oriented treatment for sleep apnea is fairly inexpensive, with or without medical insurance. No one should ever deny themselves treatment for this very serious condition just because they do not have insurance. Treatment will be worth every penny you spend!
Treatment for sleep apnea is a service! It is not simply a piece of plastic. Therefore, the fee you pay includes both an appliance and/or CPAP, BIPAP, or APAP machine, as well as complex diagnostic tests and adjustment services. Therefore, a dentist will generally charge a fee for the appliance that includes the time and expertise necessary for diagnosis and followup visits. Treatment for this condidion is not as much an appliance as it is a treatment plan!
The legal and ethical status of dentists in the treatment of obstructive sleep apnea is a bit complicated. Some dentists, while quite knowlegable in all aspects of sleep apnea cannot legally diagnose the disorder. Diagnosis must be done by a qualified physician. Furthermore, sleep apnea treatment is not paid for by dental insurance. It is, however covered by medical insurance. But medical insurance will not pay anything toward this treatment unless the request is accompanied by a diagnosis code signed by a qualified physician. Therefore, while a dentist may fabricate an appliance for a patient without a medical referral, he or she would much prefer to work with a physician on OSA cases both for insurance reasons, and for the safety of the patient.
- Diagnostic code 327.23–Obstructive Sleep Apnea
- Diagnostic code E0486–Oral Appliance to Treat Sleep Apnea
- Diagnostic code 95806–Sleep Study Unattended
There are several ways to get referrals to dentists near you who prescribe snoring appliances.
First try contacting your state dental or medical society. Run a Google search (there’s a box at the bottom of this page) for, say, “Texas Dental Society” to get the main phone number and call an office near you.
Call local otolaryngologists (ear, nose and throat specialists) to see if they work with dentists in your area.
Look up an orthodontic lab near you to see if they make snoring appliances. The larger orthodontic labs make these appliances for doctors all over the country. If you call one, you may be able to get a referral to a dentist in your area who treats snoring with these types of appliances. One lab I use all the time is Great Lakes Orthodontics, LTD. E-mail them using their contact page. Glidewell Labs makes the SilentNite appliance. Click here for their website (and their telephone number).
Is treatment for sleep apnea expensive?
First, the medical diagnosis and treatment for sleep apnea are generally covered under your medical insurance policy. You may be able to get your dental sleep appliance covered by medical insurance if you have a proper diagnosis from a physician. Finally, Even if dental treatment costs one or two thousand dollars, what is your life worth? How about the quality of your life. What would you pay for a good night’s sleep? How much is it worth to go through your day without falling asleep driving or doing repetitive tasks?
How much did you spend on your last luxury item? Even a new car costs fifteen times what it would cost to treat a dangerous medical condition—and the car will depreciate as soon as you drive it off the lot. Sleep apnea treatment is something that could prolong your life and make it much more enjoyable to boot!