From the moment it's ordered, the HST company usually mails out the equipment with 24 hours.

Upon receiving the equipment back from the patient, it usually takes them 4-7 days to upload the results and Rx and that's bc their sleep techs take a day or two to make sure the patient did the study correctly and that there is enough data to read (it's amazing that with he detailed instructions included in the kit the patient receives and the online instructions on how to use it, there are times when the patient fails to either press the start or stop button and the recordings don't have enough hours of recording or too many) and if the study was inconclusive then they have to send the patient another kit for another study (no additional charge to you). Once the techs give the green light, then the raw data goes to their sleep boarded physicians who read the day within 24-48 hours and as soon as they send the co. the report, the co. uploads the report​ ​in the patient chart and you get an email notification of that and you can log in and review it.​

It is done prior to the MAD-FIT workup that determines the 3 Dimensional Mandibular position.
If by workup you mean Sleep Screening Visit (first Dr. Form), then the answer is that
1: You have to have a diagnosis and medical necessity (Rx. for Oral Appliance Therapy - OAT) bc in the sleep study report will be other sleep disorders and co-morbidities codes besides OSA that you'll need for the pre-determination call.
2: Let's assume the patient has had a sleep study and a diagnosis os OSA. You still have to have a documented face to face consultation visit, which is the Sleep Screening visit (which could be at the time of your hygiene visit)​ prior to preauthorization call bc you'll need the evaluation code form the bottom of the form at the end of the visit.
3: You have to make sure that the patient is a candidate for OAT, i.e. no existing Perio, decay, dental disease/pathology that would preclude from OAT. Perfect opportunity to get all that dentistry done ASAP and you will only know that if you do that face-to-face consult (Sleep Screening)

​I see your point but all documents once completed are time and date stamped, so we actually protect our members by having them complete the forms in the order they are supposed to from a regulatory standpoint.
​You can still do all of the data gathering and the MAD-FIT workup in the same visit. Assuming the patient has a diagnosis and you have their sleep study that documents OSA then it's simple. Do the Sleep Screening and establish candidacy for OAT, Do the Firm Financial (Financial Agreement Form) and there you will define the total cost of the all of the procedures you will be doing. That form is not a legally binding agreement if the patient doesn't move to treatment. The patient has to be prepared to be responsible for the entire fee in the event the insurance co. decides to not pay anything towards their care even after you go through the pre-determination (no different than dental insurance where a pre-determination is not a guarantee of payment). You want to know that upfront if a patient owns their condition and values the treatment they will be receiving before your admin team spends the 10-15 mins on the phone doing the pre-determination.
Let's say they insist that they know what the insurance benefits will be, then simply leave that form blank and leave their signature field empty in the Financial Agreement Form and "SAVE and CONTINUE" and the Pre-determination form appears next. Then when you know what that benefit will be, simply go back to the financial agreement form and have them sign it and then "SAVE AND CONTINUE".

​2 Visits if they​ have a diagnosis
3 Visits to delivery of appliance from initial screening w/o a diagnosis
​Let's assume your patient has a diagnosis of OSA and has had a sleep study within the past 3 years then the workflow is ​Visit 1: Add them as a patient "ADD Patient +"​ ​and have them complete their pre-examination form or at a computer terminal chair-side.Then you complete your sleep screening form, establish candidacy for OAT ​and if they are not a candidate bc of existing dental disease then you have to take care of that.​.​ ​Same visit​: Financial Agreement followed by Medical Insurance Pre-Determination call followed by MAD-FIT workup, Bite registration and Rx. for OAT
Visit 2: Appliance delivery visit 1 week later patient completes their "Post Insertion Followup Visit" forms prior to visit ​3​
Visit 3: Appliance Insertion followup visit and referral for efficacy sleep study
Visit 4: follow up visit as soon as you receive results from that sleep study.
Visit 5: Annual follow up if they are not a patient of your hygiene practice and if they are a hygiene recall patient, then at their recall visit.
Let's assume you identify a pt. during their hygiene visit, having high probability of suffering from OSA and not diagnosed, in need of a diagnosis then the workflow is
​Visit 1: Add them as a patient "ADD Patient +"​ ​and have them complete their pre-examination form (paper as described above) or at a computer terminal chair-side.Then you complete your sleep screening form, establish candidacy for OAT and refer for sleep study.
Before the next visit you have to have a positive diagnosis of OSA.
Visit 2: Financial Agreement followed by Medical Insurance Pre-Determination call followed by MAD-FIT workup, Bite registration and Rx. for OAT
Visit 3: Appliance delivery visit. 1 week later patient completes their "Post Insertion Followup Visit" forms prior to visit 4
Visit 4: Appliance Insertion followup visit and referral for efficacy sleep study
Visit 5: follow up visit as soon as you receive results from that sleep study.
Visit 6: Annual follow up if they are not a patient of your hygiene practice and if they are a hygiene recall patient, then at their recall visit.

In that case your team would have to do that on their behalf bc now you are treating a medical condition and the documentation requirements are completely different than dental. Doctors who don't document this thoroughly risk severe monetary​ ​penalties or worse licensure sanctions (multiple patient violations) in the event of Medical insurance/Medicare audit.​

When you "ADD Patient +" from within your dashboard, you have access to the patient forms from inside the "Patient Forms" tab. You can have the patient or your team member assist the patient complete them chair-side.

As part of your certification course, you have 1 complimentary patient workflow incl. MAD-FIT workup so feel free to use yourself, team member or a family member to experiment the workflow. Once you have gone through it, it will always be there in your dashboard to review as many times as you wish.​

Once you go through experimenting with the complimentary 1st workflow exercise, you'll have it in your dashboard to review it on-demand from any web-enabled device​.

Yes, this way a patient who finds you through our website "Search for Provider feature can complete the forms before they come to see you for the sleep screening.

That's awesome. Has your team gone through the team training course as yet. Were you able to attend last weeks Webinar? If not, here it is

iPads are great. You can save "ADD PATIENT +" https://www.app-nea.com/addpatient and Dashboard https://www.app-nea.com/dashboard to your Bookmarks or Home Screen for quick access.

No special time reservations required. Once your hygienist has scored a high probability, they can add the patient right from within your dashboard and then on the iPad select the patient from your dashboard and go to "Patient Forms" and give the patient the iPad with the "Pre-Examination Visit Forms" loaded with instructions to let you or team know when done.
Once done, then on the same iPad or desktop, still logged into the patient's chart, Access "Doctor Forms" and access "Sleep Screening Form" which should take about 5 mins mx to complete and then complete the "Financial Agreement Form" which your BA's can complete in a few minutes and then your You and your DA's can complete the "Referral for Sleep Study Form" in another few minutes.
The other way is to simply "ADD PATIENT +" in your dashboard and the patient get's an email with link to complete their Pre-Examination Forms and once they have completed it, you get an email notification of that and to schedule an appointment or "Sleep Screening" and then you can schedule a patient for 20 mins max for completing the "Sleep Screening Form", "Financial Agreement Form" and "Referral or Sleep Study"

Once the patient sends the kit back, it takes anywhere from 3-7 days for the results to be uploaded into the patients chart. You get a notification of that as soon as it's uploaded.

That would be insurance fraud. Even if you are an out of network provider but opt to accepts assignment of benefits, you have to notify the insurance co. of the write-off. The way around that is to NOT UNCHECK that field in CMS-1500 form and NOT ACCEPT assignment of benefits and the patient get's the check and pay you what they received and you can then write off how ever much you like.
I would also recommend that you NOT take the insurance check the patient gets and signs over to you, because that cancelled check will go back to the insurance company and they can argue that it was equivalent to you accepting assignment of benefits.

The way around that is to NOT UNCHECK that field in CMS-1500 form and NOT ACCEPT assignment of benefits and the patient get's the check and pay you what they received and you can then write off how ever much you like. Even if you are an out of network provider and opt to accept assignment of benefits, you have to notify the insurance co. of the write-off.

No. There are no guarantees in life. But the signup is free, at no cost and access to all of the marketing is also at no cost. So I don’t see the downside.

No. We do not bill on your behalf. What we do is provide you with all the analytics and automated workflow for you to generate a claim form with a few clicks of a button and all one has to do is download it and send it along with the co-downloads of the POD, Rx for OAT and CPAP Intolerance Affidavit and everything that’s in your pts chart to satisfy Insurance Co. requirements.
We also provide all of your patients specific letters and tools for management of medical claims and there is no extra charge beyond the per patient fee of $495 for the entire workflow.
The alternative is to hire a 3rd party billing service and pay them 12-15% of billing.

You only pay $2995 once and with that you get the team training course at no additional charge for as many team members you’d like to train for as long as you are a member.

To update your contact details in all communications with patients on email and brochures please Login to the dashboard and click on the "Practice Address" tab in the left bar. After clicking on this tab you will get your practice location. Click on the "Edit Address" to edit the details and then save it after making all changes.

To know more about How to Adjust a George Gauge, Please See the Video Click Here

To know more about How to Take a Bite with Andra Gauge, Please See the Video Click Here

To know more about How to take a Bite with George Gauge, Please See the Video Click Here

To know more about How to Adjust an Andra Gauge, Please See the Video Click Here

Could you please refill the information in your profile and then try saving once again.
Please note that all fields that are marked with a red colored asterisk are mandatory to fill and complete. The data shall not save till such time all these marked fields are completed.

I would like to request you that please enter HD2018 Partner code in the box and enter the username of your email address and press SEND CODE button. You will receive an email with a verification code. Please enter that code and click on the VERIFY NOW button.
Please have a look at this video to know more about how to access MAD-FIT Workup Form.

Each morning after use and nightly before use, thoroughly clean and rinse your oral appliance using a regular toothbrush and antibacterial soap.
Toothpaste and mouthwash can be damaging to the oral appliance. Denture cleaning tablets and a soft toothbrush are ideal for cleaning an oral appliance.
Wash, Rinse and Dry the appliance completely before storing in a container.
Keep your oral appliance out of the reach of children and animals.
Some tooth and jaw tenderness is normal when beginning treatment and usually in the morning and for that reason, we have given you a Morning Repositioner (AM Aligner). The Repositioner/Aligner is to be used every morning for 5-20 minutes immediately following removal of the oral appliance. If these symptoms persist or become painful, contact our office immediately.
Follow up care is important, please be sure to make it to your scheduled follow appointments!
Please feel free to contact us with any questions regarding your oral appliance for Obstructive Sleep Apnea

They document the tongue’s resting position when someone opens their mouth comfortably. The next one is when they say “aaaaaaaaaaa” and that’s for tone of the soft palate and the third is when they stick their tongue out and open their mouths. That’s for mallampati.

That’s for patients who’ve had an ent consult and were told or report high nasal resistance or if you have a CBCT you can see.

Not really. So if you don’t know the answer to a particular question just omit it. The algorithms will self adjust.

You’ll have the option to generate a claim form right from the MAD-FIT Titration page and again right after the Appliance Insertion form is completed, you’ll have the link to generate the med ins claim and then once completed will be able to not only print the CMS but also all of the necessary documents that one needs to send along.
You also have the option to generate a claim form after each follow up visit after the insertion but insurance cos do global payments so all follow up for OAT visits for up to usually 3 years is included in the payment for the appliance.

You can order it from Ohlendorf Lab and their telephone number is 314-533-344. Website Link

Once you have screened your patient and suspect they might be suffering from OSA, add them to your dashboard to start evaluation for candidacy for Oral Appliance Therapy. To know more about How to add a patient in your dashboard, Please See the Video Click Here

• • Memory Issues - during sleep, your brain forms connections that help you process and remember new Information. Lack of sleep can negatively impact both short and long-term memory.
• • Mood Changes - sleep deprivation can make you moody, emotional, and quick-tempered. Chronic sleep deprivation can affect your mood and lead to anxiety or depression, which may escalate.
• • Weekend Immunity - too little sleep weakens your Immune system's defenses against viruses like those that cause the common cold and flu. You're more likely to get sick when you're exposed to those germs.
• • Trouble with Thinking and Concentrating - Your concentration, creativity, and problem-solving skills aren't up to par when you don't get enough rest.
• • Accidents - being drowsy during the day can Increase your risk for car and work accidents and injuries.
• • Poor Balance - lack of sleep can also affect your balance and coordination, making you more prone to falls and other physical accidents.
• • Risk of Diabetes - lack of sleep affects your body's release of insulin. People who don't get enough sleep have higher blood glucose levels and an increased risk of type 2 diabetes.
• • High Blood Pressure - If you sleep less than five hours a night, your risk for high blood pressure.
• • Weight Gain - with sleep deprivation, the chemicals that signal to your brain that you are full. As a result, you're more likely to overindulge even when you've had enough to eat.
• • Low Sex Drive - people who don't get enough sleep often have lower libido. In men, this decrease in sex drive may be due to a drop in testosterone levels.
• • Risk of Heart Disease - Sleep deprivation may lead to increased blood pressure and higher levels of chemicals linked to inflammation, both of which play roles in heart disease.​

APP-NEA is a Cloud-Based EMR and i-PMS that provides doctors with Guided Work Flow and Predictive Treatment Planning for Optimal Treatment Outcome.

APP-NEA provides a comprehensive End-to-End Dental Sleep Medicine (DSM) Practice and Patient Management Systems powered by Computational Data ​​Analytics-driven by Machine Learning and Artificial Intelligence.

APP-NEA also provides its family of doctors with:

To know more about how to Adjust an Oral Appliance. Please see the Video Click Here

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Max flat - a maxillary joint stabilization device which is to be worn at night to promote proper joint position for stabilization (This design is unsuitable for daytime wear because the patient is unable to speak or function normally while wearing this joint stabilization device.)

Mandibular Flat - a mandibular joint stabilization device which is to be worn at night to promote proper joint position for stabilization (This design is unsuitable for daytime wear because the patient is unable to speak or function normally while wearing this joint stabilization device.)

Mandibular Daytime - a mandibular joint stabilization device that allows for the ability to speak and communicate which is to be worn during the daytime for approximately 4-6 weeks to promote proper joint position for stabilization (This design is inadequate for nighttime wear as it is designed to allow for speaking and communication and daytime function .)

Max Repositioning - a maxillary repositioning joint stabilization device which is to be worn at night to stabilize condylar position that provides interdental intercuspation fixation for stability (This is a separate and distinct device from other joint stabilization devices. This is not suitable for daytime wear as it does not allow for the patient to talk or eat, and is designed to keep the jaw stabilized in a forward position.)

Mandibular Repositioning - a mandibular repositioning joint stabilization device which is to be worn during the day to stabilize condylar position that provides interdental intercuspation fixation for stability (This is a separate and distinct device from other joint stabilization devices. This is not suitable for night wear as it allows for the patient to talk or eat, and is designed to keep the jaw stabilized in a forward position .)

Maxillary and mandibular device (Dual joint stabilization device) - maxillary and mandibular joint stabilization device (dual splint) which is to be worn at night to stabilize the condylar position . (This design is unsuitable for daytime wear because the patient is unable to speak or function normally while wearing this device.

CPT 41115: Excision of a lesion on the tongue without closure, performed to remove a lesion without suturing the area.
CPT 40819: Excision of the labial or buccal frenum to address issues with oral mobility or alignment.
CPT 41520: Frenoplasty, a surgical revision of the frenum to improve function or resolve oral complications.
CPT 41010: Incision of the labial frenum to release tension or improve lip movement.
CPT 40806: Incision of the lingual frenum to address tongue-tie and enhance tongue mobility.

These procedures are commonly performed to improve oral function, mobility, or address specific medical conditions.