How to Refer/Documents Needed

How to refer your patient to the dentist for obstructive sleep apnea therapy.

doctorDear Medical Colleague, patients with a diagnosis of early or moderate OSA are often excellent candidates for oral appliance therapy. The AASM has recommended this as a first treatment option for those patients since 2006.

As you well know, there is a large population of people who should be using a PAP device, but are simply unable or unwilling to do so. Since these patients have “fallen off the wagon”, they remain at risk of serious co-morbid issues like a CVA or MI. Many of them would be willing and able to utilize an oral appliance if it was offered to them as an option. Even if this approach did not result in a return to a normal AHI, any significant reduction would certainly lower their overall co-morbid health risks.

Of course, PAP therapy remains the “Gold Standard” for those patients in the severe category, and every attempt should be made to get them and keep them on PAP therapy. However, for those who simply can’t or won’t, an oral appliance may be of significant help.


Please have your staff gather the information listed below from your records, including a signed prescription for the device. We must have the information below before we can see the patient for an exam. We want this life-saving treatment to be as affordable as possible for your patients, so we are ‘in network’ with many plans, and will handle billing and insurance issues for your patients. Most dentists are not Participating Providers in medical insurance plans.

Once the patient’s oral appliance is properly advanced, we will refer them back to the Sleep MD for a sleep study to confirm the subjective improvements we see.

Thank you again for the opportunity to participate in this life-saving therapy. If I can ever assist you or answer any questions about this approach, please don’t hesitate to call or email me. I look forward to working in partnership with you for the benefit or our mutual patients.

Should you ever have any questions, feel free to call the office, or if we are closed, reach out to me on my cell phone at 253-350-1345. You can also email me personally at

When you are ready to refer a patient for evaluation, simply write a prescription for an oral appliance, code E0486 and indicate a diagnosis of Obstructive Sleep Apnea, G47.33. Include copies of chart notes pre and post sleep study (required for Medicare) and fax everything to 866-861-6286. The prescription must be signed by the referring physician, and a copy of the diagnostic (not spit night) sleep study included, in order for us to obtain a pre-determination of benefits for your patient.

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Here is how we are keeping you safe, particularly during the COVID-19 viral outbreak.


Pre and day-of appointment screening questions to determine infection risk.

Hand sanitizing gel and masks for all patients immediately upon entering.

“No touch” infrared forehead thermometer check before treatment.

Social distancing protocol and ‘sneeze guard’ shields at the reception desk.

Medical-grade HEPA filtration units for sanitation of the air we breathe in the office.

• PPE for clinical staff includes a gown, gloves, mask, eye protection and a face shield.

Disposable sterile single-use clinical instruments are utilized wherever possible.

Reusable instruments are packaged and sterilized in an autoclave before being returned to service. Delicate reusables are soaked overnight in a hospital-grade sterilant solution.

Our autoclave is tested AT LEAST weekly by an independent microbiology lab to confirm that our autoclave is working properly.

All exposed patient chair and work surfaces are sprayed and wiped down with a hospital-grade disinfecting solution that kills viruses and bacteria between patients.

High-touch areas like computer keyboards, mice, headrests and chair arms are covered with single-use disposable barriers that are replaced after each patient.

• New Mandibular Advancement Devices are disinfected twice: by the lab after fabrication and again in our office before delivery to a patient.


Thank you for entrusting us to keep you safe while we help you get a more restful night’s sleep. After all, getting quality sleep is one of the most important things you need to stay healthy!