Insurance Questions

medicalIn order to best serve your patients, we are participating providers for: Blue Cross/ Blue Shield, Regence, Premera, Cigna, United Health Care and accept Medicare (Non-Par, with balance billing).   We do NOT accept: Provider One, Medicaid or Molina.

We can request a GAP exception from any insurance that we are not a current provider for.  A GAP exception, if granted, would allow in-network coverage for your patient.

Most insurance plans cover oral appliances, and the patient’s out-of-pocket costs typically range from $0 – $1,500.00 depending on whether their deductible has been met and the patient portion percentage. Our office sleep coordinator will check on the estimated coverage for the patient and give them an estimated cost before scheduling the patient for an exam.

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.