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Some Dental Clients Now Eligible for Mandibular Advancement Devices with Apple Health

As of January 1, 2019, Apple Health clients who have been under the care of a sleep medicine physician and are not able to use CPAP for treatment of OSA are eligible to have a custom MAD created for the treatment of their OSA.
Please read the following provider update from the Health Care Authority (HCA).

Interested in Providing Sleep Apnea Treatment as a Dental Provider?

As of January 1, 2019, Apple Health clients who have been under the care of a sleep medicine physician and are not able to use CPAP for treatment of OSA are eligible to have a custom MAD created for the treatment of their OSA. Apple Health clients must meet specific criteria and be pre authorized to qualify.

Enrolling as a Provider
In order to serve our clients, you must be enrolled as an Apple Health provider of durable medical equipment (DME). To enroll as a DME provider, please see our website.

Other Requirements

In addition to being enrolled as an Apple Health provider, we require that you also meet one of the following criteria for reimbursement as a Center of Excellence:

1. Certification in dental sleep medicine by a nonprofit organization, such as the American Board of Dental Sleep Medicine (ABDSM)

2. Designation as the dental director of a dental sleep medicine facility accredited by a nonprofit organization, such as the American Academy of Dental Sleep Medicine (AADSM)

3. Recognized continuing education in dental sleep medicine provided by a dental sleep medicine focused nonprofit organization or accredited dental school within the last 2 years

Next Steps and More Information
Once you have enrolled as a DME provider, and you have submitted verification that you meet one of the criteria for reimbursement, you can bill for mandibular advancement devices as an HCA-approved Center of Excellence for Apple Health clients.

For more information on how Apple Health administers sleep medicine programs and payment, please see the Sleep Centers Billing Guide.
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