Imagn Billing Featured Case: Oral Appliance

In this example Imagn Billing case you will see how a dental office in Washington successfully billed for a sleep appliance and even got a gap exception approved. Our Imagn Billing team processed this claim on 08/19/2020 to Cigna insurance and it was paid on 09/29/2020.

The 32-year-old male patient presented for a routine hygiene appointment and his sleep screening showed symptoms including daytime tiredness and snoring. The dentist felt these symptoms could be indicative of a sleep disorder and recommended the patient be tested. The patient agreed and tested using a home sleep test. The test was interpreted by a board-certified sleep specialist who diagnosed him with Moderate Obstructive Sleep Apnea. The specialist recommended an oral appliance and the dentist agreed that the patient is an ideal candidate for treatment.  

Proving Medical Necessity 

Having this diagnosis from the MD makes this an ideal case to bill medical insurance.  The dental office determined that this case was medically necessary by defining how the chief complaint of daytime tiredness and snoring affected the rest of the body. Which was diagnosed as obstructive sleep apnea by a board-certified sleep specialist and as a result could be treated with a dental device.

Billing Medical Insurance 

The practice collected all required documentation, which included the sleep test results with interpretation, a written prescription for an oral appliance, clinical SOAP notes and a signed CPAP Affidavit. After completing the verification of benefits, it was determined that coverage was available after the deductible is satisfied. Pre-Authorization was required and was completed with approval along with a Gap exception.

Dental Comparison

Without medical insurance’s contribution, the patient would have paid out of pocket between $3750 and $3111.84.  Medical insurance saved the patient approximately $2000, whereas dental insurance had no coverage at all. The patient also completely satisfied their deductible, so moving forward they will have less out of pocket expenses if a healthcare issue arises. 

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Imagn Medical Billing Service

Due to the complex nature of medical insurance billing, most dental offices are not equipped with the knowledge to properly credential national payers, submit successful claims, or handle aging and appeals. Imagn Medical Billing Service performs the proper credentialing and billing for you, which results in fewer denials and time well saved as you rely on expert help.

One-Time Credential Fee

$795/per dentist

The key to more successful payments

Our experts complete the process so you can start billing medical insurance. Each dentist billing medical insurance needs to be credentialed.

Pay Per Case

Verification of Benefit

$35 per vob

We get your patient’s insurance information so you can set proper expectations with the patient regarding the specific coverage available and any out of pocket fees. This is the most critical step in all of medical billing.

Per Authorization

$40 per auth

All procedures require pre-authorization in order for your practice to get paid. Gaining appropriate authorization can be challenging, let our experts get the job done for you.

Claim Submission

8% of successful claim

You don’t have time to sit on hold. Let us sit on hold and handle the claim submission work for you  We also handle the aging and appeals so you can focus on your practice.

Choose Your Software

Imagn Software is your one stop solution with both medical billing and dental sleep medicine capabilities with world-class support

What most dentist don’t know is that medical billing can increase your case acceptance rate and ensure your patients get the care they need.

Imagn Software

$195 /month

No contract and your satisfaction guaranteed.

Our goal is to give you the best experience. But if you are not satisfied then we will give you a full refund for your software access fee within 30 days of purchase.

Add Imagn Sleep Software

$100 /month

Our software provides everything you need

to give your patient’s the sleep care they deserve.

Patients can no longer afford to have dentists ignore the responsibility of providing care for sleep disorders. Two out of every three Americans report poor sleep; the ability to breathe well is the most important factor in determining a person’s sleep quality. 

Imagn Software Set-up Fee

$399 one-time fee

No contract and your satisfaction guaranteed.

Our goal is to give you the best experience. But if you are not satisfied then we will give you a full refund for your software access fee within 30 days of purchase.

Choose Your Monthly Devdent Support Program

In order for you to succeed, we offer a unique range of customer support solutions including coaching, online resources, implementation programming, and so much more. We keep an eye on the ever changing industry trends so you can focus on your practice

Medical Billing Support

$200 /month

The program to get and keep your staff trained.

Dental Sleep Medicine Support

$200 /month

The program to implement Dental Sleep Medicine into your practice.


$345 /month

Get both of the Medical Billing and Dental Sleep Medicine Support programs at a discount.

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