NEW PATIENTS

Dear Patient, 
Welcome to our office. This practice is limited to oral facial pain, temporomandibular joint disorders, and oral devices for sleep apnea. Dr. Mintz does no dentistry. For any of these problems, we like to know if you have ever worn any kind of mouth guard for a grinding problem, and if in the last five years a dentist has taken a panoramic radiograph (full view of the mouth where you stand in front of a machine that goes around your head ear to ear). If you have a guard please bring it with you for evaluation on your first visit. If you have had a panoramic radiograph, please obtain it or a copy and bring it with you to your first visit as well. If you have not, our office can take this x-ray. If you have had any other type of imaging of the TMJ joints please bring it or at least a copy of the report. Sleep patients will need to obtain a copy of their initial polysomnogram (sleep study) to bring to their first visit. 

TMJ PATIENTS:
Your first visit is a 60 minute consultation and exam where Dr. Mintz will begin by listening to all your symptoms and complaints. If you bring a guard, he will evaluate its current usage. If you bring a radiograph, he will view it to examine the temporomandibular joints. Next, he will do a comprehensive examination of the head, face, and neck. After, he will give you his opinion about your problem and a treatment plan. 

FACIAL PAIN PATIENTS: 
Your first visit is a 90 minute consultation and exam where Dr. Mintz will listen to all your symptoms and complaints. It is suggested that you bring with you a written history of your problem beginning with information related to when the problem started, what doctors you saw, what medications you tried, and what helped and what did not. Next, a comprehensive examination of the head, face, and neck will be preformed. After, he will give you his opinion about your problem and a treatment plan.

SLEEP DISORDERS PATIENTS:
Your first visit is a 60 minute consultation. If you have any of the above problems, Dr. Mintz will begin as above, if not, he will start with an examination of the mouth and review of the panoramic radiograph to ensure that you are a candidate for the use of an oral appliance. He will review your sleep study. Next, he will discuss the various devices (there are over 100 FDA approved devices, and he has had clinical experience with over a dozen) and explain to you how they work in conjunction with sleep apnea. Together you will decide in your case which is the best device for you. If you decide to go ahead with treatment, impressions are taken on this visit and sent to a lab. It takes about three weeks to get the oral device back. You will then come in for your second visit where you will be fitted and shown how to wear the device. After that there is one to approximately three follow-up visits depending on the patient. Once you are sleeping comfortably through the night utilizing the device (this can take two weeks to two months) you will be referred back to your sleep physician for another sleep study utilizing the device. We want to make sure that this oral device is taking care of the apnea. 

ABOUT INSURANCE: 
The majority of our patients have a medical problem with a dental solution, and therefore we submit to the medical insurance company. On occasion, we do submit to the dental insurance company. Our office participates only with Medicare and the Military Tricare. Our office will be happy to submit your claim forms for you but our policy is that you pay us and your insurance company reimburses you directly. Our office will also work with you where necessary to help get preauthorization for your oral devices.

Insurance coverage for oral devices for sleep apnea:  Most insurance companies do cover oral devices for sleep apnea if they determine it to be medically necessary. Some insurance companies require preauthorization and other do not. To be sure, it is suggested you call your insurance company to determine if it is a covered service and how much you might expect to be reimbursed. Secondly, ask if it needs to be preauthorized or precertified for medical necessity. Tell them you have obstructive sleep apnea with a diagnosis code 327.23 and need an adjustable mandibular repositioning appliance with a procedure code of E0486 (durable medical equipment). If you determine it needs to be preauthorized ask where the information needs to be faxed. Our office will be happy to fax this information to your insurance company after receiving a copy of both sides of your insurance card and a copy of your original sleep study.

Currently, we have information about several insurance companies:

  1. Blue Cross Blue Shield the Federal Government – policy starts with an R - you do not need a referral, it is a covered service, and they pay only about a third of the cost of the device or less depending on whether you have met your deductible or not.
  2. Carefirst – if your insurance identification number begins with an XIP you do not need a referral and it does not need to be preauthorized. It is a covered service. If your identification number begins with an XIC it does need to be preauthorized.
  3. Aetna – some policies require preauthorization and other do not. However, unless you have a sleep score of 15 or more it is not a covered service unless you have other medical conditions.
  4. All other insurance companies must be contacted to determine their policy.

Medicare Patients:  You do not need a referral to come to our office. As a participating provider most services are covered by Medicare and your supplemental insurance company. You may have to pay something if your secondary insurance does not cover their portion or a charge has gone towards a deductible.

  1. TMJ/FACIAL PAIN PATIENTS – Medicare currently covers all services Dr. Mintz provides.
  2. SLEEP PATIENTS – Medicare currently covers consultation/examinations and panoramic radiographs. They do cover oral devices for sleep apnea as durable medical equipment. This must be provided by a participating durable medical equipment company. We are not a durable medical equipment company and therefore are unable to bill Medicare for this device. There is a possibility that your secondary insurance may provide some coverage. You can check with them (see above) as well as Medicare for clarification of coverage.

Tricare Patients:  You need an authorization from your MTF or PCP to come to our office. Normally, our office receives fax authorizations by the time you phone us. If you or your dependent is active duty there are no co-pays. If you have Tricare Prime and are inactive or retired there is a $12 co-pay at each visit. If you have Tricare Standard, there are additional costs which will be discussed.

All other Patients:  If your medical insurance is an HMO, you must check with them to see if they have a participating provider in your plan that can help you or if they will give you a referral to come to our office as a non-participating provider. If your medical insurance is a PPO and you don’t regularly need a referral to go to an out of network provider, you should be able to come to our office. Hopefully, this has answered the majority of your questions. Please call if you have additional questions, or would like to set up an appointment. You may leave a message on our answering machine and your call will be returned on the next business day.

OFFICE HOURS:

Monday – 1p.m to 6p.m

Tuesday - 10a.m. to 6p.m.

Thursday - 10a.m. to 6p.m.

APPOINTMENTS:

Once an appointment is set up we request you download and print the health history form and appropriate consent form. This will need to be completed and either mailed or brought to your first visit. It is extremely important to fully fill out these forms. We need the full names and mailing addresses of your physicians and dentists so that Dr. Mintz can communicate with them regarding his findings after your initial consultation.  If you do not have internet access, we will mail these forms to you.