For Patients: Medical Billing & Insurance
Why Choose Teton Sleep Solutions?
Our Approach to Patient Care
At Teton Sleep Solutions, we prioritize your overall well-being. Dr. James L. Derrico, DDS, and Deann are dedicated to helping you achieve restorative sleep and improved health, so you can fully enjoy the activities you love in Jackson Hole’s stunning outdoors. Through collaboration with St. John’s Health Sleep specialists, your primary care physician, and your dentist, we identify the root causes of sleep and pain issues. By understanding why these challenges arise, we craft personalized treatment plans to optimize your sleep and enhance your quality of life.
For Patients: What to Expect
from Step 1 to 4, we can get you into treatment in a very short time.
Step 1. Consultation
Your path to better sleep begins with a thorough consultation and exam in our office. Dr. Derrico will review you sleep study results and discuss different appliance options for you. Our consultations are complimentary. Our goal is to provide our patients with the knowledge to make an informed decision on the best treatment to address their individual sleep concerns.
Step 2. Exam and Records
The necessary records will involve performing an intraoral exam, TMJ and head and neck muscle assessment, intraoral photographs, an intraoral digital scan of the upper and lower teeth along with an initial protrusive measurement for the lower jaw. This information will be sent to the lab to create your customized oral sleep appliance.
Step 3. Appliance Delivery
During the appliance delivery you will receive your custom-fitted appliance. The appliance will be tried in for proper fit and comfort. You will be guided on how to place and remove the appliance and how to clean and care for it. You will, also, be instructed on how to use the morning aligner to aid in avoiding any changes to your bite. Within the next few nights you’ll likely notice a decrease in snoring and you might even start feeling better when you awaken in the morning.
Step 4. Follow-Up
Within 2 weeks, Dr. Derrico will see you for a follow up appointment to discuss your comfort with the appliance. If indicated, an adjustment to your appliance will be made. Subsequent follow-up visits, two to four weeks apart, will be scheduled to make additional adjustments and further assess the effectiveness of the appliance. Once Dr. Derrico feels your appliance is providing the most therapeutic effectiveness he will send you home with a home sleep test to to assess the treatment efficacy with your appliance.
For Patients: Medical Billing & Insurance
At Teton Sleep Solutions, we understand that navigating insurance can be complex, and we’re here to help.
Sleep apnea is a recognized medical condition, and oral appliance therapy is a covered CPAP alternative for most insurance providers. Since this is a medical treatment, claims are submitted to your medical insurance, not your dental insurance, as there are no dental benefits for this treatment.
We work with most major medical insurance companies and will file claims on your behalf. As a dentist providing durable medical equipment, we are not in-network with any medical insurance providers, therefore, benefits will be paid directly to you by your insurance company.
Dr. Derrico is an approved non-participating Medicare provider. Medicare processes claims submitted by our office, and benefits are sent directly to you, the policyholder. If you have a secondary or supplemental insurance policy, we’ll also submit claims to them after Medicare pays its portion. Reimbursement varies based on your plan, but many patients with both Medicare and supplemental insurance receive 50-100% coverage for their oral appliance.
Referrals are not required to schedule an appointment for a consultation.
If you have any questions about insurance or treatment costs, call our office—we’re happy to assist.
🗎 For Referring Doctors (PDF)
FAQs
What insurance do you accept?
We work with all major medical insurance companies and will submit claims on your behalf. Teton Sleep Solutions is not contracted with medical insurance companies, as we have found that this limits the care we are able to provide for our patients
We are an approved, non-participating Medicare provider. This means that we are approved by Medicare to provide treatment and to submit a claim on a patient’s behalf with the benefits paid directly to the patient. We cannot accept the assignment of the benefits.
What is an in-network or participating provider?
A healthcare provider that has signed a contract and has agreed to accept a set fee for services provided to members of a specific health plan.
What is an out-of-network or non-contracted provider?
The healthcare provider is not in a contract for services with a specific health insurance company. There may be benefits available paid by your medical insurance company. These benefits are determined by your insurance company and are based on your individual policy.
Do I need a referral from my doctor?
We do not require referrals for a consultation, however, some insurance companies require a referral for a pre-authorization and/or submitting a medical insurance claim for treatment.