You are our patient, and we work for you. We base our treatment and treatment decisions on you, your condition, and the management of your healthcare. We will collect the fee for services rendered at each appointment based on our fee schedule and patients insurance benefits (for in network insurance carriers). Texas TMJ Sleep & Facial Pain is able to file in-network with most major medical insurance companies. Our team will work with you and your insurance company prior to treatment to help you understand your benefits and to minimize your out-of-pocket costs.
One of the first things we will do when you contact our office is asking for your medical insurance information. We do this to know what your insurance coverage will be before Dr. Virk performs any necessary treatment.
At Texas TMJ & Pain, we understand that navigating insurance can be difficult and overwhelming. Please let us know if you have any questions or need any guidance. We will be more than happy to help you understand how insurance works in our practice. We offer various payment methods including all major credit cards, cash, check and care credit. Payment plans and financial arrangements can be made on the case by case basis. We openly invite you to discuss all payment options with our staff prior to your initial appointment.
Insurance coverage for TMJ/TMD & Orofacial Pain
TMJ treatments are filed with medical insurance. Our goal is to support our patients in any way we can. Therefore, as a courtesy, we gladly assist in the filing of claims, excluding Medicare/Medicaid. We feel it is important for you to understand your plan and its payment allowances, as typically TMJ may be an exclusion from insurance policies.
Most insurance companies do cover oral devices for sleep apnea if they determine it to be medically necessary. Some insurance companies require preauthorization and others 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 pre-certified for medical necessity. Tell them you have obstructive sleep apnea with a diagnosis code G47.33 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.
Hopefully, this has answered the majority of your questions. Please call our office at (817) 251-9985 if you have additional questions, or would like to set up an appointment.