Dr. Dar Radfar took a few courses in dental sleep medicine by the so-called experts of industry. Like so many others, he burst onto the scene and in his first month, he sent Gergen’s Orthodontic Lab eight
cases. However, of those eight cases he was only paid on two due to the lack of knowledge and effort of a certain medical billing company, which I will not name. After countless insurance claims being denied or delayed, Dr. Radfar decided every time he got a claim denied he would pick up the phone and call the insurance company. He asked questions, spoke to a “peer” medical doctor, supervisor after supervisor, tallied up all they said, and came up with some conclusions. He realized a key common denominator kept coming up – a doctor’s chart notes play a pivotal role in medical billing as do diagnosis codes. Certain key phrases and words will need to be written to have a higher chance of getting paid. His chart notes are extremely precise, detailing all comorbidities, findings, reasons, and the list goes on. He even discovered that the type of sleep equipment used based on the insurance plan makes a difference on whether the oral appliance gets paid on, even though everything else indicates a necessity He switched medical billing companies and being the practitioner that he is, began working hand in hand with the medical billing company.
Dr. Radfar doesn’t see himself as an expert though. He believes that we are just practitioners who have more experience in the field of dental sleep medicine but that doesn’t mean we know everything. For the last 2 years, he has actually been educating other dentists through seminars that have either sold out or come close to it with people asking him “Is that all I have to do?” Well it’s not as easy as it sounds, clearly. Otherwise, everyone would be making an average of $7,000 per patient per oral appliance as Dr. Radfar informed me he does.
Dr. Radfar’s philosophy is simple, we, as practitioners did the work, why are we not getting paid in a timely matter? He spends an hour on this topic during his seminars and provides details on what the chart notes need to look like in order to win the battle against insurance companies. Because of this attention to detail, time and time again we see him get paid thousands of dollars per patient. He explained to me how he has been on hold, gotten into verbal arguments, asked for direct fax lines and emails, spoken to one supervisor one day and another one another day, just to get two different answers to the same question. He calls insurance companies weekly trying to figure out how he, and any dentist, who takes his seminar can reduce insurance denials and profit from treating sleep apnea.
So what does he do differently than other dentists practicing dental sleep medicine? Sure, he’s getting more new patient consults from medical doctors in the community, whom he has connected with, but ultimately getting reimbursed at the highest level from medical insurance is what Dr. Radfar truly spent his time perfecting. It’s never all about the money – quality patient care, and providing a service that saves lives provides ultimate satisfaction.
Dr. Radfar, who is also a diplomate of the American Sleep & Breathing Academy Dental Division, is now doing over twenty cases per month and receiving handsome reimbursement on all of them. He is out there teaching other dentists the proper procedures so that they can avoid the headaches associated with dealing with medical insurance. That’s the funny thing about these so-called expert trainers; the guys doing the training aren’t actually the ones doing the work. Sleep apnea is a serious medical condition, and the treatment of it can prevent multiple diseases, including death. Medical insurances should provide coverage for a diagnosed sleep apnea patient, as any patient treated should ideally live a healthier life with less medical expenses down the line. Dentists have the right to screen and treat their patients, and they have the right to get reimbursed at any level they feel provides value for what they have found and helped treat. So what’s saving someone’s life worth? Well Dr. Radfar believes you cannot put a price on life!
David Gergen CDT opened his family-owned Gergen’s Orthodontic Lab in Phoenix, AZ in 1986 and now employees over 80 people. David Gergen has been a nationally respected dental lab technician for over 25 years. He received the award for “The Finest Orthodontic Technician in the Country” given by Columbus Dental in 1986. He also received a lifetime achievement award by Dr Harold Gelb Academy as Americas greatest Orthodontic technician of all time, in 2012. He has worked for some of the pioneers in the orthodontic and sleep dentistry fields. Gergen and his father John Gergen began Gergen Orthodontic labs in 1984 and have grown it into one of the most respected labs in the country. One of his proudest achievements is receiving The National Leadership award for Arizona Small Businessman of the Year in 2004. David is the Dental Director of the American Sleep and Breathing Academy and he has also taken a spot at Tufts University teaching seminars for the Continuing-Ed program on Dental Sleep Medicine.