The subject of developing a coordinated plan for an effective outreach program to patients requires trained employees, protocols in place for documentation and treatment, marketing, and effective reimbursement. This subject is voluminous in nature and there is usually a cost to you at every turn. With so many opinions available on this subject, this module will provide you with foundational thoughts that you can build from.
Every aspect of your program should fit your personality, your practice’s persona, goals, expectations, timelines, patient population, and costs to implement. This is not an overnight happening, but with a thought-out cost-conscious approach one can become exceptionally successful in a relatively short period of time. As with anything we create in our lives, a solid foundation is needed. This begins with you, the doctor. Your entire staff will be guided by your passion or lack of, knowledge, expectations, and goals.
The Knowledge Factor
Your ability to provide a credible knowledge base that is evident to your employees, patients and referral network of healthcare providers is essential as is the ability to fluently discuss the intricacies of this field with other medical providers. The sleep provider community is small, and first impressions are essential. Taking your time to develop this foundation is an investment in your future. As I mentioned, there is a cost factor with every step of the way. I recommend taking most of your seminars that are not product supported. At this point in your journey you are learning the basics, developing your foundation, and making inroads into the field. One excellent and inexpensive way to educate yourself is to google a topic and simply read the study summaries. PubMed and other scientific resources can provide an excellent foundation at no cost and will make any seminar more impactful with your expanded knowledge base. Remember that most seminars simply repeat research that you are now reading on your own time.
Developing credentials through the AADSM, AAOP, or AACP is essential. At this time the Diplomate status with the ABDSM is the only recognized certification for DSM with organized medicine and this can definitely make a difference with your referral sources. Beyond the credentialing process, the clinical factor is the hardest issue to overcome and one that your referring providers are looking for. TDSS can provide clinical assistance for you as a part of your membership and is something that should be taken advantage of. The importance of understanding the over 100 different oral appliances are all doing essentially the same thing, mimicking the CPR move using a mechanical device. The OA you choose to work with must be one you are able to work with easily, have trained your staff on, have available spare parts, easily modifiable, expandable for unique case situations and affordable for the patient and your practice when considering your reimbursement rates.
In the end, the difficult part of this field is to develop the knowledge, be able to apply your knowledge in a fluid, easily understandable manner for both your patient and referral sources and have your therapy affordable for your patient and practice.
Expectations
When you began to consider entering into the field of DSM, what were your expectations or did you really have any? I am sure you asked yourself if this would be simply an easy add-on to the practice or could it become something on a larger scale. I have found that most doctors don’t grasp the entire concept and potential of DSM until they begin to understand the disease entity itself and the vastness of the issue within our general population. Once the doctor understands the potential opportunity, the next question is usually how I can incorporate this therapy into my practice and what can I expect from it.
At the forefront of your expectations after the Knowledge Factor is accomplished is how can I expect to be paid. Expectations are a product of being able to be reimbursed for a procedure. OAT is a medical therapy, paid for by medical insurance, diagnosed by a physician, treated with a durable medical device (DME), and treated by a dentist. Virtually all cases at this time are billed and paid as a GAP exemption, out of network claim, or cash. These are difficult choices and a significant out of pocket expense for a large segment of your patient population. TDSS has solved this issue for a significant number of major insurance carriers creating higher expectations for an office wanting to enter into this field. Much the same with your dental practice, developing a referral network and getting the work out to your community is the core of elevating your expectations. In essence TDSS has provided you with the foundation for you to build upon. When you combine your increased knowledge base and in-network status, your referrals will increase. By implementing both a subtle and more direct in-office education/marketing program, seek speaking engagements with community groups and your website marketing initiatives now will all come into play. For example, being contracted with the VA and Tricare provides for an excellent opportunity to speak at VFW and American Legion meetings.
Your dental practice took time to develop and the same issues and difficulties in growing your dental practice will apply here also. The significant advantage as a TDSS member is that in-network medical coverage is rarely found for this therapy. TDSS has significantly solved this issue.
Using your Staff to Spread the Word
How many times when either you, your assistant or hygienist have been reviewing a patient’s medical history have seen they are taking medication for or have high blood pressure, diabetes, atrial fibrillation, depression, Parkinson’s Disease, Ehler- Danlos Syndrome, epilepsy, Factor 5 Liden, nocturia, PTSD, or cardiovascular disease. Those patients have a high-risk factor for OSA and this is a segment of your practice that you could talk to about sleep apnea. Having your staff knowledgeable about the basics would go a long way towards bringing these patients into treatment. The Epworth Sleep Scale should be available in the waiting room for a patient to fill out. This is a passive means of marketing and opens discussion for you and your team. TDSS also has available marketing articles that are interesting and informative for your patients to either read while in your waiting area or sent to with an office newsletter.
In many cases you are laying seeds for your patients to consider for themselves, family members or friends. With time your efforts will blossom with increased referrals. Tying your marketing campaign back to an easy to navigate informative website is also an important factor in developing your referral base. Your staff is simply confirming your patient’s suspicions in many cases. For example, after patients have been given the right information you will hear some state, “I didn’t think my gasping when asleep was normal”, or “could that be why I am going to the bathroom three times at night”.
It is also especially important for your front desk employees to be able answer basic questions with well thought out answers. Over the years and still as of today, when I call offices their front desk employees have given the following answers.
- “I know the doctor has made a few of those snore appliances.”
- “I have never heard of that but I will ask the doctor.”
- “He just took a course on that.”
- “I know she has made some but she is not really interested in that.”
It is essential that every individual answering the phone participate in some form of role playing. Short, knowledgeable, informative, and professional answers have to be provided since that phone call is the first impression your office will provide a prospective patient.
