Reimbursement

DreamSleep’s whole team training approach ensures that each member of your team understands how every action they take affects reimbursement. All DreamSleep practices are enrolled in our Nexus Bill program which combines a versatile 3rd party billing solution paired with customized training, coaching and protocol development. Your team will understand the insurance landscape in your area to maximize reimbursement.

Nexus Bill

Nexus Bill is the fastest and most efficient way to manage the complex process of management of your claims reimbursement success. This 1 year program of whole-team approach to area of practice ensures that each member of your team understands how our program benefits your patients and their personal part to play in delivering treatment. The Whole Team approach is key to this protocol, ensuring consistent message delivery and comprehensive screening. Maintenance fees will be applied. Additional contracts per acceptance of services will be necessary based on payers.
Nexus Bill includes intensive training for your team, ongoing coaching and assistance.

Your team will:

• Become proficient in a Sleep/DMSD/TMD specialty medicine group practice and a durable medical equipment network
• Have a team to help you and your patients do well: both clinically and financially
• Provide you with options such as but not limited to: Out-of-Network, In-Network health plan contracts for PPO plans: Aetna, UHC, UMR, Blue Cross, Cigna and more
• We connect you with Specialty Physicians & nurse practitioners to supervise your patients and to provide the necessary face-to-face options, on-site or via telemedicine when needed
• Together: we share the patient for best practice, and compliance

The Nexus Bill program has 2 stages:

1. 3rd Party Biller
   1. Learn how to process paperwork, learn the terminology
   2. Build claims experience + claim history
   3. Learn insurance landscape in area
   4. Understand who pays out-of-network, who needs in-network
2. In-Network status for office if appropriate
   1. Under offices NPI number
   2. Depending on rates may stay or progress to 3rd level

We will always guide you towards the billing option that pays the best rates in your area.

Nexus Activation Network

For practices that are experiencing roadblocks to reimbursement through Nexus Bill due to the local insurance environment or policies, the Nexus Network may be appropriate. Enrollment in the Nexus Network allows your practice to use our NPI number and our negotiated rates which may be higher than out-of-network through Nexus Bill. Participation in the Nexus Network includes case & compliance oversight by our Medical Director and continued coaching on a case-by-case basis to ensure optimal reimbursement. Your dedicated billing specialist will make recommendations for approval to be done with patient’s most favorable to your practice level of benefits. Each case will be analyzed to determine the best approach to proceed, utilizing the patient’s benefits In-network level or Out-of-Network level.

Nexus Network offers several benefits to qualifying practices:

• Under our NPI number
• Bill using our contracted rates
• IN-Network with major payors and plans
• Increased approvals
• Medical Director oversight
• Compliance oversight
• Continued team coaching to optimize medical reimbursement