Insurance & Financial Information
Oral Medicine of Wisconsin
Insurance Coverage Overview
At Oral Medicine of Wisconsin, we provide specialized care for temporomandibular disorders (TMD), oral medicine, and sleep apnea services, including oral appliance therapy and diagnostic imaging. Because these services can involve both dental and medical components, insurance coverage can be complex.
Medical Insurance: At this time, we bill medical insurance at this location. (Detailed list of in-network insurance coming soon)
For TMD - Medical insurance companies may cover certain services. Some procedures like oral splint therapy may require prior authorization and it is often difficult to guarantee coverage for them. Our billing team will help you navigate the process but please be mindful that coverage for TMD services through medical insurances can be challenging.
For Sleep Apnea services- Medical insurance companies do cover sleep apnea services provided certain conditions are met. We typically need 1) A diagnosis of sleep apnea through a sleep study and copy of the sleep study, 2) Referral from a doctor recommending oral sleep apnea device for managing sleep apnea and 3) sometimes most recent clinical visit notes from a sleep doctor.
For oral medicine services - medical insurance may cover consultation and biopsy services, which our billing team can help you navigate.
Pre-authorization & Referrals: Many insurance companies require pre-authorization or referrals before approving specialty procedures. We will assist you with this process whenever possible.
Network Status: While we participate in some insurance networks, many of our specialty services are considered out-of-network. This may affect your out-of-pocket costs.
Patient Responsibility & Insurance Verification
Because insurance policies differ greatly, we strongly encourage you to verify your own benefits directly with your insurance provider before your appointment. When you speak with an insurance representative, please:
Take note of the agent’s name and reference or claim number of your conversation.
Ask specific questions about your plan’s coverage for TMD and sleep apnea services, including diagnostics, oral appliances, and follow-up visits.
Familiarize yourself with insurance terms such as deductible, copay, coinsurance, annual maximum, and covered services.
Common insurance terminology it helps to be familiar with:
Deductible: The amount you must pay out of pocket each year before your insurance starts covering services.
Copay: A fixed fee you pay at the time of your visit, set by your insurance plan.
Coinsurance: The percentage of costs you share with your insurance after meeting your deductible.
Annual or Lifetime Maximum: The maximum dollar amount your insurance will pay for a particular service
Covered Services: Medical or dental procedures that your insurance plan agrees to pay for, fully or partially
This information helps avoid surprises and ensures you understand your financial responsibility.
Payment & Billing Policies
Payment is expected at the time of service unless you have made prior arrangements.
We accept major credit cards, checks, and cash.
For larger treatment plans, we offer payment plans through third-party financing options—please ask for details.
We provide insurance estimates in advance based on your plan benefits and the planned treatment. However, final responsibility for payment rests with the patient, as actual insurance reimbursements can vary.
After your visit, we will provide an itemized statement and assist with billing or claims questions.
Financing Options: CareCredit and More
We understand that healthcare costs can be a challenge. If your insurance does not cover certain services, or if you prefer assistance with managing payments, we offer CareCredit—a trusted healthcare financing option that provides flexible payment plans with low or no interest for qualified applicants.
CareCredit can help make treatment more affordable by allowing you to pay over time rather than in a lump sum. Our staff can help you apply and explain the available plans during your visit or consultation.
Please ask about CareCredit or other financing alternatives when scheduling your appointment.
Questions?
If you have questions about insurance, benefits, billing procedures, or financing options, please contact our billing coordinator at 414-433-7592 or email [email protected]. We want your focus to be on your health, not on financial uncertainty.
Get In Touch
Email:
[email protected]
Address:
8405 W Forest Home Ave, Suite 203, Greenfield, WI 53228
Assistance Hours
Mon – Fri 8:00am – 5:00pm
Saturday/Sunday – CLOSED
Phone Number:
414-401-3144
Fax Number
414-401-3146
