Sleep specialists
We bill what we know
Billing & credentialing
One team, both
Any EMR or EHR
We work in your system
No lock-in
No exclusivity or minimums
Why a specialist matters here
Most billing companies are generalists. They can file a claim for anything and know the particulars of nothing, which is fine until the claims are for sleep studies.
Sleep billing has its own traps. In-lab and home testing carry different codes and different documentation requirements. Prior authorization rules vary by payer and change often. Out-of-network work has its own risks. Titration and split-night studies get coded wrong routinely. Oral appliances bill through medical insurance rather than dental, with specific documentation requirements that catch out practices new to it. And denials in this space usually trace back to documentation the practice could have supplied at the time, if anyone had told them.
Opus has been in the business of medicine since 2009. We know which codes get paid, which denials are worth appealing, and where practices consistently leave money behind — because we have run the labs, not just billed for them.
Billing services
Complete back-office billing, from patient setup through final collection.
Before the claim
- Patient setup and demographics
- Verification of insurance benefits
- Processing of prior authorizations
- Charge posting
The claim
- Filing all insurance claims, electronic or paper
- Payment posting
- Denial management and appeals
- Collections follow-up
Around it
- Patient invoicing
- Insurance company and patient relations
- Quality control review
- Standard and custom monthly reporting
We work in all major EMR and EHR systems. There is nothing to migrate and no platform of ours to buy.
Credentialing and payer contracting
Why people choose us
Getting credentialed is the part that quietly costs practices the most, because every week a provider is not credentialed is a week of work that either cannot be billed or gets billed out of network.
- Physician and provider credentialing
- Managed care contract credentialing
- Insurance contracting and rate negotiation
- Re-credentialing and maintenance
We do not bill Medi-Cal at this time. Everything else — Medicare and all major commercial payers — we do. We would rather tell you that on the website than after you have signed.
Out-of-network work. We handle out-of-network billing as well as in-network, including the follow-up and appeals that come with it. What makes sense for your practice depends on your market and your payer mix, and we will talk it through before you commit to either.
Timelines belong to the payer; responsiveness belongs to us. How long credentialing takes is largely outside anyone’s control. What is inside our control is submitting complete applications and following up rather than waiting, which is the difference between a three-month credentialing and a nine-month one.
Dental practices billing medical
If your practice provides oral appliance therapy or home sleep testing, that work bills through medical insurance rather than dental. Different codes, different documentation, different payers, and rules that change again for Medicare.
This is where dental practices moving into sleep most often stall — the clinical side works and the money does not arrive. We set up the medical billing process, in network or out, and run it for you.
New practices and start-ups
Starting a practice, or adding sleep to an existing one, is the point at which billing decisions are cheapest to get right and most expensive to get wrong. Providers who are not credentialed cannot bill. Payer contracts signed at the wrong rate stay signed for years. A billing system chosen badly gets replaced at cost.
We set the whole back office up from the beginning: billing systems, credentialing your providers with the payers you need, insurance contracting, and the workflow around them. If you are also building a sleep center, this runs alongside that work rather than after it.
Other specialties
Sleep is what we know best, but our teams bill general medical and dental practices as well. If you are outside sleep and want to know whether we are a fit, ask — we will tell you honestly if you would be better served by someone who specializes in your field.
What you see every month
Standard and custom monthly reporting, so you are not guessing about your own revenue. Collections, claims filed, denials and their causes, days in accounts receivable, and outstanding balances — with a short note on anything that moved and why.
Security
Every team member works to HIPAA-compliant practices. We execute a business associate agreement with every client — we have our own and will sign yours — and Opus carries a cyber liability policy sized for hospital vendor requirements.
We work in all major EMR and EHR systems. There is nothing to migrate and no platform of ours to buy.
How we price
Billing is quoted per client. What it costs depends on how your practice is set up, what is involved, and what kind of practice it is — a solo dentist adding sleep is a different job from a multi-provider lab with several payer contracts. We quote before we start, so the cost is something you agree to rather than discover.
Credentialing is quoted per provider and per payer. There is no flat rate, because there genuinely is not one — the paperwork differs by physician and by plan, and a single application to one payer is not the same job as a panel of providers across several. We quote before we start, so you know the cost rather than discovering it.
What you sign
A short letter of agreement covering fees, scope, reporting, and logistics. No exclusivity, no minimum, and no term commitment. Billing and credentialing can be taken separately.
There is no practice too small for this to be worth doing. A solo provider is as welcome as a multi-site group.
Common questions
Let’s talk
Tell us what your practice bills, what is not working, and where you think the money is going. We will tell you honestly whether we can help.