The Top 5 Mistakes Dentists Make When Adding Sleep to Their Practice

Every year, thousands of dentists try to add Dental Sleep Medicine (DSM) to their practice.
Most never make it past the starting line.

It’s not because they aren’t passionate about helping patients — it’s because they underestimate how complex DSM really is.
DSM isn’t a simple add-on procedure. It’s a new business model layered into your existing practice, with medical rules, payer systems, and workflows that don’t look anything like traditional dentistry.

At Black Rose Practice Management (BRPM), we’ve seen what makes DSM succeed — and what causes it to fail.
Here are the top five mistakes that derail most DSM launches and how to avoid them.

1. Skipping Credentialing or “Doing It Later”

Most dentists start by focusing on equipment, appliances, or training — not credentialing.
But here’s the truth: until your practice is properly credentialed, you can’t bill medical insurance for oral appliance therapy. That means you’re treating patients for free or relying on cash-only models that limit your growth.

Medicare, in particular, has strict guidelines for sleep appliance billing, and getting credentialed can take 60–90 days (or more).Waiting until your first patient to start this process is too late.

Smart Move:
Start with credentialing first.
Our Smart Start™ system includes your first DSM credential — handled start to finish — so your billing is ready by the time you see your first patient.

2. Using Dental Codes Instead of Medical Codes

DSM billing does not use dental codes.
Appliances, sleep studies, and evaluations all require medical CPT and HCPCS codes — and each payer has different documentation rules.

We’ve audited hundreds of dental offices that spent months sending claims under D-codes, wondering why nothing was getting paid.

Smart Move:
Learn or outsource your DSM coding early.
BRPM’s Smart Start™ includes billing setup and Verification of Benefits (VOB)training so your team knows what codes to use, how to document properly, and how to prevent denials.

3. No Clear Workflow or Team Ownership

Adding DSM affects nearly every department in your office —front desk, assistants, and admin staff.
Without clear roles, even simple tasks like verifying benefits or calling referrals fall through the cracks.

The result? Missed follow-ups, frustrated patients, and inconsistent outcomes.

Smart Move:
Create defined roles and workflows from day one.
Our Smart Start™ and Billing Audit programs include step-by-step process templates that help every team member know their part — from intake to claim submission.

4. Ignoring Referral Relationships

A sustainable DSM program thrives on referrals from physicians, ENTs, and sleep clinics.
Many dentists launch DSM without a referral plan, assuming patients will find them online.

But without a medical referral base, your patient pipeline dries up fast — even if your clinical skills are top-tier.

Smart Move:
Build referral management into your launch strategy.
BRPM helps offices develop professional referral systems with tracking, follow-up, and reporting — turning introductions into ongoing relationships that grow your sleep volume month after month.

5. Trying to DIY Everything

The “figure it out yourself” approach works fine when you’re hanging a new TV — not when you’re building a compliant medical division inside a dental office.

DIY DSM launches often lead to:

• Incomplete credentialing

• Unpaid claims

• Disconnected workflows

• Team burnout

Dentists who go solo usually spend more time fixing problems than helping patients — and most give up within the first year.

Smart Move:
Don’t reinvent the wheel.
Smart Start™ was built so dentists can launch DSM quickly, legally, and profitably — with credentialing, billing setup, and referral readiness all included.

Avoid the Growing Pains. Start Smart.

Adding sleep to your dental practice can change everything —your revenue, your patient outcomes, your fulfillment as a provider.
But success comes from structure, not guesswork.

By avoiding these five common mistakes and partnering with BRPM from the beginning, you’ll save time, prevent denials, and start your DSM journey strong.

Smart Start™ gives you the foundation, workflows, and confidence to launch DSM the right way — from day one.

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