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Message Number 265532
Re: Itchy heel problem View Thread
Posted by Mad Mary on 6/04/10 at 16:35

I have had itchy heels (both) since August of 2009 and also severe cracking that makes grooves in my heels, which becomes irritated by sock lint that gets in the grooves. One thing that I have noticed about this problem is I have a red spot (looks like a hot spot) that occasionally shows up on the side of my foot near the arch. I was wondering if anyone else has noticed a red spot?
Well, I have been to the dermatologist, who also checks for nerve damage. I have been diagnosed with eczema and am allergic to a component of rubber, which, I apologize because I don't have the name right in front of me, but it starts with an M and is very long.
My heels itch and then crack a lot and end up bleeding, mostly in dryer, hotter weather. Then the tips of my fingers split and bleed until I had to go in and get a steroid shot, which did finally relieve the problem; after three shots everything cleared up. But, after three months of relief, the heel itching has come back with a vengeance, along with the split fingertips. I believe that in my case they are related somehow. The doctor won't let you take steroid shots for longer that three months, His next suggestion was to take methotrexate, a cancer drug!!!!!!! (which is used to treat rheumatoid arthritis and psoriasis) I have opted not to go that route yet, but am seriously considering it if this itching doesn't go away.
The itch is so maddening at night I sit up and scratch my heels for many minutes on the bed rails or with a back scratcher. It is insane!! I also suffer from plantar fasciitis and heel spurs. My podiatrist tells me the itching is probably not due to any of these conditions. I think these doctor's may think it's in my head, or, of course it could be due to stress, age, gender, etc.....
My history: I am on my feet a lot with work, I do a lot of cardio, and I like to go out dancing, and I have also worn heels since I was a young teenager, which has been many years! I would think if these problems contributed to the itching I would have had the problem long before now. I also did gymnastics for many years. The only medications I take are protonix ; for acid reflux, calcium pills, and a multi-vitamin. I have had my gallbladder removed, which had been five years ago. Who knows, maybe that has something to do with it. I am not severely overweight, although I could stand to lose a few pounds, my cholesterol is alright (168) except I need to work on the good being a little higher. and the bad being a little lower. I am not Peri-menopausal or menopausal, I do not have high blood pressure, thyroid problems, nerve damage, or athlete's foot. I do get very hot (year round) as if I were going through menopause, and when I am extremely hot my face and neck turn really red, but I have had this problem all of my life, except for the redness in my face and neck; that has only been going on for a few months. (I know, that is probably not related and is a whole other problem that the doctors I've seen cannot figure out!-what a shock!). I just wanted to make a list of my problems to see if anyone has any similar symptoms that can be put together to find out what other problems we may have in common.
You would think there would be a doctor/specialist that could put things together and figure something out, I know for all of the training and schooling they take, you should not have to go to several doctor's and pay thousands of dollars just to get the I really don't know answer!!!!
I would like to add that I also saw an internist (recommended by my family doctor), whose specialty was to put all the problems together. I was there 10 minutes, found out her specialty was diabetes; and that was her focus-by the way. I am not diabetic. She told me, 'let's take one problem at a time'. This is why my doctor sent me to her so she could put everything together! I received my bill from the internist for $272.00 and was in shock. I am a medical biller and coder, so I know I was charged for a level 4 visit, which a one-hour thorough exam. I contacted my insurance, they investigated and my bill was reduced to a level 1 visit; $49.00.
I WOULD HATE TO THINK HOW MANY PHYSICIANS OUT THERE ARE ALL ABOUT THE MIGHTY DOLLAR AND FORGOT WHY THEY WENT TO MEDICAL SCHOOL IN THE FIRST PLACE-TO HEAL PEOPLE!!!! I am finishing up school for surgical technology, and am definitely not in it for the money I want to help protect the patient. So I do know quite a bit about the surgical field, but I guess not enough about family doctors and specialists. I AM JUST FRUSTRATED! Sorry about the venting.

Result number: 1

Message Number 263786

Re: 7 years and still no relief View Thread
Posted by Dottie on 3/03/10 at 18:30

James! Hello....I hope you read this. There is so much great info on this thread that I may just print it. But I must ask you about the spinal implant. My podiatrist is really hep on the spinal implant thingy that has wires up your spinal cord. I went to one pain clinic but they were jerks and refused to talk to me even in general terms unless I had a psych exam, a cardiologist exam, an MRI, nerve conduction study and God knows what else. The amount of money I would have spent would have been insane. The doctor told me he did not want to 'waste his time' on me if it turned out after a psych that I was 'nuts.' I was furious. But I am very curious about this procedure. There also was an article in our local paper about a woman who thought her insurance would pay for the implant but after it was done Aetna billed her ONE HUNDRED THOUSAND DOLLARS. They said it was an experimental surgery.

Anyway...long story short: What was your experience like with the spinal cord implant procedure for pain management?

Result number: 2

Message Number 262785

Re: Dyna Splint experience for anyone? View Thread
Posted by aw on 1/14/10 at 12:14

I thought the rent was outrageous. they billed by insurance $359/month for a finger splint. then my insurance paid $200. I pay $50. (80/20). (the normal insurance reduction from what is asked). its just a little spring. the whole thing looks like it could be manufactured for a couple hundred dollars. That is $359/month RENT. so if I keep it 3 months, that is over $1000 for a splint wiht a spring in it.
my therapist is having me buy a small splint for $32 for longer term support.

Result number: 3

Message Number 262407

Re: 728.71 code problem with insurance claim View Thread
Posted by Dr. Wedemeyer on 12/20/09 at 13:09

There are always reason codes on the Explanation of Benefits, ie; there is a numeral, alpha prefix (or both) next to the code billed that corresponds to a written explanation on the EOB. Can you tell us what the explanation for the denial says?

It may also be that many insurers have guidelines on the appropriate progression of care and reimbursement. A night splint may not be indicated following surgery but may be covered prior to surgery.

Result number: 4

Message Number 262066

Re: orthotic pricing question View Thread
Posted by Dr. Wedemeyer on 11/27/09 at 15:40

No Stacy, that is not an excessive fee for custom orthoses.

They are typically billed as a left and a right. Don't be surprised if there are also separate charges billed for an office visit/evaluation, and dispensing, fitting/training on subsequent visits. this is all perfectly reasonable and standard practice so long as the services were performed.

Result number: 5

Message Number 260418

Holy Crap. My insurance paid the claim for custom orthotics! Now, 3/4 or full length?? View Thread
Posted by Rebecca S. on 9/08/09 at 10:26

I am shocked to say that I got a letter in the mail on Friday stating the my insurance company paid the claim my podiatrist filed for custom orthotics. He did a foam box impression with me sitting on the edge of a chair and had me rest my foot on top of the box, relax my foot and leg completely, and he pushed each foot down into the foam. I paid a $25 casting fee and then he billed them out. We both expected a denial because the policy states they are only covered after 6 months of alternate treatments, but...well...the claim has been paid. So now they will send the impressions to the lab. I inquired as to the type of device, and it is to be a semi-rigid 3/4 length orthotic. I have been wearing full length Powersteps Protechs in my New Balance shoes and they are doing me pretty well. I have heard/read that a lot of people find the 3/4 orthoses uncomfortable at the ball of the foot area. How do 3/4 inserts work with shoes? If you put them in a shoe w/ a removable footbed do you have to cut the footbed and put a piece back in? What about shoes w/o a removeable insole? I would like something that I can wear with a variety of styles, if possible, but most importantly, I want to understand the difference between the two and I wonder if I should just ask for a full length insert since that is what I'm wearing now? What are the advantages/disadvantages?

Result number: 6
Searching file 25

Message Number 259745

Re: Health Care questions View Thread
Posted by wendyn on 8/16/09 at 06:16

I think you made some good points Julie (and I enjoyed the two articles that you sent - I'm going to forward them on to my mom for the tin-foil hat branch of the family...not that they'll do in any good, but hey).

I have several cousins in the US and I've heard some interesting stories from them. One cousin moved jobs and then found out she was pregnant. She was told that insurance would not cover any 'pre-existing conditions' and her pregnancy was deemed such.

During her pregnancy, she and her husband (who have a very modest income) had to pick and choose which pre-natal tests were really necessary and which they could afford.

Sure, the hospital had top-notch facilities and sure, there was no wait time - but every single penny of her pre-natal care was coming directly out of their pockets. They prayed every day that her pregnancy would go smoothly - a premature baby would have buried them financially and likely put them into bankruptcy.

But hey - the care they did have was some of the best in the world. :)


Another cousin was in labour with her second child. En route to the hospital, she and her husband noticed it was about 20 minutes to midnight. They had been told that if they checked in before midnight they would be billed for a full day (which I believe was somewhere around $3,000). So, they drove to Starbucks and waited out the extra 20 minutes in an effort to save money. Anyone who knows anything about women in labour knows that a woman having a second baby should go the the hospital when she knows she's ready, and she should not be basing that decision on her hospital bill.

That said - I'm sure that the care she received in the hospital (once she got ther) was first rate.

It all reminds me a bit of a (hypothetical) country bragging that it only has the finest wine, most tender meat, and richest milk. The fact that they only some of the people in then country actually get to eat that food while others starve or spend their whole income on food is irrelevant - the important thing is that the food that some do have is the best in the world. When faced with possible change, the members who have access to the good food are outraged:

'You mean I would have to stand in line for my food!? I will not wait for food. When I want food I want it now and I will only settle for the best. I am worth it and the people going hungry are not my problem.'

Not a social philosophy I will ever understand.

Now, as fascinating as all of this is (and it is) I'll check out of this discussion for a few weeks while I'm vacationing in Germany. Have a nice few weeks everyone...

Result number: 7

Message Number 259587

Re: Waiting View Thread
Posted by john h on 8/11/09 at 12:56

Rick: Like you I have been going to my GP for over 20 years. I need no appointment as she does not take them. I have never waited more than 30 - 45 minutes on a walk in visit. What is likely to happen is she will accept no new patients under a system that would fill up her office every day. She told me she is very happy with the number of patients she has. Some of the GPs in town no longer accept any more Medicare patients due to low payment and yet the discussions about paying for this is to cut Medicare spending which is already at rock bottom as far as a GP is concerned. We have a shortage of GP's and fewer Doctors are going into that speciality due to low pay. Waiting times could be days to weeks to see your GP under an Obamacare plan. Your Doctor, to keep his/her pay up will push through more and more patients with less and less time for you. Looking at the Medicare reimbursement for my last visit to the Doctor Medicare paid her less than half of what she billed. There is billions of dollars of fraud in Medicare and Medicaid but cutting the Doctors pay is not the way to achieve better outcome or save money. Like the Democrats I say let tax the scum bag rich, big oil, big pharmaceuticals and anyone else who is inherently evil.

I read the the Democrats may be organizing Union Labor groups to attend these town hall meetings to keep them under control or counter the oposition. Sounds like a great idea for the 1920's-1930's era.
Union retirees and Union medical care is some of the best out there. Why would they be so anxious for a public option? The car companies certainly would find it more advantageous and economical to drop their medical coverage and pay the 7% penalty and let them go to he public option. Many other companies will take the same approach. That is how we will end up with universal coverage if the public option is in the final plan.

What is the real talking points for a government option? Cheaper. Certainly as they are a not for profit group, self insure, have unlimited funds and on and on. But what is likely to happen after that? To get their cost lower and lower you will receive less and less service leading to waiting lines and rationing in one form or the other. The 75% of Americans who are happy with their insurance now will find that as their current insurance company loses more and more insureds their cost will go up and you will pay more and more and your company may eventually go out of business. Their is no way a for profit insurance company to compete with a government run company with the built in lack of overhead. They will likely not have to pay any taxes. That alone could run the private companies out of business. Would the government run insurance company give you better care or coverage. No! Why would it. Cheaper does not mean better.

Why do we not just tell the people like it is and that we will have to pay the required taxes to support the uninsured and forget destroying a system that 75% of the people like. Our taxes will be breath taking but if that is what it takes then stop trying to come up with bogus options like taxing the rich, soda pop tax, tax high end insurance plans, etc. Obama promised no new taxes for those making less the $250,000 a year. So he made a mistake. I can understand that as he had no experience. Make everyone buy insurance whether they want it or not. I agree. Insure those with pre existing conditions. I agree. Raise the money to pay for all this by spreading it among us all and stop pretending the rich can pay for it. I agree. We as a people say we want everyone covered but balk at paying for it. There remains no free lunch although Polosi and company would have us think so. I notice that on many of these congressional junkets they even have a Doctor go along with them. How does that fit into a plan? He could set up a clinic aboad one of those new Gulfstream jets the House wants and the Pentagon does not. Seems like the tail is wagging the dog on these new jets.

Result number: 8

Message Number 259276

Re: I overpaid for Powersteps View Thread
Posted by Dr. DSW on 7/31/09 at 21:07

I happen to agree with you. Although a doctor or any business is certainly entitled to make a profit, I agree that charging $125 for that product, in addition to the office visit and co-pay just to dispense the PowerSteps in beyond excessive.

I would make an appointment or a phone call to speak with the doctor and let him/her know your feelings. I would let the doctor know that his excessive billing for the OTC product may have cost him/her a patient. And if what you said is accurate, and all the doctor did during your second appointment was spend one minute with you to try on the PowerSteps, you may want to tell him/her that you'll report that event to the insurance carrier, because I'm sure that he/she billed the insurance company for more than a 'brief' visit if he/she's also making a $100+ profit on a product that cost him/her a little over $20.

Speak up, it may work. He should be charging about $40-50 to cover his cost of shipping, time to order, stock, etc., and still make it worthwhile. The highest price I've heard is about $60-65 and the the docs justify the price by stating that they have to buy a lot of different sizes, lay out the money to 'stock' their offices, pay shipping, eat the cost of returns, etc., and still like to make a little profit. But $125 is excessive.

Maybe I should raise my price!!

Result number: 9

Message Number 258289

Re: Curious about dry needling View Thread
Posted by Dr. DSW on 6/22/09 at 06:34

Dr. Z,

Although it is being SOLD to podiatry as a covered procedure, in reality there is no 'real' procedure code that covers this procedure. I was recently at a seminar, and there are a lot of creative ways to attempt to bill for this procedure and the company will make many recommendations, but as far as I am aware, there are still no 'assigned' codes for this procedure, therefore it should be billed as an unlisted code.

Similarly, arthroreisis procedures/STJ implants have no 'real' code although if you go to training classes or seminars they come up with some VERY creative ways to bill. But the bottom line is that you'd better be prepared to pay back all that money if you're audited and the code isn't accurate.

Result number: 10

Message Number 256616

Re: topaz procedure View Thread
Posted by Marien on 4/04/09 at 12:40

Unlisted
Coding for the Topaz Procedure (Bruce Werber, DPM)

04/03/2009 David J. Freedman, DPM


RE: Coding for the Topaz Procedure (Bruce Werber, DPM) From: David J. Freedman, DPM
I reviewed Dr. Werber's response to Dr. Goldsmith comments and it is unfortunate but Dr. Werber does not understand coding. The fact is CPT code 28899 or 27899, just as Dr. Goldsmith related in his comments, are the only codes that Podiatric surgeons can currently bill for this type of procedure.

Dr. Werber stated: 'why would we use an unlisted CPT code for using radio frequency coblation for tendon repair, or in treating plantar fasciosis. If you are treating tendinosis using radio frequency coblation, use the appropriate code for tendon repair.'

It is wonderful that there are new procedures like Topaz are being done and that he is an advocate of such a modality, but you have to understand coding. There is no code for 'coblation'or 'Topaz'. He should be asking the industry representatives he has been working with at Topaz; why they have not attempted to receive a CPT Code for their procedure. The reason they have not to date is there is not enough evidence based medicine to support a new CPT Code. His suggestion of using another CPT code, that in no way describes the coblation procedure, constitutes fraudulent billing.

I encourage podiatrists doing this or any new technology procedure. Verify the CPT billing before you begin with credible resources like APMA or AMA. The fact that the new modality is not specifically related in the CPT Code is a major reason not to bill with an existing CPT Code that seems closely related to the procedure but is not the procedure described in CPT.

Do not put your practice at risk by listening to individuals that do not have coding experience, credentials or understand CPT. The best place to validate a procedure and the way it is billed is to send a request to the CPT Assistant to get a formal ruling from the American Medical Association's CPT Assistant.

Do not get caught up in fraudulent billing.

David J. Freedman, DPM, Silver Spring, MD, DJFREEDMAN at aol.com

Result number: 11

Message Number 255104

Re: seeing some relief! View Thread
Posted by Dr. DSW on 2/16/09 at 09:32

That's great news. I've been a strong supporter of the Strassburg Sock on this site and in my office for MANY years. The number one complaint I hear about the Strassburg Sock is that it bends the toes back too much causing discomfort or cramping.

Well, the Strassburg Sock works on a theory called the 'windlass effect' and that includes pulling the toes back to a degree. However, I have a slight 'modification' for those that have tried the sock and can not tolerate their toes being pulled 'back' so much.

I recommend that instead of putting on the sock and pulling back the strap, that FIRST you maximally dorsiflex your foot. That means bend your foot up toward your leg, THEN tighten the strap. That will prevent the toes from being pulled back as much, and will allow the ankle to get a better stretch. It will put more of the stretch on the ankle, and less on the toes.

This modification has worked very well for my patients.

I would recommend that you continue with the Strassburg Sock if you are having success. In addition to the Strassburg Sock, many of my patients have had significant relief when I prescribe a product called a Dyna-Splint. This is a product that is actually prescribed by your doctor and is billed to your insurance company (if it is approved). The rep from the company than fits you either at your doctor's office or at home. It looks like a big night splint, but it is spring loaded and applies a constant force on the foot to dorsiflex the ankle. It can be adjusted to gradually increase the load. My patients have had tremendous success with this product and it's something I highly recommend.

Result number: 12

Message Number 254588

health insurance gone wild..... View Thread
Posted by marie:) on 1/30/09 at 15:40

'I just recently 'dropped' an insurance carrier that used to be fee for service, meaning I received payment for each service provided for a patient each time that patient was seen. I billed for a service if and when that service was provided.'

Health insurance has become a racket. Their goal is not to pay claims. Their interest is making money and not on health care. It's out of control and you have shared a prime example.

Result number: 13

Message Number 254571

Re: that was from: View Thread
Posted by Dr. DSW on 1/30/09 at 11:32

John,

Some of the fees I receive from Medicare are lower than when I started practice 23 years ago! In the interim, NONE of my overhead has decreased in the time span, and as I'm sure you can imagine, quite the opposite has occurred. The majority of my overhead has gone up ridiculous amount over that time. My utilities have soared, my staff payroll increases each year, my insurance costs constantly rise, supply costs elevate and so does EVERY aspect of running a practice, in addition to home expenses. My malpractice premiums have more than tripled over that time span.

Please name ONE other profession, whether it be a skilled trade, laborer or professional that has is making LESS money now than 20 years ago???

It really has gotten out of control. I know of at least 6 very high quality internal medicine doctors in my area that have left private practice and are now working for private corporations in 'administration', because they could no longer afford to keep their practices profitable.

These were all excellent doctors with established busy practices, that just could not take the constant insurance cut backs.

I just recently 'dropped' an insurance carrier that used to be fee for service, meaning I received payment for each service provided for a patient each time that patient was seen. I billed for a service if and when that service was provided.

Well, the company decided to change to 'capitation', which means they now 'assign' me a specific number of patients, and I get paid a specific amount of money every month per patient, regardless of whether I see that patient or not. If I see the patient 10 times or never see ANY of the patients, I receive the same check. If I perform MAJOR surgery on the patient, I receive the same check.

So, the company 'assigned' 80 patients to be 'capitated' to me, for a GRAND total of $150.00 a month!!!! That means that no matter how many of those patients came to my office that month, and no matter what procedure(s) I performed, INCLUDING major surgery, my TOTAL check received for the month would be $150.00 (plus a co-pay if they had a co-pay)!!!!!

Ironically, most of the 80 patients, were ALREAY patients of mine, therefore, the utilization rate would be extremely high. The only way for a scenario like this (capitation) to work is when a doctor is 'capitated' or 'assigned' to several thousand patients and receives a VERY large check, with the hope that very few of those patients will actually utilize his services. This way you are getting the check for a lot of patients, but few are actually utilizing the services.

They say the 'breakeven' point is a utilization of approximately 5%.
But in my case, most of the 80 patients 'assigned' to me were ALREADY using me, so for me to continue seeing these patients for a GRAND TOTAL of $150 a month would have been absurd. That comes to less than 1.50 per patient/per visit and that would average 20 patients per week. At that rate I'd be out of business in a few months.

But that's what the insurance companies are expecting us to 'accept', and amazingly, the majority of my colleagues are so hungry, they accepted this proposal.

You'll see me selling shoes in Payless before you see me accepting 1.50 per patient. At that rate, I'd rather provide my services for free for those that truly can't afford insurance, and not to make the already rich insurance companies richer.

Result number: 14

Message Number 254550

Re: that was from: View Thread
Posted by Dr. DSW on 1/29/09 at 18:22

Susan,

As usual, it's always the doctor's fault. All the doctors you have met are bad, don't want to take the time to speak with the patient etc. Look back at ALL your posts, and they always follow the same exact pattern.

Someone writes a post, then you take one of that person's quote and spin it into a negative with one of your experiences or one of your friend's experiences, etc.

Well, I've been in medicine for over 23 years, and I don't know the quality of medicine where you live, but if the doctors in my area were all as bad as you describe, we'd all be out of business. Do you ever have anything good to say or is your head always stuck in the sand when it comes to positive thinking?

So Susan, what EXACTLY is your solution. When a doctor comes out of training with over six figures in loans, then has a malpractice premium of tens of thousands of dollars, has to pay rent, electric, heat, water, office liability insurance, workmen's comp insurance for his employees, office staff salaries, business overhead, professional membership dues, continuing education fees, supply costs, etc., etc., and then gets $20-30 from the insurance company for an office visit, do you REALLY expect a doctor to be able to spend 30 or 45 minutes with you??

A short while ago I performed a major rearfoot reconstructive surgery, that tied me up in the operating room for a few hours. The patient will be seen for follow up in my office for up to 6 months for post operative care, and I can not bill for any post operative care for 120 days following the procedure, since it's all part of the surgical fee. I billed the insurance several thousand dollars, and received a whopping $348.00 for the procedure, which includes ALL the follow up care. So, in essence the surgery COST me money to perform.

So what is YOUR solution Susan. I currently book 4 patients an hour. Yes, 1 patient every 15 minutes, which is conservative in today's times. A 'new' patient gets 1/2 hour. That allows me to pay my bills. I never walk out of a room until all my patient's questions are answered and the problem is resolved.

But, do you complain when your doctor is running behind schedule? Did you ever get pissed off because you had to wait in your doctor's office?

Well, you can't always have your cake and eat it too. Patients want ALL their questions answered, but then get angry if they have to wait in the waiting room. Well, sometimes unexpected problems arise during the course of the day requiring extra time and/or attention, or a patient just keeps asking questions, so I keep answering, even if it takes me longer than the 'allotted' time slot.

Then, someone else complains that he/she had to wait. So no one is EVER happy, unless he/she was the one with the problem.

And the patient does have to take some responsibility for themselves. If they have a question or problem they have to simply speak up and become their own advocate. It's time to stop making the doctor the scapegoat all the time and time to start taking responsibility for yourself.

And let's not forget the MAJOR contributor to the problems with our system, the one entity that's making all the money.....the insurance carriers.

Result number: 15

Message Number 254123

Re: night splint did not work for me View Thread
Posted by Dr. DSW on 1/18/09 at 18:03

Actually, the majority of patients can not sleep in night splints, so don't feel bad. Although many patients also have difficulty with the Strassburg Sock if not used with some of my recommended 'modifications', it's the night splint I often recommended since it's simply a sock and not bulky. Most night splints are bulky and don't allow the patient to move around or sleep.

Some of the newer dorsal night splints (Scott sells one on this site) are much more comfortable, but in my opinion, do not provide enough dorsiflexion.

You may want to wear your night splint when you're simply sitting around eating dinner, doing paper work, watching TV, etc, instead of while sleeping. Additionally, next time you're at your doctor, you may want to ask him/her about the use of a DynaSplint. It's similar to a night splint but places a constant spring loaded force on the area to help stretch the soft tissues. It's billed to your insurance and the majority of insurance companies to cover this item.

Once again, it's way to bulky to sleep with, therefore I recommend it's use while inactive in the house.

Result number: 16

Message Number 253630

Re: Dr. Wedemeyer View Thread
Posted by Dr. Wedemeyer on 1/01/09 at 21:16

Jen

The plan should specify what benefits are available for PT and Chiropractic, they are separate and distinct services with reference to spinal manipulation. Manipulation is a very broad term with a lot of overlap. Manipulation performed by a licensed Chiropractor to the spinal column is distinctly different from manual manipulation performed to the same structure by say a PT (or a DC).

The Manual Therapy CPT code 97140 is used by PT's to denote any form of manual manipulation performed by a PT. It is a timed code and billed in 15 minute increments, thus you could bill several units of this code in one session per the physicians' script. DC's also use this code for manipulation that is not Chiropractic spinal manipulation or as an adjunct to such.

Manual Therapy CPT Code 97140 is defined as: connective tissue massage, joint mobilization and manipulation, manual lymphatic drainage, manual traction, passive range of motion, soft tissue mobilization and manipulation, and therapeutic massage.

I once heard this code referred to as the 'Swiss Army Knife' of therapeutic coding.

If your benefits specifically state they cover PT they will cover this code. Manipulation is very broad term outside of chiropractic and manual traction of the hip by your PT fits this description but you are corect, it is not necessarily spinal manipulation asperformed by a DC.

When we call and verify benefits for patients as a courtesy, in addition to asking if chiropractic is specifically covered, we also inquire about the PT modalities that we provide as well using specific CPT codes. In your case you should look at the codes your PT billed on your visits and inquire if they are still a benefit because benefits can change from year to year.

Let me know if you need anymore help. I became pretty billing savvy over the years sparring with insurers.

Result number: 17

Message Number 252679

Re: DRX 9000 View Thread
Posted by Dr. Wedemeyer on 11/30/08 at 17:01

'Maintenance' treatment is a very common theme with chiropractors Chris. While I am not an advocate of suggesting to patients treatment that is not necessary, I do have some sympathy for the concept for chronic pain patients such as yourself (and certain specific degenerative and congenital factors to name two).

I agree with you that these machines have value and have never doubted that (for that matter so does medication, surgery and conservative measures such rest, spinal manipulation, physical medicine etc). Are these machines the panacea that that SOME manufacturers and SOME doctors claim? No, they have a success and failure rate as does everything else that is dependant upon choosing the correct treatment for that patients presentation and probable outcome.

The trick is finding a doctor who is more concerned about your outcome than their income.

If they would simply be more discriminating in selecting their patients based on the probability of a good outcome, state the facts to patients up front and present a reasonable treatment plan based on the available research and outcomes and for a reasonable fee, we would not have this ignominious and despicable mess that we see today.

The real problem as I personally see it (and this is just an educated opinion is that one company went completely cowboy and made the most sweeping misstatements in their marketing and misled the doctors about the billing of this procedure, the origin and testing of their machine and manipulated their data to reflect a far too positive set of outcomes to sell their product.

Chris you wrote:

'My insurance pays for one round of twenty treatments per year'

I would be cautious about what CPT (Current Procedural Terminology) code is being billed for your therapy if they are paying specifically for the Vax-D decompression procedure. As I have stated here before I am not aware of any insurer (including Medicare) that pays for this service under any code other than the 97012 code for mechanical traction and I use that code in my office and charge $25.00 (of course I do not own a 'spinal decompression' machine).

The only appropriate codes to bill an insurer for 'spinal decompression' on any of these machines is S9090 (Medicare requires the use of 97799) and again, NO insurer pays for this procedure under your policy benefits to my knowledge.

That could leave you or the provider open to the insurer asking for a refund if they audit these claims. Word to the wise; this is essentially a 'cash business' at this time.

If you still have your Eplanation of Benefits (EOB) from the insurer I would like to know (as would the doctors who own these machines) which company is paying for this procedure under the above guidelines.

Continued good health and progress to you and your spouse Chris.

Result number: 18

Message Number 252630

Re: EPF Surgery Problems to April & Bud View Thread
Posted by Mary on 11/28/08 at 00:59

Jana

I went to the same type of woman podiatrist you went to. She pushed foot cyrosurgery before any conservative treatment. She checked out my insurance than billed terrible prices since insurance would pay. I never even saw her before or after the operation for Plantar faciitis. I continue to ice and exercise. She told me to go back to work immediately after first visit. I needed to rest in the beginning not much later when it became cronic. Many more or her patients were unhappy with her. I would go with orthopedic type doctor for bad foot problems. Podiatrists depend on sugeries to make money. Orthpedic doctors that are in a group get set prices. Never rush into surgery. I'm afraid to have the release. Good Luck, and don't do cyrosurgery.

Result number: 19

Message Number 250019

Is Palin's Daily Expense Account Unusually High??? View Thread
Posted by marie:) on 9/09/08 at 16:14

Fox did a great comparison between Palin and other governor's. They also explained some special considerations for Alaska. Does it make a difference that she was paid to sleep in her own house?

http://elections.foxnews.com/2008/09/09/palins-daily-allowance-practices-unusual-among-female-governors/
Alaska Gov. Sarah Palin’s reported practices of collecting a “per diem” allowance for days spent at her private home and charging the state for her family’s travel expenses do not appear to be shared by other female governors with children.

But the 49th State’s reimbursement practices may be different from other states.

Palin, John McCain’s running mate, billed the state of Alaska for 312 nights spent at home during her first 19 months as governor, the Washington Post reported Tuesday. The article said she received close to $17,000 in charges for daily expenses.

Result number: 20
Searching file 24

Message Number 249205

Re: Cryosurgery for Plantar Fasciitis in Kentucky View Thread
Posted by Mary beth on 8/13/08 at 21:56

terrible results from cyrosurgery for plantar fasciitis made the situation worst. Dr. would not try conservative treatments first.
Dr. would not tell the price of anything going in. Billed insurance close a terrible high amount much latter on after the operation and procedures522. Sorry we did not look around. procedure too new. No good results can be proven; has not be out long. It was a bad mistake. Hope it helps someone else so they don't do it.

Result number: 21

Message Number 247947

Re: DRX 9000 Lawsuits View Thread
Posted by Tony L. Hoang on 6/24/08 at 19:30

Dr. Wedemeyer,

I followed the link you provided to the ChiroWeb.com article. If you look at the email at the end of the article, you will see that Drs. Edwards and Vaughan may have a motive for making the statements they did in their article. Go to their website at www.marketdecompression.com and you will see they are selling a marketing package for the Chattanooga Triton DTS system.

Let me make it clear I am not standing up for any of the 'high priced' spinal decompression companies, but I just don't like it when articles are written with ulterior motives. It is in these Drs interest to down play the cost of decompression systems. The Triton DTS is about one-tenth the cost of some systems.

It's hard to get unbiased opinions in our field. Everyone is out for their own best interest. The Triton DTS is marketed as a traction unit, and thus is billed as a traction therapy.

Result number: 22

Message Number 245562

Re: Topaz-procedure code View Thread
Posted by Dr. DSW on 4/07/08 at 13:06

That is actually a very controversial question and topic. In some of the lectures that I've attended, they've stated that in actuality, the code that the company tells the doctor to bill really isn't 'kosher' or accurate and that the doctor should bill the code 27999 (I think that's the code) which is a non-specified code, and then the doctor is supposed to provide an operative report with the code billed to explain the procedure that was actually performed.

Result number: 23

Message Number 244878

Re: Surgery in 2005 View Thread
Posted by Dr. DSW on 3/22/08 at 07:27

In the case you describe, it IS the doctor's fault and not the billing company. There are very specific guidelines regarding different levels of codes to bill for office visits, consultations, etc. If a doctor walked into the room for a very brief time and didn't perform any repeat exam, etc., then I'd bet that this doctor billed for a higher office visit code than he/she really should have for the visit. Unfortunately, that's a common practice.

For example, my wife recently saw a specialist for a problem, and she referred HERSELF, even though I basically told her to see the guy due to his reputation. He did send me a letter and her primary care doctor a letter.

When I received the explanation of benefits from the insurance company, he billed the initial visit as a 'high level' CONSULTATION, not an initial office visit. By law, the definition of a consultation means the patient was SPECIFICALLY referred by a particular doctor (usually with an prescription) for a particular problem. For example, I may give a patient an RX to see a neurologist that states 'consultation to rule out tarsal tunnel syndrome, please evaluate with EMG/NCV'.

This does require a letter be sent to the referring physician, and in the notes it does require some mention of the referring physician.

HOWEVER, NO ONE REFERRED my wife to this doctor. She referred herself. Despite this, he billed for a 'consultation' rather than an office visit because it pays significantly more $$$$$.

So you are correct, some doctors do abuse the system, it's not always the insurance company or the billing company.

Result number: 24

Message Number 244860

Re: Surgery in 2005 View Thread
Posted by Jen R on 3/21/08 at 18:10

Dr. Wander...

I have no doubt that all doctors could retire as young men if they got anything close to what I see on my statements. I think the thing that bothered me the most is that when I get statements from UPMC (University of Pittsburgh Medical Center) they come from some company that does the billing for them. I'd be willing to bet that the doctors have no idea what's being charged. When I went to a pain management doctor...I saw her 3 times. The first two times she gave me spinal nerve blocks. The 3rd time she came in...I told her I didn't have any pain relief from the nerve blocks...and she told me there was nothing more she could do for me. The conversation lasted less than a minute. When I got the statement for her services the cost for that appointment was somewhere around $180. If I'm doing the math correctly that's $10,800 per HOUR!! I was floored. I actually called to complain about it and was doubly shocked when the billing company was nowhere close (geographically) to the medical center, had no relationship to the doctor, and they just billed according to codes. What a crock! I believe most doctors to be fair and the fact that medical decisions and billings are left to those who know nothing about the patient, procedures, etc. is just beyond my comprehension. I guess that explains my own question as to why some doctors wouldn't take insurance.

Jen

Result number: 25

Message Number 244630

Re: DRX9000 - Question View Thread
Posted by Dr. Wedemeyer on 3/16/08 at 11:35

'I paid $2400 for 12 sessions sessions and became pain free (first time in 2 years) for 3 months AND my insurance reimbursed 60% of that (out of network) because it DOES cover chiropractic treatments.'

I wonder if you could break this down by description of the service because at $200 a treatment and ($1,440 at 60%out of network)that would mean that your provider is in reality charging $80 per for spinal decompression. The rest of the charges would be entirely physical medicine procedures and in order to bill $120 visit and be reimbursed for that amount they would have to include a charge for chiropractic manipulative therapy (CMT).

Spinal decompression is not a 'chiropractic' treatment as defined by the medical terminology codes (CPT). The only distinctly 'chiropractic code is for CMT. Are you saying that your doctor billed insurance for CMT along with several ancillary charges because in your case your insurance coverage is very good? This sounds very fraudulent.

Assuming that I did the math correctly how could anyone pay for a machine that expensive if they relied on that fee schedule? Especially when you consider that fewer than average patients have insurance with coverage that good. What about the cash patients? Does your doctor have two sets of fee schedules then (which is fraudulent btw unless you are offering a discount for 'payment at the time of service').

Nancy this doesn't really add unless your doctor is billing precisely in the manner that is getting providers in trouble.

Result number: 26

Message Number 243640

Re: JSB Orthotics Questions View Thread
Posted by Dr. Wedemeyer on 2/24/08 at 11:30

Arch it becomes increasingly more confusing at this point but I will offer some advice based on how I handle this in my office.

First in my state doctors are allowed to offer a separate fee for 'payment at the time of service'. A doctor may choose to charge a lower fee for certain financial hardships and this includes patients without benefits for that particular service or without insurance coverage at all.

This is assuming that the doctor is not contracted with that particular insurer. If he/she is a participating doctor then all deductible and co-payments and patient responsibility portions of the claim must be collected as per their contract.

If he is not a 'par' provider then that doctor can elect to charge you the lower fee. I would discuss with him/her what was promised regarding the charges and them telling you that they would be billed in 2007. Since they were not and offices make mistakes, he/she should be willing to reduce the fee based on the insurance not covering the services.

I would refuse politely to pay the charges for supplies, no one that I know of charges for plaster and if they do the fee is modest.As Jeremy said certain elements of the fee for the orthoses are considered included charges. Supplies are one of them.

Good luck

Result number: 27

Message Number 243591

Re: JSB Orthotics Questions View Thread
Posted by Dr. Wedemeyer on 2/23/08 at 12:32

Not very many people are aware that doctors fees (and charges for durable medical equipment such as orthoses) are based on the prevailing Medicare reimbursement for your area. Lets say that Medicare allows $250 per foot for an in-shoe, removable orthosis. That would be the floor or minimum a provider should charge and most good PPO insurance will reimburse at a higher rate, usually 120-140% of Medicare.

Cognizant of this, providers will typically charge in this range and that is appropriate depending on the actual code description. The same is true for office visits, surgery, medications etc. This is for all providers who accept Medicare assignment. Those who do not participate in Medicare can charge whatever the market will bear.

Doctors cannot even discuss their fee structure with each other although insurers can and do. Sound fair?

To get to Arch's question the charge for the orthoses sounds appropriate and although the office visit may not seem appropriate to you, it probably very well is. The insurer at the minimum should pay for the office visit and some part of the orthoses.

As for the billing it should not matter on what date it was billed but that it was filed timely for you to receive benefits. The date the orthotics were dispensed is the date they should have on the billing record. The fitting date is, believe it or not, subject to another charge for orthotic fitting independent of the examination date.

As i read this you were casted on December 29th, 2007 and fitted/provided the orthoses in January of 2008. Is that correct? If this is the scenario then the Evaluation & Management (office visit) code is for 12/29/2007 and everything after, including the orthoses would have dates billed in 2008. That appears correct unless they enticed you in some way by stating that it would all be billed in 2007. The problem here is that in 2008 you probably have a new deductible for office visits and durable medical equipment.

Also what Jeremy said about charging for plaster and supplies is very true. There is an equivalent code for these items but no company that I am aware of reimburses for them. If you get stuck with these charges I would discuss it with the doctor, he/she will in all likelihood excuse them. JSB makes a good product as Jeremy stated but the onus of making the device work is not the labs but the providers based on his/her rx.

At my office the supplies are included (especially since plaster is very inexpensive). It is appropriate to bill for ALL procedures performed on that visit even when reimbursement is not expected so your doctor (or his biller) is just being a stickler for accuracy. $210 for these items seems unreasonable though, probably by about $200.

I sometimes use expensive resin impregnated socks to cast orthoses and even this I absorb as a cost of doing business.

I did my own billing for a long time Arch so I understand these issues fairly well should you want my help.

Result number: 28

Message Number 243563

JSB Orthotics Questions View Thread
Posted by Arch on 2/23/08 at 00:03

Hey Guy & Gals,

I just received a bill from my podiatrist and have some questions ...

First, I know prices can vary greatly between doctors etc. I have gotten inserts before and so have several of my family members and it has never been over $400 a pair. This new doctor, though, charged over $1000 for my new corrective inserts. $210 dollars of that was for 'Plaster Supplies' and $175 for a 20 minute office visit. The inserts themselves were $305 each side. These are to help with flat feet and the doctor is a local, single doctor practice Podiatrist that has been in business for ~20 years in a (slightly) economically depressed suburb.

I'd never heard of JSB Orthotics before, are they normally this expensive? Is the price and the quality complementary? Why would this (I almost said 'my') Podiatrist use these people if they are so crazy expensive?

And is $105 a foot ($210 total) for 'Plaster Supplies' reasonable, considering he charged $175 for the (20 minute) visit where he made the plaster mold? His aide was at best in college, possibly high school. Maybe she was shadowing? She just cleaned the plaster from my feet and made small talk.

On top of the unforeseen price, they lied to me about the insurance. I repeatedly told them (and they know who I am because I work next door) that I needed the insurance to be billed before the end of the year. They told me when I had the inserts made (December 29th) that they billed everything to insurance, and since there's no charge for the fitting visit that everything would be under 2007. Lo and behold, the date on the bill was the date of the fitting visit - well into 2008.

Regardless of my frustration at having to pay all of this $1000 bill, three nights ago (after having the inserts for a few weeks) I started having good amounts of pain in my right food right where the insert seems to leave the most pressure. I've made sure to stay off my feet as much as possible since then and my foot has been fine. I didn't work out or anything and I am 21 years old, so I should be able to walk to all my classes without problem. Now, I am afraid to go back there and bring it up because I might get another $175 charge. Does anyone know if there is supposed to be a grace period with these inserts?

Many thanks for reading this message and what advice or knowledge you can give :)

Result number: 29

Message Number 243033

Re: Great link: American Academy of Podiatric Sports Medicine View Thread
Posted by Dr. Wedemeyer on 2/10/08 at 14:03

This is precisely the reason that the AMA's proprietary coding system should be changed. I spent hours once searching for those three and could only come up with the one code. None of the billers that I knew were very knowledgeable either.

Looking back I should have just asked you in the first place, thanks Dr. DSw.

Result number: 30

Message Number 241551

Re: NC Podiatrist Indicted for Alleged 500K Diabetic Shoe Fraud View Thread
Posted by larrym on 1/04/08 at 18:20

I thibk what jeremy means is he went to asia and had sub par shoes made. They probably made the codes on a technical basis but I would imagine a crrok would not have the most exacting standards. So in a sense he was the manufacture, distributor, biller supplier etc. all in one. In short the shoes probably cost him about $10 pair and he didnt have a middle man so he was making a pretty good margin.

Another way to look at this is if a Dr could get his own line or prescription pain meds manufactured in asia and import them himself. then he could diagnose a patient, prescribe a med and he would have his own pharmacy in his office that would provide the meds and do the billing

Result number: 31

Message Number 241540

Re: NC Podiatrist Indicted for Alleged 500K Diabetic Shoe Fraud View Thread
Posted by Dr. Wedemeyer on 1/04/08 at 14:13

Jeremy I do not understand what the doctor was doing, this is probably why I am not diabolical enough to ever think up such scams. Are you saying that he billed patients (Medicare)for shoes he brokered to customers, I don't know why this confuses me.

I prefer to practice from the stance that when a patient is referred in with the TSB certification that they have pathology or the probability of developing such that is best served by a custom insert.

The heat molded inserts in your hands are much different than in the hands of some 'fitter' working in a pharmacy. This is the point that I was trying to make. As a 'fitter' working under a doctor or facilities license they are merely supervised and God only knows if they provide total contact, follow up, and bill the appropriate codes.

Result number: 32

Message Number 241535

Re: NC Podiatrist Indicted for Alleged 500K Diabetic Shoe Fraud View Thread
Posted by Jeremy L, C Ped on 1/04/08 at 12:02

Now, hold on. The problem is not that SADMERC permits dispensal of an A5512 heat moldable insert. When done properly, and as prescribed, it is an extremely protective and effective device. The problems are those individuals (fortunately, a minority) who either provide a device that has not been properly fitted and modified, or provide this kind of device while billing for a custom molded A5513 coded device.

There is another, and even more questionable practice made by the doctor singled out in this report. He went direct to the Far East, and had an laughable collection of shoes made. In addition to what he sold to others as a product distributor, he billed for these shoes himself garnering additional profit margin. What are your feelings about this kind of practice?

Result number: 33
Searching file 23

Message Number 239191

Re: Steel Toed Boots View Thread
Posted by Dr. Wedemeyer on 11/08/07 at 13:07

Bobby there are various materials available in orthotic design and they are typically chosen for your particular foot type, weight and pathology.

With PTTD I question the use of cork as the base orthotic material, especially when it is apparent that your physician prescribed a supramalleolar (SMO)with straps ankle foot orthosis.

You describe being early to late stage 2 PTTD and there is a quantitative difference in the approach to managing the two. In late stage 2 and beyond it would be more typical to choose polypropylene plastic or carbon fiber and fiberglass composites in varying rigidity according to your weight and level of dysfunction.

Yes a picture would probably be of interest and as well the codes the fitter billed the insurer (they will begin with the letter L).

Has your physician seen the orthosis and did he or she comment on the device?

All said as Dr. Ed discussed a properly shanked and fit boot (or any well built enclosed shoe) will augment the effect of the orthosis assuming that the script was filled appropriately.

Result number: 34

Message Number 239147

Re: Steel Toed Boots View Thread
Posted by Jeremy L, C Ped on 11/07/07 at 19:01

Well, it's not necessarily a diabetic insert. It's certainly not the A5513 coded device you may be thinking. And it's within script to make a 3020 or 3000 device with a cover as he describes. However, what he received is clearly not a SMO. There is no variance on that script, as there mus be clearance over the malleoli. I hope his insurance was billed for what was actually made, and that the referring physician was consulted prior to making a change in treatment protocol.

Result number: 35

Message Number 238115

Re: ANOTHER Shoe question for Jeremy View Thread
Posted by Jeremy L, C Ped on 10/20/07 at 11:46

McMahan's did a DMO?? That is so very NOT like what I have come to know about them. They either do custom functional or accommodative inserts, or modify existing pre-molded inserts. If you look on your insurance Explanation of Benefits form form when those inserts were made, take a look at what coding was billed. If it states L3000, L3010 or L3020, please very strongly consider seeking care elsewhere. If it states the service was L3030 (as it should be), then you very likely will want to have the insert re-examined.

Result number: 36

Message Number 237915

Other scholarly views on genocide View Thread
Posted by john h on 10/17/07 at 09:37

Tuesday, October 02, 2007
Open letter to honorary represantatives for H. Res. 106
Dear Honorary Represantatives,

I am writing in strong objection to H.Res. 106, a callously one-sided effort, spearheaded by some members of Congress with large Armenian communities in their district, to rewrite Turkish history and defame people of Turkish heritage as perpetrators of genocide and genocide deniers. H.Res. 106 reflects no more than the “buying power” of the Armenian lobby in the United States. It forces the sale of American principles of fairness and justice, for it is not the purview of the legislature to be fact finder and judge on what is in essence a criminal charge by the Armenian lobby. It forces the sale of American foreign policy which consistently supports greater research and dialogue on what it defines as a historical and legal controversy. It foresees the sale of American interests abroad by alienating a staunch ally who deserves nothing less than fairness and justice. It purchases a resolution replete with anti-Turkish and anti-Muslim hatred that reflect ultra-nationalist Armenian orthodoxies. H.Res. 106 damages the definition of the high crime of genocide. As Princeton University history professor, Bernard Lewis stated on April 14, 2002, at the National Press Club on C-Span 2: “[T]hat the massacre of the Armenians in the Ottoman Empire was the same as what happened to Jews in Nazi Germany is a downright falsehood. What happened to the Armenians was the result of a massive Armenian armed rebellion against the Turks, which began even before war broke out, and continued on a larger scale. But to make this a parallel with the holocaust in Germany you would have to assume the Jews of Germany had been engaged in an armed rebellion against the German state, collaborating with the allies against Germany. That in the deportation order the cities of Hamburg and Berlin were exempted, persons in the employment of the state were exempted, and the deportation only applied to the Jews of Germany proper, so that when they got to Poland they were welcomed and sheltered by the Polish Jews. This seems to me a rather absurd parallel.” The authors of H.Res. 106 claim that the charge of genocide fits the bill. But they ignore experts and scholars who disagree with the Armenian allegation of genocide. They conveniently ignore the war crimes of Armenian militias and Armenians fighting with the Russian Army against the Muslim and Jewish populations of the Ottoman Empire. In H.Res. 106, they have dangerously over billed America in their corrupted version of history and perverse understanding of the crime of genocide.

Fuat Ornarli

Posted by Fuat Ornarli at 9:53 PM 0 comments


Thursday, July 12, 2007
POCKET GUIDE
Sources of information on alleged Armenian claims of Genocide Against The Turks.
In order to reach truth and to unwind racist bias, read below works and commentaries, including those by neutral scholars and directors,

Find out what Armenian Premier Senin Ovanes Kacaznuni said in 1923 Dashnak Party Conference in Bucharest-Romania, about Armenian treachery. Available from iletisim at kaynakyayinlari.com ISBN 975-343-438-3 or from TPK enquiries at tpk.org.uk
You may peruse http://www.tallarmeniantale.com/, by author Holdwater & http://www.eraren.org/bilgibankasi/en/index.htm The “Armenian Research” FoundationRead on internet www.tallarmeniantale.com/c-f-dixon-BOOK.htm, written by a British officer in 1916 – the portrayal of Anatolian Armenian character

Examine Guenter Lewy's 'The Armenian Massacres in Turkey, A Disputed Genocide' ISBN-13:978-0-87480-849-0 available on Amazon.com (Jewish author from USA) Salahi Sonyel's 'The Turco-Armenian Imbroglio' ISBN-0-9504886-6-6, available at Cyprus Turkish Association 0207 437 4940 kibristc at btconnect.com (Cypriot Turk author) films to watch are: 'The Armenian Revolt 1894-1920' documentary DVD by Third Coast Films, P.O. Box 664, Clarion, PA 16214, USA, info at thirdcoastfilms.com (by an American Director) This is a MUST !! &'Sari Gelin' documentary DVD through http://www.sarigelinbelgeseli.com/ info at sarigelinbelgeseli.com (maybe available on eBay) (by a Turkish Director)have a look at http://www.armenians-1915.blogspot.com/ by Turkish Armenians (including free downloadable books and automatic translation of site text into several languages), Read Prof. Turkkaya Ataov's WHAT HAPPENED TO OTTOMAN ARMENIANS?
ISBN 1=4243=1004-0 (obtainable from ssaya at superonline.com), (Turkish author)'MYTH OF TERROR' by late Erich Feigl (1986) Zeitgeschichte/Bucherdienst Austria (Austrian Author) which contains the signatures of 63 foreign Academics refuting the Armenian claims

http://www.tallarmeniantale.com/terrorism-breakdown.htm
for Armenian terrorism against Turks.. why Armenians are not talking about their terrorists? an interesting read (in 3 languages) of memoirs of a Russian Officer on Armenians at http://www.tsk.mil.tr/ermeni_sorunu/kitap.htm (click on the book for downloading) or access it and others at http://www.tsk.mil.tr/eng/ermeni_sorunu_salonu/armenianissues_index.htm (from Turkish Military archives reputed to be richest on this issue)There are also several powerful books on this subject by the American author Justin McCarthy http://homepages.cae.wisc.edu/~dwilson/Armenia/mccarthy.html

The TURKS ARE READY, WILLING AND ABLE TO FACE THE ARMENIANS AT A PUBLIC INQUIRY FOR THE SAKE OF TRUTH. WHAT ARE THEY AFRAID OF?
The Turkish Government wants an independent International historical commission to thoroughly research the background but the Armenians are refusing to participate!. Do ask them why..! If truth scares them, then let it be.

--------------------------------------------------------------
Comments by neutral Scholars and Outcomes of Trials

The Middle East Journal 61.2 (Spring 2007): p348(2).

Result number: 37

Message Number 235519

Danger Will Robinson Danger! View Thread
Posted by john h on 9/05/07 at 10:00

It was not me that received this call and I cannot vouch for it but here it is:

90# on your telephone

I dialed '0' and asked the operator who confirmed that this was correct so please pass it on. PASS ON TO EVERYONE YOU KNOW I received a telephone call last evening from an individual identifying himself as an AT&T Service technician (could also be TELUS) who was conducting a test on the telephone lines. He stated that to complete the test I should touch nine (9), zero (0), the pound sign (#), and then hang up. Luckily, I was suspicious and refused. Upon contacting the telephone company, I was informed that by pushing 90#, you give the requesting individual full access to your telephone line, which enables them to place long distance calls billed to your home phone number. I was ! ;furthe r informed that this scam has been originating from many local jails/prisons DO NOT press 90# for ANYONE. The GTE Security Department requested that I share this information with EVERYONE I KNOW.

After checking with Verizon they said it was true, so do not dial 90# for anyone!!!!! PLEASE HIT THAT FORWARD BUTTON AND PASS THIS ON TO EVERYONE YOU KNOW

Result number: 38

Message Number 235077

Re: anyone... someone...this is my big reach out to the people at heelspurs.com View Thread
Posted by Kevin L on 8/28/07 at 17:48

Dr DSW
Below are all the Podiatry providers that take my insurance within 30 miles of my zip 11223 (Brooklyn NY) In alphabetical order…then with detailed info address…etc etc..
A
Abady, Robert, DPM 1
Abeles, Jay, DPM 11
Abrahamson, Hal, DPM 11
Alfieri, Donna M., DPM 1
Alongi, Maryanne, DPM 11
Amante, Gregory, DPM 5
Amato, Richard, DPM 11
Amico, Susan G., DPM 5
Archer, Jean V., DPM 5
Aronica, Frank R., DPM 5
Asaro, Carlo S., DPM 1
Assini, Joseph, DPM 5
Axman, Wayne R., DPM 11
B
Babayev, Emil, DPM 5
Bagner, Jerome E., DPM 11
Baird, William T., DPM 5
Balboa, Henry M., DPM 11
Barbaro, Thomas, DPM 11
Bar-David, Tzvi, DPM 1
Barkoff, Matthew W., DPM 11
Barkoff, Steven L., DPM 5
Barlizo, Sharon R., DPM 1
Barone, Salvatore A., DPM 5
Barragan, Juan C., DPM 1
Bartol, David M., DPM 5
Bass, Elliot L., DPM 5
Bass, Fara D., DPM 5
Bautista, Debbie P., MD 1
Bayerbach, Frank, DPM 1
Becker, Jack S., DPM 11
Bell, Burt L., DPM 5
Bendeth, Marc L., DPM 11
Benzakein, Ralph, DPM 5
Berlin, Kim, DPM 11
Bienenfeld, Jay D., DPM 5
Biller, Bob S., DPM 11
Bilotti, Mary A., DPM 11
Birch, Gregory M., DPM 5
Bover, Elina, DPM 5
Braun, Suzanne G., DPM 5
Breitman, Debra, DPM 11
Breth, Evan G., DPM 5
Bubbers, Linda A., DPM 11
Buenahora, Joseph A., DPM 11
Burzotta, John L., DPM 11
Bushansky, Abe A., DPM 1, 5
Butters, Marva, DPM 5
Butts, Bryon G., DPM 1
Buxbaum, Frederick D., DPM 5
Buzermanis, Steven Z., DPM 5
C
Caimano, Francis X., DPM 11
Campbell, Andrew, DPM 1
Campbell, Douglas E., DPM 5
Caprioli, Russell, DPM 11
Caprioni, Enrico P., DPM 5
Carlton, Lawrence S., DPM 5
Castillo, Dennis E., DPM 5
Catanese, Dominic J., DPM 1
Charlot, Giznola J., DPM 1, 5
Cheng, Tung W., DPM 6
Chernick, Stephen B., DPM 11
Chionis, Anthony, DPM 1
Chopra, Jaideep, DPM 1, 6
Cicio, Gary, DPM 6
Ciment, Avraham Y., DPM 1
Cohen, Greg E., DPM 6
Cohen, Richard B., DPM 6
Cohen, Robert J., DPM 1, 11
D
Dacher, Jeffrey, DPM 6
D'Amato, Theodore A., DPM 6
D'Angelo, Nicholas A., DPM 6
Daniel, Lawrence B., DPM 6
Davies, Daniel A., DPM 11
Davies, Gregory F., DPM 11
De Bello, John A., DPM 1
DeCicco, John J., DPM 11
DeLeon, Jose L., DPM 1
Dellolio, Joseph A., DPM 1
DeMeo, James R., DPM 6
Dennis, Lester N., DPM 6
DeSantos, Pasquale, DPM 6
Dhandari, Angeleta, DPM 1
Dharia, Sumit S., DPM 6
Dixit, Chaitanya V., DPM 6
Donovan, Glenn J., DPM 6
Dorazi, Stephen T., DPM 6
Dubov, Spencer F., DPM 11
E
Edelstein, Michael C., DPM 1
Ehrlich, Josh C., DPM 6
Einhorn, Jill L., DPM 6
Elsinger, Elisabeth C., DPM 1
F
Fagen, Leonard, DPM 6
Falcone, Jeffrey J., DPM 6
Feldman, Gary B., DPM 11
Ficke, Henry, DPM 6
Finkelstein, Barry I., DPM 1
Fiorenza, Dominic, DPM 11
Fox, Corey, DPM 11
Fox, Roberta A., DPM 11
Frankel, Bruce, DPM 1
Freiser, Mark A., DPM 1
Fridman, Robert, DPM 1
Friedlander, Bruce W., DPM 6
Fuchs, David B., DPM 11
G
Ganjian, Afshin, DPM 6
Garcia, Sandra P., DPM 1
Garofalo, Alfred A., DPM 6
Garofalo, Gail F., DPM 11
Gasparini, Mark C., DPM 11
Gaudino, Salvatore C., DPM 2, 6
Geiger, Arthur, DPM 6
George, Thomas, DPM 2, 6, 11
Gertsik, Vladimir V., DPM 6
Gervasio, Joseph, DPM 11
Giammarino, Philip A., DPM 6
Ginsberg, Steven E., DPM 2
Giordano, Richard S., DPM 2
Gitlin, David, DPM 2
Glockenberg, Aaron, DPM 2, 6
Goez, Emilio A., DPM 2, 11
Goldenberg, Perry Z., DPM 2
Goldman, Gershon A., DPM 6
Goldstein, Harold L., DPM 2
Goldstein, Israel, DPM 7
Golub, Cary M., DPM 12
Gonzalez, Ivan, DPM 7
Goodman, Warren J., DPM 7
Gottlieb, Robert J., DPM 12
Gramuglia, Vincent J., DPM 2
Greenbaum, Bruce R., DPM 7
Greenbaum, Mitchell A., DPM 12
Greiff, Lance, DPM 2, 12
Grossman, Myles, DPM 12
Guberman, Ronald M., DPM 7
Gutierrez, David, DPM 2
Gventer, Mark, DPM 7
H
Habib, Henry, DPM 7
Harris, Carl F., DPM 2
Heller, David P., DPM 7
Herbert, Scott E., DPM 12
Herman, Craig P., DPM 2, 7
Hershey, Paul E., DPM 12
Herzberg, Abraham, DPM 12
Hickey, John, DPM 12
Honore, Lesly S., DPM 12
Horl, Lawrence, DPM 12
Horowitz, Mitchell L., DPM 7, 12
I
Iorio, Anthony R., DPM 2
Irwin, Robert A., DPM 12
Isaacson, Ernest, DPM 2
Ivanovs, Ray, DPM 7
J
Jackalone, John A., DPM 12
Jacobs, Louis W., DPM 2
Jarbath, John A., DPM 7, 12
Joshi, Pradip M., DPM 2
Jusma, Francoise D., DPM 7
K
Kaiser, Craig A., DPM 7
Kapadwala, Imtiyaz I., DPM 7
Karpe, David E., DPM 12
Kashefsky, Helene P., DPM 12
Kasminoff, June G., DPM 12
Katz, Alex S., DPM 7
Katzman, Barry, DPM 7
Kessler, Howard N., DPM 12
Kisberg, Stephen, DPM 12
Kitton, Stuart E., DPM 12
Klein, Michael S., DPM 12
Klirsfeld, Jeffrey S., DPM 12
Knobel, Jeffrey, DPM 7
Kohn, Arlene F., DPM 12
Kolberg, John J., DPM 2, 12
Koslow, Paul M., DPM 12
Kumrah, Praveen, DPM 2
L
Lafferty, William A., DPM 7
Lai, Katherine M., DPM 2
Landau, Laurence D., DPM 12
Landy, Robert J., DPM 2, 12
LaRocca, Albert, DPM 12
Larsen, Joseph A., DPM 12
LaSalle, Michael, DPM 2
Lepore, Frank L., DPM 7
Levine, Stanley, DPM 12
Levitsky, David A., DPM 12
Levitz, Steven J., DPM 7
Levy, Brian K., DPM 7
Levy, Denise A., DPM 2
Levy, Paul J., DPM 2
Liswood, Paul J., DPM 7
Livingston, Douglas W., DPM 12
Livingston, Leon B., DPM 13
Livingston, Michael D., DPM 13
Locastro, Robert M., DPM 2
Lok, Jonat, DPM 2
Lopiano, Steven N., DPM 2
Losyev, Sergey, DPM 7
Lucido, Jeffrey V., DPM 7
Lynn, Brian P., DPM 2, 13
M
Mahgerefteh, David, DPM 7, 13
Makower, Bryan L., DPM 7
Mandato, Mark, DPM 7
Mantzoukas, Argirios, DPM 7
Marcelonis, Debra A., DPM 7
Marchese, Nicholas A., DPM 13
Marville, Jillion, MD 3, 7
Masani, Farhan, DPM 13
Matthews, Frederick, DPM 8
McElgun, Terence M., DPM 13
Mckay, Douglas J., DPM 8
Mcshane, William J., DPM 13
Meliso, Vincent D., DPM 8
Meller, Edward P., DPM 8
Meshnick, Joel A., DPM 8, 13
Micallef, Joseph, DPM 8, 13
Moazen, Ali, DPM 13
Mollica, Peter W., DPM 8
Mollica, Raymond J., DPM 8
Montag, Richard M., DPM 13
Montalvo, Luis, DPM 8
Morreale, Edward, DPM 8
N
Nachmann, Dennis S., DPM 3
Naik, Hetal B., DPM 8
Nekritin, Vadim, DPM 8
Nester, Elizabeth M., DPM 13
Nester, Matthew J., DPM 13
Newmark, Alan J., DPM 8
Nezaria, Yehuda, DPM 13
Novofastovsky, Raisa, DPM 8
O
Odinsky, Michael E., DPM 8
Odinsky, Wayne Z., DPM 13
Oliva, Imelda A., DPM 3, 8
Orlando, Anthony, DPM 8
Oropall, Robert, DPM 3
Owusu, Stephen E., DPM 8
P
Pace, George N., DPM 8
Pace, John F., DPM 8
Pannell, Richard, DPM 3
Papa, Philip M., DPM 8
Passik, Arthur L., DPM 8
Pawson, John F., DPM 8
Pecora, Maria, DPM 8
Pedro, Helder F., DPM 8, 13
Perez, Walter H., DPM 8
Peterson, Donald T., DPM 13
Pierre, Nadja M., DPM 8
Pierre, Nedjie, DPM 9
Plotka, Steven D., DPM 3
Posner, Jonathan, DPM 3
Prince, Steven L., DPM 9, 13
Purvin, Jay M., DPM 13
R
Rabiei, Payman, DPM 9
Radler, Bruce L., DPM 9
Rampino, Robert, DPM 3
Ransom, Sherry M., DPM 3
Raskin, Simon, DPM 9
Reifer, Howard J., DPM 9
Richardson, Hugh L., DPM 13
Richman, Tara, DPM 3
Romano, Constance A., DPM 9
Rosen, Alan J., DPM 9
Ross, Charles F., DPM 3
S
Saadvandi, Terence M., DPM 9
Sande, Hervey, DPM 9
Scheiner, David M., DPM 9
Schikman, Lana, DPM 9
Schneidermesser, Susan G., DPM 9
Schulman, Leonard B., DPM 3
Scotti, Lorenzo, DPM 3
Shapiro, Eugene, DPM 9
Shechter, David Z., DPM 9
Shechter, Stuart B., DPM 9
Sherman, Gary, DPM 9
Silberstein, Jeffrey, DPM 9
Silverstein, Alan B., DPM 9
Snyder, Robert S., DPM 3
Spector, Donald, DPM 3
Spellman, Dean S., DPM 3
Spielfogel, William D., DPM 9
Spilken, Terry, DPM 3
Spindler, Harlan, DPM 9
Stanimirov, Catherine, DPM 9
Steiner, Richard M., DPM 3, 9
Stern, Stuart M., DPM 3
Strassman, David, DPM 3
Strassman, Lawrence, DPM 3
Stuto, Joseph C., DPM 9
T
Tabari, Issac, DPM 3
Tajerstein, Alan R., DPM 9
Tanenbaum, Mark, DPM 9
Tartack, Ira, DPM 9
Tavroff, Clifford D., DPM 9
Thompson, Michael, DPM 3
Trepal, Michael J., DPM 9
Trivlis, Maryann Z., DPM 9
U
Unger, Leslie M., DPM 9
V
Vader, Bonnie, DPM 9
Velasco, Debra, DPM 3
Vincetic, Anto, DPM 3
Vitale, Thomas, DPM 3
W
Waiss, Samuel M., DPM 9
Wallach, Jacob B., DPM 9
Walter, Eric G., DPM 3
Wexler, Craig, DPM 3
Winston, Wayne, DPM 4
Wolstein, Lewis, DPM 4
Wolstein, Peter D., DPM 4
Woltman, Robert T., DPM 4, 10
Z
Zonenashvili, Merabi, DPM 10
Zwiebel, Neil S., DPM 10

PODIATRY
Abady, Robert, DPM
181172P
731 White Plains Rd
Bronx, NY 10473
(718) 589-8324
181173P
Burnside Medical Center
165 E Burnside Ave
Bronx, NY 10453
(718) 563-0003
St Barnabas Hospital
Alfieri, Donna M., DPM
37006P
4206 Barnes Ave
Bronx, NY 10466
(718) 325-6487
Mount Vernon Hospital, Our
Lady of Mercy Medical Center
Asaro, Carlo S., DPM
37182P
1400 Pelham Pkwy S
Bronx, NY 10461
(718) 918-7224
50629P
3424 Kossuth Ave
Bronx, NY 10467
(718) 519-3589
Jacobi Medical Center, North
Central Bronx Hospital
Speaks Italian
Bar-David, Tzvi, DPM
36919P
3616 Henry Hudson Pkwy E
Bronx, NY 10463
(718) 548-5757
Columbia-Presbyterian
Medical Center
Speaks HebrewSpanish
Barlizo, Sharon R., DPM
357781P
HHC-Lincoln M&MH Center
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center, Metropolitan
Hospital Center
Speaks FrenchSpanish
Barragan, Juan C., DPM
36954P
St. John's Medical Center
1561 Westchester Ave
Bronx, NY 10472
(718) 328-6200
Speaks Spanish
Bautista, Debbie P., MD
301273P
St. Barn Ambulatory Care
4487 3rd Ave
Bronx, NY 10457
(718) 960-1780
301276P
Union Comm Hlth Ctr
2021 Grand Concourse
Bronx, NY 10453
(718) 960-3933
348297P
CCDC/Burnside Med Ctr
731 White Plains Rd
Bronx, NY 10473
(718) 589-8324
Our Lady of Mercy Medical
Center, St Barnabas Hospital
Bayerbach, Frank, DPM
216992P
Mercy Community Care
4234 Bronx Blvd
Bronx, NY 10466
(347) 341-4300
39016P
Metropolitan Podiatry Ass
667 E 233rd St
Bronx, NY 10466
(718) 430-6066
M1246P
2371 Arthur Ave
Bronx, NY 10458
(718) 364-6199
Brunswick General Hospital,
Brunswick Hospital Center, Inc,
Good Samaritan Hospital,
Good Samaritan Hospital (West
Islip)
Speaks
SpanishGermanItalian
Bushansky, Abe A., DPM
368478P
1715 University Ave
Bronx, NY 10453
(718) 960-5616
368491P
1963 Grand Concourse
Bronx, NY 10453
(718) 294-5000
Brooklyn Hospital Center
(Downtown Campus), Interfaith
Medical Center, Parkway
Hospital
Butts, Bryon G., DPM
349336P
421 E 149th St
Bronx, NY 10455
(718) 401-3668
The Mount Sinai Hospital of
Queens
Speaks Spanish
Campbell, Andrew, DPM
36957P
St. Barnabas Hospital
4422 3rd Ave
Bronx, NY 10457
(718) 960-9000
56967P
Union Community Health Ct
260 E 188 St
Bronx, NY 10458
(718) 220-2020
56970P
St. Barnabas Ambulatory C
4487 3rd Ave
Bronx, NY 10457
(718) 960-1780
56972P
Bronx Park Medical Pavill
2016 Bronxdale Ave
Bronx, NY 10462
(718) 863-8695
St Barnabas Hospital
Catanese, Dominic J., DPM
37141P
Orthopedic Surgery Dept.
1695 Eastchester Rd
Bronx, NY 10461
(718) 405-8430
Albert Einstein College of
Medicine, Community Hospital
at Dobbs Ferry, Montefiore
Med Ctr (Henry & Lucy Moses
Div), SAINT MARYS
HOSPITAL
Charlot, Giznola J., DPM
357878P
HHC-Jacobi Medical Center
1400 Pelham Pkwy S
Bronx, NY 10461
(718) 918-6610
357880P
HHC-North Central Bx Hosp
3424 Kossuth Ave
Bronx, NY 10467
(718) 519-2108
Jacobi Medical Center, Kings
County Hospital Center, North
Central Bronx Hospital
Chionis, Anthony, DPM
54771P
1725 Edison Ave
Bronx, NY 10461
(718) 892-5542
Parkway Hospital, St John's
Episcopal Hospital - Far
Rockaway
Speaks Greek, Modern
(1453-)
Chopra, Jaideep, DPM
284748P
NY Westchester Square Med
2475 Saint Raymonds Ave
Bronx, NY 10461
(718) 792-1100
Staten Island University
Hosp-North, University
Hospital of Brooklyn
Speaks Hindi
Ciment, Avraham Y., DPM
351611P
Soundview Healthcare ntwk
731 White Plains Rd
Bronx, NY 10473
(718) 589-8324
351618P
Diallo Medical Center
1760 Westchester Ave
Bronx, NY 10472
(718) 892-8474
351623P
Jessica Guzman Med Ctr
616 Castle Hill Ave
Bronx, NY 10473
(718) 239-9013
351628P
Burnside Medical Center
165 E Burnside Ave
Bronx, NY 10453
(718) 563-0003
Our Lady of Mercy Medical
Center, St Barnabas Hospital,
Westchester Medical Center
Speaks Hebrew
Cohen, Robert J., DPM
M4190P
140-1 Elgar Pl
Bronx, NY 10475
(718) 671-0400
Our Lady of Mercy Medical
Center, Parkway Hospital
Speaks French
De Bello, John A., DPM
289396P
New York Foot Care Srvc
3635 E Tremont Ave
Bronx, NY 10465
(718) 409-0400
3114603P
New York Foot Care Svc
421 E 149th St
Bronx, NY 10455
(718) 365-6363
36995P
New York Foot Care Svc
3201 Grand Concourse
Bronx, NY 10468
(718) 365-6363
Montefiore Med Ctr (Henry &
Lucy Moses Div), Mount Sinai
Hospital of Queens, North
Shore University Hospital, Our
Lady of Mercy Medical Center,
Parkway Hospital
Speaks Spanish
DeLeon, Jose L., DPM
179943P
625 E Fordham Rd
Bronx, NY 10458
(718) 933-1900
37252P
2111 Williamsbridge Rd
Bronx, NY 10461
(718) 828-6060
Our Lady of Mercy Medical
Center
Speaks Spanish
Dellolio, Joseph A., DPM
38329P
4362 White Plains Rd
Bronx, NY 10466
(718) 994-7054
Montefiore Med Ctr (Jack D
Weiler Hosp of A Einst), Our
Lady of Mercy Medical Center,
Westchester Medical Center
Speaks Spanish
Dhandari, Angeleta, DPM
116473P
North Central Bronx Hosp
3424 Kossuth Ave
Bronx, NY 10467
(718) 519-3589
116482P
Jacobi Medical Center
1400 Pelham Pkwy S
Bronx, NY 10461
(718) 918-5700
Jacobi Medical Center, North
Central Bronx Hospital
Edelstein, Michael C., DPM
178750P
3224 Grand Concourse
Bronx, NY 10458
(718) 561-0041
Our Lady of Mercy Medical
Center
Speaks Spanish
Elsinger, Elisabeth C.,
DPM
37257P
MAP-Dept of Ortho Sgy
3400 Bainbridge Ave
Bronx, NY 10467
(718) 920-2060
Montefiore Med Ctr (Henry &
Lucy Moses Div)
Speaks German
Finkelstein, Barry I.,
DPM
169233P
3327 Bainbridge Ave
Bronx, NY 10467
(718) 881-7990
194335P
NY Podiatry & Foot Surg
2425 Eastchester Rd
Bronx, NY 10469
(718) 881-7990
227755P
Wilson Orthopedics
75 E Gun Hill Rd
Bronx, NY 10467
(718) 798-1000
Montefiore Med Ctr (Jack D
Weiler Hosp of A Einst), United
Hospital Medical Center (NY)
Speaks HebrewYiddish
Frankel, Bruce, DPM
200374P
Lincoln Medical & Mental
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center
Freiser, Mark A., DPM
36628P
Bronx Footcare
421 E 149th St
Bronx, NY 10455
(718) 292-5045
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center, St
Barnabas Hospital
Speaks SpanishFrench
Fridman, Robert, DPM
351650P
3616 Henry Hudson Pkwy
Bronx, NY 10463
(718) 548-5757
Columbia-Presbyterian
Medical Center
Garcia, Sandra P., DPM
353857P
Happy Feet
953 Southern Blvd
Bronx, NY 10459
(718) 542-0472
Board Certified
Male Female
Wheelchair Accessible
353859P
Uptown Healthcare Mgmt In
930 E Tremont Ave
Bronx, NY 10460
(718) 860-1111
Forest Hills Hospital
Speaks Spanish
Gaudino, Salvatore C.,
DPM
37096P
71 Metropolitan Oval
Bronx, NY 10462
(718) 829-6436
Mount Sinai Medical Center,
Parkway Hospital, Queens
Hospital Center
George, Thomas, DPM
197631P
3219 E Tremont Ave
Bronx, NY 10461
(718) 792-8115
Hempstead General Hospital
Med Ctr., New York
Westchester Square Medical
Center
Ginsberg, Steven E., DPM
132102P
2391 Arthur Ave
Bronx, NY 10458
(718) 365-4141
SVCMC-St Marys Hospital
Brooklyn, St Joseph's Hospital
Division, CMC
Giordano, Richard S.,
DPM
36494P
1217 Castle Hill Ave
Bronx, NY 10462
(718) 828-6982
Northern Westchester Hospital
Center, Our Lady of Mercy
Medical Center
Gitlin, David, DPM
379153P
HHC-Lincoln M&MH Center
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Metropolitan Hospital Center
Glockenberg, Aaron,
DPM
201399P
Lincoln Med & Mental Hlth
234 E 149th St
Bronx, NY 10451
(718) 579-4900
276540P
2445 Arthur Ave
Bronx, NY 10458
(718) 733-1999
Kings County Hospital Center,
Lincoln Medical & Mental
Health Center, Our Lady of
Mercy Medical Center, St
Barnabas Hospital, Union
Hospital of the Bronx (closed)
Speaks PolishHebrew
Goez, Emilio A., DPM
301254P
Union Comm Hlth Ctr
2021 Grand Concourse
Bronx, NY 10453
(718) 960-3933
301255P
St Barn Ambulatory Care
4487 3rd Ave
Bronx, NY 10457
(718) 960-1780
371846P
St. Barnabas Hospital
4422 3rd Ave
Bronx, NY 10457
(718) 960-6105
51028P
Bronx Park Med Pavilion
2016 Bronxdale Ave
Bronx, NY 10462
(718) 863-8695
Nassau University Medical
Center, Saint Catharines
General Hospital, St Barnabas
Hospital
Speaks Spanish
Goldenberg, Perry Z.,
DPM
231271P
3250 3rd Ave
Bronx, NY 10456
(718) 328-3668
St Barnabas Hospital
Goldstein, Harold L.,
DPM
187909P
2016 Bronxdale Ave
Bronx, NY 10462
(718) 863-8695
37017P
St. Barnabas Hospital
4422 3rd Ave
Bronx, NY 10457
(718) 960-6105
371962P
St Barnabas Ambulatory C
4487 3rd Ave
Bronx, NY 10457
(718) 960-6488
371965P
Union Community Health Ct
2021 Grand Concourse
Bronx, NY 10453
(718) 960-3933
371966P
Union Community Health Ct
260 E 188th St
Bronx, NY 10458
(718) 220-2020
St Barnabas Hospital, United
Hospital Medical Center (NY),
White Plains Hospital Center
Speaks SpanishItalian
Gramuglia, Vincent J.,
DPM
216990P
Mercy Community Care
4234 Bronx Blvd
Bronx, NY 10466
(347) 341-4300
49500P
AllMed Medical & Rehab
4377 Bronx Blvd
Bronx, NY 10466
(718) 325-0700
49501P
Metropolitan Podiatry Ass
667 E 233rd St
Bronx, NY 10466
(718) 430-6066
M1576P
3795 E Tremont Ave
Bronx, NY 10465
(718) 828-3333
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center
Speaks SpanishItalian
Greiff, Lance, DPM
354487P
3333 Henry Hudson Pkwy
Bronx, NY 10463
(718) 601-2100
Brooklyn Hospital Center
(Downtown Campus), New
York Flushing Hospital &
Medical Center, Parkway
Hospital
Gutierrez, David, DPM
M1570P
2100 Bartow Ave
Bronx, NY 10475
(718) 320-0200
Our Lady of Mercy Medical
Center
Speaks Spanish
Harris, Carl F., DPM
201401P
Lincoln Med & Mental Hlth
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Harlem Hospital Center,
Lincoln Medical & Mental
Health Center
Herman, Craig P., DPM
227774P
Advanced Foot Care
3396 E Tremont Ave
Bronx, NY 10461
(718) 409-2121
300046P
Bronx Health Center
975 Westchester Ave
Bronx, NY 10459
(718) 991-9250
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center
Speaks Spanish
Iorio, Anthony R., DPM
357778P
HHC-Lincoln M&MH Center
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center, Metropolitan
Hospital Center
Isaacson, Ernest, DPM
341669P
Parkchester Family Foot
1340 Metropolitan Ave
Bronx, NY 10462
(718) 863-3338
Beth Israel Medical Center
(Petrie Campus), Our Lady of
Mercy Medical Center
Speaks Hebrew
Jacobs, Louis W., DPM
36524P
4240 Hutchinson River Pkwy
E
Bronx, NY 10475
(718) 671-2233
Speaks SpanishHungarian
Joshi, Pradip M., DPM
36975P
1963A Daly Ave
Bronx, NY 10460
(718) 617-6141
39978P
1650 Selwyn Ave
Bronx, NY 10457
(718) 590-1800
Bronx-Lebanon Hospital
Center - Fulton Division, Our
Lady of Mercy Medical Center
Speaks Spanish
Kolberg, John J., DPM
351082P
1387 Grand Concourse
Bronx, NY 10452
(718) 992-9918
New Island Hospital
Speaks Spanish
Kumrah, Praveen, DPM
187664P
2015 Grand Concourse
Bronx, NY 10453
(718) 299-7295
214484P
Uptown HealthCare Mgmt
1778 Jerome Ave
Bronx, NY 10453
(718) 764-1661
221984P
1807 Randall Ave
Bronx, NY 10473
(718) 617-2468
New York Westchester Square
Me, Our Lady of Mercy
Medical Center
Speaks HindiPunjabi
LaSalle, Michael, DPM
200845P
Lincoln Medical & Mental
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center
Lai, Katherine M., DPM
37068P
Center for Podiatric Care
1500 Astor Ave
Bronx, NY 10469
(718) 882-6881
Beth Israel Medical Center
(Petrie Campus), Mount Sinai
Medical Center, Our Lady of
Mercy Medical Center
Landy, Robert J., DPM
37072P
1340 Metropolitan Ave
Bronx, NY 10462
(718) 863-3338
Massapequa General Hospital,
Our Lady of Mercy Medical
Center, Parkway Hospital,
Southside Hospital, Winthrop
University Hospital
Speaks Spanish
Levy, Denise A., DPM
141439P
Hyperbaric Unit
111 E 210th St
Bronx, NY 10467
(718) 920-6655
Montefiore Med Ctr (Henry &
Lucy Moses Div)
Speaks Spanish
Levy, Paul J., DPM
169192P
2545 Wallace Ave
Bronx, NY 10467
(718) 231-2500
36736P
2539 Fish Ave
Bronx, NY 10469
(718) 231-2500
Brooklyn Hospital Center
(Downtown Campus), Our Lady
of Mercy Medical Center
Speaks Spanish
Locastro, Robert M.,
DPM
124212P
731 White Plains Rd
Bronx, NY 10473
(718) 893-7773
Southside Hospital, St
Barnabas Hospital, St
Catherine of Siena, St
Catherine of Sienna Medical
Center
Lok, Jonat, DPM
227010P
East Tremont Medical Ctr
930 E Tremont Ave
Bronx, NY 10460
(718) 860-1111
New York Downtown Hospital
(Beekman), Our Lady of Mercy
Medical Center
Lopiano, Steven N., DPM
36777P
3108 Kingsbridge Ave
Bronx, NY 10463
(718) 548-1102
Our Lady of Mercy Medical
Center
Speaks SpanishItalian
Board Certified
Male Female
Wheelchair Accessible
Lynn, Brian P., DPM
38157P
Ctr for Ortho Specialty
1695 Eastchester Rd
Bronx, NY 10461
(718) 405-8430
38159P
MAP - Dept. of Ortho Surg
3400 Bainbridge Ave
Bronx, NY 10467
(718) 920-2060
Long Island Jewish Medical
Center, Montefiore Med Ctr
(Henry & Lucy Moses Div)
Speaks Spanish
Marville, Jillion, MD
179966P
Morris Heights Hlth Ctr
625 E 137th St
Bronx, NY 10454
(718) 401-6578
49882P
Morris Heights Hlth Cntr
85 W Burnside Ave
Bronx, NY 10453
(718) 716-4400
Nachmann, Dennis S.,
DPM
188735P
Urgent Foot Care,PC
3594 E Tremont Ave
Bronx, NY 10465
(718) 597-5800
37260P
Urgent Foot Care PC
3058 E Tremont Ave
Bronx, NY 10461
(718) 409-0500
37261P
1216 Beach Ave
Bronx, NY 10472
(718) 597-1107
40448P
326 E 204th St
Bronx, NY 10467
(718) 655-3410
53065P
1387 Grand Concourse
Bronx, NY 10452
(718) 992-9918
Bronx-Lebanon Hospital
Center - Fulton Division,
Montefiore Med Ctr (Jack D
Weiler Hosp of A Einst), New
York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center
Speaks Spanish
Oliva, Imelda A., DPM
357238P
HHC Morrisania D & T Ctr
1225 Gerard Ave
Bronx, NY 10452
(718) 960-2781
357786P
HHC-Lincoln M&MH Center
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Kings County Hospital Center,
Metropolitan Hospital Center,
Morrisania Hospital
Speaks TagalogSpanish
Oropall, Robert, DPM
142725P
Metropolitan Podiatry Ass
667 E 233rd St
Bronx, NY 10466
(718) 430-6066
18943P
820 Lydig Ave
Bronx, NY 10462
(718) 792-5900
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center
Speaks German
Pannell, Richard, DPM
288046P
HHC-Morrisania D &TC
1225 Gerard Ave
Bronx, NY 10452
(718) 960-2781
Harlem Hospital Center,
Metropolitan Hospital Center
Plotka, Steven D., DPM
200379P
HHC Lincoln Hospital
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center, Mount Sinai
Medical Center, Raritan Bay
Medcal Center, Robert Wood
Johnson University Hosp.
Speaks Spanish
Posner, Jonathan, DPM
105432P
Jonathan Posner, DPM
360 E 193rd St
Bronx, NY 10458
(718) 933-2400
105434P
Jonathan Posner, DPM
1621 Eastchester Rd
Bronx, NY 10461
(718) 405-8040
143124P
MMG - CHCC
305 E 161st St
Bronx, NY 10451
(718) 579-2500
P0052P
2532 Grand Concourse
Bronx, NY 10458
(718) 960-1500
Montefiore Med Ctr (Henry &
Lucy Moses Div)
Rampino, Robert, DPM
157922P
North Central Bronx Hosp
3424 Kossuth Ave
Bronx, NY 10467
(718) 519-3630
157925P
Jacobi Medical Center
1400 Pelham Pkwy S
Bronx, NY 10461
(718) 918-5700
Coney Island Hospital
Ransom, Sherry M., DPM
198963P
Derm & Surgery Associates
3620 E Tremont Ave
Bronx, NY 10465
(718) 792-4700
Mount Vernon Hospital
Richman, Tara, DPM
364345P
Tej Podiatric Group P.C.
1963-A Daly Ave
Bronx, NY 10460
(718) 617-6141
Bronx-Lebanon Hospital
Center - Fulton Division
Ross, Charles F., DPM
3113966P
HHC-Lincoln Med & Mntl HC
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center, Metropolitan
Hospital Center
Schulman, Leonard B.,
DPM
36464P
MMC-Family Care Center
3444 Kossuth Ave
Bronx, NY 10467
(718) 920-2273
Montefiore Med Ctr (Henry &
Lucy Moses Div)
Scotti, Lorenzo, DPM
36715P
North Central Bronx Hosp
3424 Kossuth Ave
Bronx, NY 10467
(718) 519-3589
51545P
Jacobi Medical Center
1400 Pelham Pkwy S
Bronx, NY 10461
(718) 918-7224
Coney Island Hospital, Jacobi
Medical Center, North Central
Bronx Hospital
Speaks ItalianSpanish
Snyder, Robert S., DPM
46604P
3867 E Tremont Ave
Bronx, NY 10465
(718) 792-8790
Forest Hills Hospital, Parkway
Hospital
Speaks Spanish
Spector, Donald, DPM
36812P
Cambridge Podiatry Center
259 W 231st St
Bronx, NY 10463
(718) 548-3080
St Joseph's Medical
Center-Yonkers
Spellman, Dean S., DPM
381596P
Middletown Podiatry Assoc
1200 Waters Pl
Bronx, NY 10461
(718) 863-5511
New York Westchester Square
Medical Center
Spilken, Terry, DPM
200471P
HHC Lincoln Hospital
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center
Steiner, Richard M., DPM
188831P
3530 Henry Hudson Pkwy E
Bronx, NY 10463
(718) 548-3550
379697P
Kingsbridge Community Med
170 W 233rd St
Bronx, NY 10463
(718) 543-0700
SVCMC-St Vincents Manhattan
Stern, Stuart M., DPM
36652P
Morris Park Podiatry
1015 Morris Park Ave
Bronx, NY 10462
(718) 863-3737
New Island Hospital, Plainview
Hospital, Syosset Hospital
Strassman, David, DPM
349822P
MMC - Dept of Surgery
111 E 210th St
Bronx, NY 10467
(718) 920-6603
Montefiore Med Ctr (Jack D
Weiler Hosp of A Einst), New
York Methodist Hospital, New
York Westchester Square
Medical Center
Strassman, Lawrence,
DPM
358330P
MMC - Eastern Vascular
1825 Eastchester Rd
Bronx, NY 10461
(718) 792-8115
Montefiore Med Ctr (Jack D
Weiler Hosp of A Einst), New
York Westchester Square
Medical Center
Tabari, Issac, DPM
208998P
108 E 183rd St
Bronx, NY 10453
(718) 295-4600
Lutheran Medical Center,
Nassau University Medical
Center
Speaks FARSI,
EASTERNPersian
Thompson, Michael, DPM
36705P
2574 Frisby Ave
Bronx, NY 10461
(718) 892-8382
Brooklyn Hospital Center
(Downtown Campus), Our Lady
of Mercy Medical Center
Velasco, Debra, DPM
201409P
HHC Lincoln Hospital
234 E 149th St
Bronx, NY 10451
(718) 579-4900
214314P
Segundo Ruiz Belvis DTC
545 E 142nd St
Bronx, NY 10454
(718) 579-4000
288345P
HHC-Morrisania D &TC
1225 Gerard Ave
Bronx, NY 10452
(718) 960-2781
Lincoln Medical & Mental
Health Center, Metropolitan
Hospital Center
Speaks Spanish
Vincetic, Anto, DPM
231369P
3635 E Tremont Ave
Bronx, NY 10465
(718) 409-0400
Montefiore Med Ctr (Henry &
Lucy Moses Div), Mount
Vernon Hospital
Speaks Croatian
Vitale, Thomas, DPM
201089P
HHC Lincoln Hospital
234 E 149th St
Bronx, NY 10451
(718) 579-4900
Lincoln Medical & Mental
Health Center
Walter, Eric G., DPM
142727P
Metropolitan Podiatry Ass
667 E 233rd St
Bronx, NY 10466
(718) 430-6066
357174P
1619 Pelham Pkwy N
Bronx, NY 10469
(718) 665-3410
36967P
Bronx Foot Rehab Assoc.
326 E 204th St
Bronx, NY 10467
(718) 655-3410
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center, SJRH -
St Johns Division, St Barnabas
Hospital
Speaks German
Specialist
Board Certified
Male Female
Wheelchair Accessible
PODIATRY (Continued)
Wexler, Craig, DPM
36647P
2391 Arthur Ave
Bronx, NY 10458
(718) 365-4141
Newton Memorial Hospital,
Our Lady of Mercy Medical
Center
Winston, Wayne, DPM
359588P
Signature Health Center
220 E 161st St
Bronx, NY 10451
(718) 537-1100
Forest Hills Hospital
Wolstein, Lewis, DPM
42408P
100-1 De Kruif Pl
Bronx, NY 10475
(718) 671-7226
New York Westchester Square
Medical Center, United
Hospital Medical Center (NY),
White Plains Hospital Center
Speaks Spanish
Wolstein, Peter D., DPM
19917P
1340 Metropolitan Ave
Bronx, NY 10462
(718) 863-3338
Speaks SpanishTagalog
Woltman, Robert T., DPM
174899P
1488 Metropolitan Ave
Bronx, NY 10462
(718) 823-6239
174900P
Wellness Medical Asso
1180 Morris Park Ave
Bronx, NY 10461
(718) 863-8465
Long Island Jewish Medical
Center, New York Westchester
Square Me, Peninsula Hospital
Center
Board Certified
Male Female
Wheelchair Accessible
PODIATRY
Amante, Gregory, DPM
199177P
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital
Speaks Spanish
Amico, Susan G., DPM
184838P
SL Quality Care Diagnosti
9708 Seaview Ave
Brooklyn, NY 11236
(718) 444-0520
184843P
SL Quality Care Diagnosti
1902 86th St
Brooklyn, NY 11214
(718) 621-9400
184852P
SL Quality Care Diagnosti
1220 Avenue P
Brooklyn, NY 11229
(718) 376-1004
49812P
9731 4th Ave
Brooklyn, NY 11209
(718) 836-1800
SVCMC-St Vincents Staten
Island, Staten Island University
Hosp-North, Victory Memorial
Hospital
Speaks ItalianSpanish
Archer, Jean V., DPM
105663P
Brookdale Family Care Ctr
2554 Linden Blvd
Brooklyn, NY 11208
(718) 240-8600
40532P
Jamaica Hosp Medical Ctr
3080 Atlantic Ave
Brooklyn, NY 11208
(718) 647-0240
Jamaica Hospital
Speaks Spanish
Aronica, Frank R., DPM
36667P
20 Plaza St E
Brooklyn, NY 11238
(718) 638-6387
Catholic Medical Center (NY),
Long Island College Hospital
Speaks SpanishItalian
Assini, Joseph, DPM
36727P
8616 3rd Ave
Brooklyn, NY 11209
(718) 948-3838
Doctors Hosp. of Staten Island,
Lutheran Medical Center,
Staten Island University
Hosp-North, Victory Memorial
Hospital
Speaks Italian
Babayev, Emil, DPM
224479P
Perloff Medical PC
2626 E 14th St
Brooklyn, NY 11235
(718) 368-2626
37241P
Professional Medical Plaz
2269 Ocean Ave
Brooklyn, NY 11229
(718) 339-8200
46696P
421 Ocean Pkwy
Brooklyn, NY 11218
(718) 287-4200
Lutheran Medical Center, New
York Methodist Hospital
Speaks Russian
Baird, William T., DPM
37008P
Plaza Foot Care, PC
5412 Kings Plz Mall
Brooklyn, NY 11234
(718) 377-1212
Peninsula Hospital Center
Speaks
SpanishFrenchRussian
Barkoff, Steven L., DPM
36921P
248 Roebling St
Brooklyn, NY 11211
(718) 599-0505
Brooklyn Hospital Center
(Downtown Campus), New
York Methodist Hospital
Speaks Spanish
Barone, Salvatore A.,
DPM
36884P
1601 Voorhies Ave
Brooklyn, NY 11235
(718) 646-5553
Lutheran Medical Center
Speaks SpanishGerman
Bartol, David M., DPM
139333P
North Star Orthopedics
1408 Ocean Ave
Brooklyn, NY 11230
(718) 338-0909
59239P
North Star Orthopedics
2615 E 16th St
Brooklyn, NY 11235
(718) 745-8787
59240P
North Star Orthopedics
26 Court St
Brooklyn, NY 11242
(718) 935-0311
M6958P
1000 Church Ave
Brooklyn, NY 11218
(718) 826-4000
M6958P
740 64th St
Brooklyn, NY 11220
(718) 439-2000
Parkway Hospital
Bass, Elliot L., DPM
36493P
2381 E 29th St
Brooklyn, NY 11229
(718) 743-1400
49605P
Elliot L Bass, MD
2 W End Ave
Brooklyn, NY 11235
(718) 743-2900
Bass, Fara D., DPM
50123P
2 W End Ave
Brooklyn, NY 11235
(718) 743-1400
M100
2381 E 29th St
Brooklyn, NY 11229
(718) 743-1400
New York Methodist Hospital
Speaks Yiddish
Bell, Burt L., DPM
105602P
7608 20th Ave
Brooklyn, NY 11214
(718) 837-8003
113259P
3065 Brighton 5Th St
Brooklyn, NY 11235
(718) 332-2722
New York Community Hospital
of Brooklyn
Benzakein, Ralph, DPM
36761P
2241 Ocean Ave
Brooklyn, NY 11229
(718) 998-1375
New York Community Hospital
of Brooklyn
Speaks
ArabicHebrewRussianSpani
sh
Bienenfeld, Jay D., DPM
47072P
165 Taylor St
Brooklyn, NY 11211
(718) 599-0753
Peninsula Hospital Center
Speaks
SpanishHebrewYiddish
Birch, Gregory M., DPM
36595P
6419 Bay Pkwy
Brooklyn, NY 11204
(718) 232-6737
Staten Island University
Hosp-North
Bover, Elina, DPM
353725P
A. Amerimed Physician P.C
1655 E 13th St
Brooklyn, NY 11229
(718) 339-3100
353726P
A. Amerimed Physician P.C
1100 Coney Island Ave
Brooklyn, NY 11230
(718) 434-7533
New York Methodist Hospital
Speaks AbkhazianAfam
(Oromo)
Braun, Suzanne G., DPM
142989P
2171 Nostrand Ave
Brooklyn, NY 11210
(718) 758-8920
359508P
710 Parkside Ave
Brooklyn, NY 11226
(718) 270-2075
University Hospital of Brooklyn
Speaks SpanishItalian
Breth, Evan G., DPM
49200P
Evan G. Breth, DPM
2352 Ralph Ave
Brooklyn, NY 11234
(718) 251-0200
M1550P
263 7th Ave
Brooklyn, NY 11215
(718) 369-8080
M1551P
United Medical Assoc
9001 3rd Ave
Brooklyn, NY 11209
(718) 748-2900
M1552P
7124 18th Ave
Brooklyn, NY 11204
(718) 234-3333
Lutheran Medical Center, New
York Methodist Hospital
Bushansky, Abe A., DPM
231380P
734 Pennsylvania Ave
Brooklyn, NY 11207
(718) 493-5986
37057P
711 Eastern Pkwy
Brooklyn, NY 11213
(718) 493-5986
Brooklyn Hospital Center
(Downtown Campus), Interfaith
Medical Center, Parkway
Hospital
Butters, Marva, DPM
343047P
158 Clarkson Ave
Brooklyn, NY 11226
(718) 783-4780
Brooklyn Hospital Center
(Downtown Campus), Kings
County Hospital Center
Buxbaum, Frederick D.,
DPM
36540P
1501 W 6th St
Brooklyn, NY 11204
(718) 837-0442
New York Community Hospital
of Brooklyn, New York
Methodist Hospital, Parkway
Hospital
Buzermanis, Steven Z.,
DPM
57282P
1230 Neptune Ave
Brooklyn, NY 11224
(718) 615-3200
57282P
3245 Nostrand Ave
Brooklyn, NY 11229
(718) 615-3777
57282P
345 Schermerhorn St
Brooklyn, NY 11217
(718) 858-6300
Campbell, Douglas E.,
DPM
37122P
MAIMONDES MED CTR
BROOKLYN, NY 11219
(718) 283-7593
54942P
4801 Fort Hamilton Pkwy
Brooklyn, NY 11219
(718) 853-7469
54944P
241 Willoughby St
Brooklyn, NY 11201
(718) 853-7469
Maimonides Medical Center
Caprioni, Enrico P., DPM
163554P
326 7th St
Brooklyn, NY 11215
(718) 369-7192
New York Methodist Hospital
Speaks ItalianSpanish
Carlton, Lawrence S.,
DPM
36731P
1981 Flatbush Ave
Brooklyn, NY 11234
(718) 338-8715
Brooklyn Hospital Center
(Downtown Campus)
Castillo, Dennis E., DPM
0X190P
345 Clinton Ave
Brooklyn, NY 11238
(718) 783-7300
105747P
450 Clarkson Ave
Brooklyn, NY 11203
(718) 783-7300
376722P
SUNY Downstate Med Ctr
840 Lefferts Ave
Brooklyn, NY 11203
(718) 783-7300
376724P
SUNY Downstate Med Ctr
445 Lenox Rd
Brooklyn, NY 11203
(718) 783-7300
Brooklyn Hospital Center
(Downtown Campus), Interfaith
Medical Center, Kingsbrook
Jewish Medical Center,
University Hospital of Brooklyn
Speaks Spanish
Board Certified
Male Female
Wheelchair Accessible
)
Charlot, Giznola J., DPM
358034P
HHC-Kings County Hospital
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Jacobi Medical Center, Kings
County Hospital Center, North
Central Bronx Hospital
Cheng, Tung W., DPM
36670P
299 Livingston St
Brooklyn, NY 11217
(718) 624-2150
Speaks Chinese
Chopra, Jaideep, DPM
283717P
Medical Office
462 Ocean Pkwy
Brooklyn, NY 11218
(718) 856-6010
284749P
1324 Bergen St
Brooklyn, NY 11213
(718) 774-5224
362592P
710 Parkside Ave
Brooklyn, NY 11226
(718) 270-2045
363451P
University Phys of Bklyn
450 Clarkson Ave
Brooklyn, NY 11203
(718) 270-2045
Staten Island University
Hosp-North, University
Hospital of Brooklyn
Speaks Hindi
Cicio, Gary, DPM
36673P
142 Joralemon St
Brooklyn, NY 11201
(718) 624-3003
Beth Israel Med Ctr (Kings
Hwy Division), Long Island
College Hospital, New York
Downtown Hospital (Beekman)
Cohen, Greg E., DPM
168309P
142 Joralemon St
Brooklyn, NY 11201
(718) 624-3003
Cabrini Medical Center, Long
Island College Hospital
Cohen, Richard B., DPM
36732P
1331 E 16th St
Brooklyn, NY 11230
(718) 375-3400
Brooklyn Hospital Center
(Downtown Campus)
D'Amato, Theodore A.,
DPM
369717P
9731 4th Ave
Brooklyn, NY 11209
(718) 745-3177
Staten Island University
Hosp-North, Victory Memorial
Hospital
D'Angelo, Nicholas A.,
DPM
M1613P
6511 20th Ave
Brooklyn, NY 11204
(718) 837-7300
New York Methodist Hospital
Speaks Italian
Dacher, Jeffrey, DPM
36847P
3901 Nostrand Ave
Brooklyn, NY 11235
(718) 648-9104
Woodhull Medical & Mental
Health Ctr
Speaks Yiddish
Daniel, Lawrence B.,
DPM
10292P
2832 Linden Blvd
Brooklyn, NY 11208
(718) 240-2000
58558P
Lawrence B. Daniel, DPM
1576 E 66th St
Brooklyn, NY 11234
(718) 241-3803
Brooklyn Hospital Center
(Downtown Campus),
Montefiore Med Ctr (Henry &
Lucy Moses Div), Montefiore
Med Ctr (Jack D Weiler Hosp
of A Einst)
DeMeo, James R., DPM
169482P
1545 Atlantic Ave
Brooklyn, NY 11213
(718) 613-4856
Cabrini Medical Center,
Interfaith Medical Center,
Mount Vernon Hospital, SJRH -
St Johns Division
DeSantos, Pasquale, DPM
371165P
HHC-Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital
Speaks ItalianSpanish
Dennis, Lester N., DPM
50225P
746 Manhattan Ave
Brooklyn, NY 11222
(718) 389-4404
Catholic Medical Center (NY),
New York Flushing Hospital &
Medical Center, New York
Hospital Medical Center of
Queens, St Joseph's Hospital
Division, CMC, United
Hospital Medical Center (NY),
Wyckoff Heights Medical
Center
Dharia, Sumit S., DPM
349314P
552 Saint Marks Ave
Brooklyn, NY 11238
(516) 359-3339
Speaks Gujarati
Dixit, Chaitanya V., DPM
229092P
NY Medical Associates
98 Avenue U
Brooklyn, NY 11223
(718) 372-0500
39505P
1700 Flatbush Ave
Brooklyn, NY 11210
(718) 692-1120
M1245P
2235 W 9th St
Brooklyn, NY 11223
(718) 372-0400
Jamaica Hospital, New York
Methodist Hospital, Our Lady
of Mercy Medical Center
Speaks SpanishHindiItalian
Donovan, Glenn J., DPM
348058P
HHC-Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital
Dorazi, Stephen T., DPM
144643P
374 Stockholm St
Brooklyn, NY 11237
(718) 963-7233
Franklin Hospital, New York
Hospital Medical Center of
Queens, New York United
Hospital Medic, Sound Shore
Medical Center of Westchester,
Wyckoff Heights Medical
Center
Speaks Spanish
Ehrlich, Josh C., DPM
341691P
Astrocare Medical Center
1669 Bedford Ave
Brooklyn, NY 11225
(718) 467-7200
36823P
1651 Coney Island Ave
Brooklyn, NY 11230
(718) 382-2221
49886P
1535 51st St
Brooklyn, NY 11219
(718) 436-8886
Maimonides Medical Center,
Staten Island University
Hosp-North
Speaks
HebrewYiddishRussian
Einhorn, Jill L., DPM
36976P
2616 Avenue U
Brooklyn, NY 11229
(718) 891-2706
Beth Israel Med Ctr (Kings
Hwy Division), Maimonides
Medical Center
Fagen, Leonard, DPM
36474P
1390 Pennsylvania Ave
Brooklyn, NY 11239
(718) 642-2088
Brookdale Hospital Medical
Center
Speaks Spanish
Falcone, Jeffrey J., DPM
168454P
8012 3rd Ave
Brooklyn, NY 11209
(718) 745-5600
New York Methodist Hospital
Ficke, Henry, DPM
177873P
2875 W 8th St
Brooklyn, NY 11224
(718) 266-3131
288626P
444 Avenue X, Ste 1E
Brooklyn, NY 11223
(718) 375-1616
288630P
2015 Bath Ave
Brooklyn, NY 11214
(718) 375-1616
Long Beach Memorial Hospital
Speaks
GermanItalianSpanish
Friedlander, Bruce W.,
DPM
229664P
567 9th St
Brooklyn, NY 11215
(718) 840-0220
Long Island College Hospital
Speaks SpanishFrench
Ganjian, Afshin, DPM
37177P
146 Sheridan Ave
Brooklyn, NY 11208
(718) 235-6100
Coney Island Hospital, St
Joseph's Hospital Division,
CMC
Speaks
PersianSpanishRussianItalia
n
Garofalo, Alfred A.,
DPM
226023P
Woodhull Med & Ment HC
760 Broadway
Brooklyn, NY 11206
(718) 388-5889
Bellevue Hospital Center,
Gouverneur Hospital, Woodhull
Medical & Mental Health Ctr
Gaudino, Salvatore C.,
DPM
114762P
Boro Medical, PC
540 Atlantic Ave
Brooklyn, NY 11217
(718) 855-4900
37094P
Bensonhurst Fam. Foot Ctr
7819 18th Ave
Brooklyn, NY 11214
(718) 234-7054
51018P
Bensonhurst Family Foot
420 74th St
Brooklyn, NY 11209
(718) 836-1017
Mount Sinai Medical Center,
Parkway Hospital, Queens
Hospital Center
Geiger, Arthur, DPM
52948P
Kings County Hospital Ctr
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Kings County Hospital Center
George, Thomas, DPM
197909P
888 Fountain Ave
Brooklyn, NY 11208
(718) 235-0574
Hempstead General Hospital
Med Ctr., New York
Westchester Square Medical
Center
Gertsik, Vladimir V., DPM
193957P
Gertsik Podiatry< PC
415 Ocean View Ave
Brooklyn, NY 11235
(718) 934-4842
New York Methodist Hospital
Speaks Russian
Giammarino, Philip A.,
DPM
149919P
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
199181P
HHC-Sheepshead Bay Ctr
3121 Ocean Ave
Brooklyn, NY 11235
(718) 646-9190
36584P
8607 21st Ave
Brooklyn, NY 11214
(718) 266-1986
Coney Island Hospital,
Lutheran Medical Center
Speaks SpanishItalian
Glockenberg, Aaron,
DPM
36620P
Kings County Hospital Ctr
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Kings County Hospital Center,
Lincoln Medical & Mental
Health Center, Our Lady of
Mercy Medical Center, St
Barnabas Hospital, Union
Hospital of the Bronx (closed)
Speaks PolishHebrew
Board Certified
Male Female
Wheelchair Accessible
Goldman, Gershon A.,
DPM
372901P
Fayn Medical PC
1517 Voorhies Ave
Brooklyn, NY 11235
(718) 648-2491
Forest Hills Hospital, Parkway
Hospital
Speaks
HebrewFrenchYiddishSpanis
h
Goldstein, Israel, DPM
169498P
Ezra Medical Center
571 McDonald Ave
Brooklyn, NY 11218
(718) 686-7600
228018P
468 Ocean Pkwy
Brooklyn, NY 11218
(718) 693-0578
Speaks
YiddishRussianRomanianHe
brew
Gonzalez, Ivan, DPM
137870P
East New York D & TC
2094 Pitkin Ave
Brooklyn, NY 11207
(718) 240-0400
Brooklyn Hospital Center
(Downtown Campus), Kings
County Hospital Center, St
Joseph's Hospital Division,
CMC, University Hospital of
Brooklyn
Speaks
SpanishFrenchPortugueseIt
alian
Goodman, Warren J., DPM
213648P
Kings Highway Podiatry
380 Avenue U
Brooklyn, NY 11223
(718) 376-3077
Victory Memorial Hospital
Speaks FrenchSpanish
Greenbaum, Bruce R.,
DPM
P0058P
3000 Ocean Pkwy
Brooklyn, NY 11235
(718) 265-2600
Staten Island University
Hosp-North, Staten Island
University Hosp-South
Guberman, Ronald M.,
DPM
144825P
Wound Healing & Hyperbar
374 Stockholm St
Brooklyn, NY 11237
(718) 381-8402
FLUSHING HOSPITAL
MEDICAL CENTER, Franklin
Hospital, Jackson Heights
Hospital Division (closed),
Sound Shore Medical Center of
Westchester, Wyckoff Heights
Medical Center
Speaks Spanish
Gventer, Mark, DPM
49889P
434 3rd St
Brooklyn, NY 11215
(718) 499-7583
New York Community Hospital
of Brooklyn
Speaks RussianSpanish
Habib, Henry, DPM
44484P
8000 4th Ave
Brooklyn, NY 11209
(718) 833-8136
SVCMC-St Vincents Manhattan
Speaks ItalianArabic
Heller, David P., DPM
36550P
843 Utica Ave
Brooklyn, NY 11203
(718) 345-8923
49818P
2124 Knapp St
Brooklyn, NY 11229
(718) 743-4121
Interfaith Medical Center
Herman, Craig P., DPM
363912P
94-98 Manhattan Avenue
Brooklyn, NY 11206
(718) 388-0390
New York Westchester Square
Medical Center, Our Lady of
Mercy Medical Center
Speaks Spanish
Horowitz, Mitchell L.,
DPM
123582P
Quality Health Center Inc
138 Division Ave
Brooklyn, NY 11211
(718) 387-2408
Ivanovs, Ray, DPM
226092P
Woodhull Med & Ment HC
760 Broadway
Brooklyn, NY 11206
(718) 388-5889
Woodhull Medical & Mental
Health Ctr
Jarbath, John A., DPM
155825P
2051 Flatbush Ave
Brooklyn, NY 11234
(718) 677-1000
Forest Hills Hospital, New York
Hospital Medical Center of
Queens, Parkway Hospital,
Peninsula Hospital Center
Speaks FrenchCreoles and
pidgins, French-based
(Other)
Jusma, Francoise D., DPM
221129P
Cumberland D & T Ctr
100 N Portland Ave
Brooklyn, NY 11205
(718) 260-7500
221130P
Woodhull Med & Ment HC
760 Broadway
Brooklyn, NY 11206
(718) 388-5889
M4204P
100 Parkside Ave
Brooklyn, NY 11226
(718) 940-5288
Brooklyn Hospital Center
(Downtown Campus), Woodhull
Medical & Mental Health Ctr
Speaks FrenchCreoles and
pidgins, French-based
(Other)
Kaiser, Craig A., DPM
361854P
1220 Avenue P
Brooklyn, NY 11229
(718) 376-1004
361888P
19-02 86th St
Brooklyn, NY 11214
(718) 621-9400
361892P
9708 Seaview Ave
Brooklyn, NY 11236
(718) 444-0520
37134P
465 Ocean Pkwy
Brooklyn, NY 11218
(718) 941-3796
Maimonides Medical Center,
New York Methodist Hospital
Kapadwala, Imtiyaz I.,
DPM
37207P
220 A. Saint Nicholas Ave
Brooklyn, NY 11237
(718) 418-8540
50700P
2848 Church Ave
Brooklyn, NY 11226
(718) 703-3000
Kingsbrook Jewish Medical
Center, Wyckoff Heights
Medical Center
Speaks UrduHindi
Katz, Alex S., DPM
291819P
2797 Ocean Pkwy
Brooklyn, NY 11235
(718) 615-4444
New York Community Hospital
of Brooklyn
Speaks
RussianHebrewSpanish
Katzman, Barry, DPM
M0791P
233 Nostrand Ave
Brooklyn, NY 11205
(718) 826-5900
New York Flushing Hospital &
Medical Center, New York
Hospital Medical Center of
Queens, Parkway Hospital
Speaks Spanish
Knobel, Jeffrey, DPM
M4199P
1636 E 14th St
Brooklyn, NY 11229
(718) 336-1800
M4200P
662 Bedford Ave
Brooklyn, NY 11211
(718) 336-1800
Beth Israel Medical Center
(Petrie Campus), Brookdale
Hospital Medical Center,
Jamaica Hospital
Speaks RussianYiddish
Lafferty, William A., DPM
355861P
858 Schenectady Ave
Brooklyn, NY 11203
(718) 604-5574
SVCMC-St Vincents Staten
Island, Staten Island University
Hosp-North
Lepore, Frank L., DPM
194379P
349 Henry St
Brooklyn, NY 11201
(718) 780-8104
Catholic Medical Center (NY),
Long Island College Hospital,
Wyckoff Heights Medical
Center
Speaks ItalianSpanish
Levitz, Steven J., DPM
371880P
3010 Avenue L
Brooklyn, NY 11210
(718) 258-1820
Brooklyn Hospital Center
(Downtown Campus), Wyckoff
Heights Medical Center
Levy, Brian K., DPM
109695P
1390 Pennsylvania Ave
Brooklyn, NY 11239
(718) 642-2088
Brookdale Hospital Medical
Center, Kingsbrook Jewish
Medical Center
Speaks Spanish
Liswood, Paul J., DPM
37131P
Comprehensive Podiatry Sv
7212 4th Ave
Brooklyn, NY 11209
(718) 745-0256
53864P
506 6th St
Brooklyn, NY 11215
(718) 780-5850
Lutheran Medical Center, New
York Methodist Hospital
Speaks RussianSpanish
Losyev, Sergey, DPM
173305P
2005 Ocean Ave
Brooklyn, NY 11230
(718) 645-4324
Lutheran Medical Center
Speaks Russian
Lucido, Jeffrey V., DPM
36833P
441 77th St
Brooklyn, NY 11209
(718) 745-3800
54176P
150 55th St
Brooklyn, NY 11220
(718) 630-7095
Doctors Hosp. of Staten Island,
Lutheran Medical Center
Speaks ItalianSpanish
Mahgerefteh, David, DPM
349781P
4405 16th Ave
Brooklyn, NY 11204
(718) 633-8662
Parkway Hospital
Speaks Yiddish
Makower, Bryan L., DPM
100861P
Downstate Foot &Ankle Pod
121 Dekalb Ave
Brooklyn, NY 11201
(718) 250-8753
101467P
176 Fenimore St
Brooklyn, NY 11225
(718) 940-0400
36786P
100 Parkside Ave
Brooklyn, NY 11226
(718) 768-1906
54693P
Downstate Foot & Ankle Po
322 Linden Blvd
Brooklyn, NY 11226
(718) 768-1906
Brooklyn Hospital Center
(Downtown Campus), New
York Methodist Hospital
Speaks SpanishFrench
Mandato, Mark, DPM
298290P
HHC-Kings County Hospital
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Kings County Hospital Center,
Metropolitan Hospital Center
Mantzoukas, Argirios,
DPM
221092P
HHC-Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital
Speaks Greek, Modern
(1453-)
Marcelonis, Debra A.,
DPM
173195P
465 New Lots Ave
Brooklyn, NY 11207
(718) 240-8900
Jamaica Hospital
Board Certified
Male Female
Wheelchair Accessible
PODIATRY (Continued)
Marville, Jillion, MD
49868P
353 Empire Blvd
Brooklyn, NY 11225
(718) 221-9244
Matthews, Frederick, DPM
302146P
Frederick Matthew DPM
1641 Bergen St
Brooklyn, NY 11213
(718) 778-2938
Interfaith Medical Center
Speaks Spanish
Mckay, Douglas J., DPM
54837P
1704 Mermaid Ave
Brooklyn, NY 11224
(718) 265-0900
Staten Island University
Hosp-North
Meliso, Vincent D., DPM
212393P
1029 Manhattan Ave
Brooklyn, NY 11222
(718) 383-3377
37004P
Lorimer Foot Care
411 Graham Ave
Brooklyn, NY 11211
(718) 383-2518
New York Methodist Hospital
Speaks Italian
Meller, Edward P., DPM
112287P
Ambulatory Care Clinic
1 Brookdale Plz
Brooklyn, NY 11212
(718) 240-5045
112288P
Urban Strategies
1873 Eastern Pkwy
Brooklyn, NY 11233
(718) 240-8700
Jamaica Hospital, St Joseph's
Hospital Division, CMC
Meshnick, Joel A., DPM
105804P
Kings Country Medical Doc
2705 Mermaid Ave
Brooklyn, NY 11224
(718) 265-2222
191516P
2876 W 27th St
Brooklyn, NY 11224
(718) 265-2222
57875P
ODA Primary Health Care
14-16 Heyward St
Brooklyn, NY 11211
(718) 260-4600
Lutheran Medical Center,
Staten Island University
Hosp-North
Micallef, Joseph, DPM
106156P
1095 Flatbush Ave
Brooklyn, NY 11226
(718) 240-8800
Brookdale Hospital Medical
Center, Forest Hills Hospital,
Jamaica Hospital, New York
Hospital Medical Center of
Queens
Mollica, Peter W., DPM
36634P
8223 14th Ave
Brooklyn, NY 11228
(718) 875-9357
36635P
410 Clinton St
Brooklyn, NY 11231
(718) 875-9357
36636P
585 Schenectady Ave
Brooklyn, NY 11203
(718) 604-5481
Interfaith Medical Center,
Kingsbrook Jewish Medical
Center, New York Methodist
Hospital
Speaks Italian
Mollica, Raymond J.,
DPM
36621P
8223 14th Ave
Brooklyn, NY 11228
(718) 236-2871
50026P
Raymond J Mollica, MD
410 Clinton St
Brooklyn, NY 11231
(718) 875-1105
Catholic Medical Center (NY),
Kingsbrook Jewish Medical
Center, Lutheran Medical
Center, New York Methodist
Hospital
Montalvo, Luis, DPM
37021P
7523 Fort Hamilton Pkwy
Brooklyn, NY 11228
(718) 745-7266
Lutheran Medical Center,
Wyckoff Heights Medical
Center
Speaks Spanish
Morreale, Edward, DPM
0X185P
736 Ocean Pkwy
Brooklyn, NY 11230
(718) 437-9343
SVCMC-St Vincents Manhattan
Speaks ItalianSpanish
Naik, Hetal B., DPM
113873P
Lafayette Med Office PC
468 Lafayette Ave
Brooklyn, NY 11205
(718) 399-6234
145498P
1417 Foster Ave
Brooklyn, NY 11230
(718) 421-6300
37256P
121 Dekalb Ave
Brooklyn, NY 11201
(718) 250-8753
Brooklyn Hospital Center
(Downtown Campus), Lutheran
Medical Center, Maimonides
Medical Center
Speaks
HindiGujaratiSpanishUrdu
Nekritin, Vadim, DPM
294087P
2306 Avenue U
Brooklyn, NY 11229
(718) 769-8210
St John's Episcopal Hospital
Speaks Russian
Newmark, Alan J., DPM
36637P
34 Plaza St E
Brooklyn, NY 11238
(718) 857-9004
54470P
372 Kingston Ave
Brooklyn, NY 11213
(718) 604-0675
Brooklyn Hospital Center
(Downtown Campus)
Speaks
SpanishHebrewFrench
Novofastovsky, Raisa, DPM
214483P
1812 Quentin Rd
Brooklyn, NY 11229
(718) 382-1773
37025P
3066 Brighton 6
Brooklyn, NY 11235
(718) 382-1773
37026P
8622 Bay Pkwy
Brooklyn, NY 11214
(718) 333-2121
51725P
All Medical Care L.L.P.
8622 Bay Pkwy
Brooklyn, NY 11214
(718) 333-2121
Lutheran Medical Center, New
York Community Hospital of
Brooklyn
Speaks Russian
Odinsky, Michael E.,
DPM
P0019P
200 Montague St
Brooklyn, NY 11201
(718) 422-8000
P0019P
546 Eastern Pkwy
Brooklyn, NY 11225
(718) 604-4800
Oliva, Imelda A., DPM
139001P
Kings County Hospital Ctr
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Kings County Hospital Center,
Metropolitan Hospital Center,
Morrisania Hospital
Speaks TagalogSpanish
Orlando, Anthony, DPM
371187P
HHC-Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital, Forest
Hills Hospital, Lutheran
Medical Center, North Shore
University Hospital
Owusu, Stephen E., DPM
208624P
434 Rockaway Ave
Brooklyn, NY 11212
(718) 346-2628
37081P
Mount Zion Podiatry,PC
106 Pennsylvania Ave
Brooklyn, NY 11207
(718) 385-2085
Jamaica Hospital, St Joseph's
Hospital Division, CMC
Pace, George N., DPM
373411P
Manhattan Footcare
133 Smith St
Brooklyn, NY 11201
(718) 330-1117
Cabrini Medical Center, Long
Island College Hospital, New
York Downtown Hospital, New
York Downtown Hospital
(Beekman)
Speaks Spanish
Pace, John F., DPM
45625P
John F. Pace, MD
398 Court St
Brooklyn, NY 11231
(718) 834-0909
Long Island College Hospital,
SVCMC-Bayley Seton
Papa, Philip M., DPM
141176P
Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital
Passik, Arthur L., DPM
45847P
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
Coney Island Hospital,
Massapequa General Hospital,
Plainview Hospital, Syosset
Hospital
Speaks SpanishItalianGreek,
Modern (1453-)
Pawson, John F., DPM
134403P
9229 Flatlands Ave
Brooklyn, NY 11236
(718) 257-1444
202015P
Bay Park Medical, PC
6403 18th Ave
Brooklyn, NY 11204
(718) 621-0800
New York Community Hospital
of Brooklyn
Speaks
SpanishRussianChineseHeb
rew
Pecora, Maria, DPM
40587P
3245 Nostrand Ave
Brooklyn, NY 11229
(718) 615-3777
Forest Hills Hospital, Jamaica
Hospital, New York Hospital
Medical Center of Queens, St
Joseph's Hospital, St Joseph's
Hospital Division, CMC
Speaks Spanish
Pedro, Helder F., DPM
339019P
Family Physician FHC
5616 6th Ave
Brooklyn, NY 11220
(718) 439-5440
339024P
Caribbean American FHC
3414 Church Ave
Brooklyn, NY 11203
(718) 940-9425
54244P
Sunset Park Family Health
150 55th St
Brooklyn, NY 11220
(718) 630-7208
Long Island Jewish Medical
Center, Lutheran Medical
Center
Perez, Walter H., DPM
114659P
Advanced Walkin Foot CAre
2146 Beverley Rd
Brooklyn, NY 11226
(718) 675-1100
216489P
2919 Avenue T
Brooklyn, NY 11229
(718) 336-4390
38123P
Advanced WalkIn Foot Care
1214 Coney Island Ave
Brooklyn, NY 11230
(718) 677-7700
Brooklyn Hospital Center
(Downtown Campus), Interfaith
Medical Center, Jamaica
Hospital
Speaks
SpanishRussianTurkish
Pierre, Nadja M., DPM
225911P
Woodhull Med & Ment HC
760 Broadway
Brooklyn, NY 11206
(718) 388-5889
Brooklyn Hospital Center
(Downtown Campus), Woodhull
Medical & Mental Health Ctr
Speaks French
Pierre, Nedjie, DPM
145469P
552 Saint Marks Ave
Brooklyn, NY 11238
(718) 398-8700
37250P
3400 Snyder Ave
Brooklyn, NY 11203
(718) 693-4060
37251P
The Brooklyn Hospital Cen
121 Dekalb Ave
Brooklyn, NY 11201
(718) 488-3708
Brooklyn Hospital Center
(Downtown Campus)
Speaks FrenchCreoles and
pidgins, French-based
(Other)
Prince, Steven L., DPM
125224P
JHMC DTC - East New York
3080 Atlantic Ave
Brooklyn, NY 11208
(718) 647-0240
Jamaica Hospital, V A Hospital
- St. Albans
Rabiei, Payman, DPM
214667P
Metropolitan Foot Care PC
94-13 Flatlands Ave
Brooklyn, NY 11236
(718) 649-6464
58033P
Metropolitan Foot Care PC
3309 Church Ave
Brooklyn, NY 11203
(718) 209-0013
Kingsbrook Jewish Medical
Center, Long Island Jewish
Medical Center, Parkway
Hospital
Speaks HebrewPersian
Radler, Bruce L., DPM
36518P
6416 17th Ave
Brooklyn, NY 11204
(718) 236-2821
Staten Island University
Hosp-North
Raskin, Simon, DPM
377535P
Simon Raskin, DPM, P.C.
1409 Gravesend Neck Rd
Brooklyn, NY 11229
(718) 332-7771
Reifer, Howard J., DPM
152842P
1670 E 17th St
Brooklyn, NY 11229
(718) 382-9200
174814P
2433 86th St
Brooklyn, NY 11214
(917) 974-8726
174816P
3059 Brighton 13Th St
Brooklyn, NY 11235
(917) 974-8726
198147P
Quentin Medical, PC
280 Quentin Rd
Brooklyn, NY 11223
(718) 336-4499
217778P
157 York St
Brooklyn, NY 11201
(718) 222-0333
Brooklyn Hospital Center
(Downtown Campus), Kings
County Hospital Center
Speaks Spanish
Romano, Constance A.,
DPM
36902P
386 Graham Ave
Brooklyn, NY 11211
(718) 389-9870
Cabrini Medical Center,
Interfaith Medical Center
Speaks Italian
Rosen, Alan J., DPM
36933P
5402 Flatlands Ave
Brooklyn, NY 11234
(718) 444-3338
Brookdale Hospital Medical
Center
Saadvandi, Terence M.,
DPM
349531P
Physicare Multi Services
150 55th St
Brooklyn, NY 11220
(718) 253-3900
349532P
Nostrand Community Medica
220 13th St
Brooklyn, NY 11215
(718) 769-4988
349533P
Brighton Community Medica
9000 Shore Rd
Brooklyn, NY 11209
(718) 646-5500
Lutheran Medical Center
Speaks Arabic
Sande, Hervey, DPM
52950P
Kings County Hospital Ctr
451 Clarkson Ave
Brooklyn, NY 11203
(718) 245-3325
Kings County Hospital Center
Scheiner, David M., DPM
208600P
Good Health Medical, P.C.
3019 Brighton 1St St
Brooklyn, NY 11235
(718) 743-9700
Brunswick Hospital Center Inc,
South Nassau Comm. Hospital,
South Nassau Communities
Hosp., South Nassau
Communities Hospital,
Winthrop University Hospital
Speaks RussianSpanish
Schikman, Lana, DPM
359328P
Kingsbrook Jewish Med Ctr
585 Schenectady Ave
Brooklyn, NY 11203
(718) 604-5388
Kingsbrook Jewish Medical
Center
Speaks Russian
Schneidermesser, Susan
G., DPM
37048P
18 Prospect Park W
Brooklyn, NY 11215
(718) 398-7593
37049P
894 Eastern Pkwy
Brooklyn, NY 11213
(718) 778-7311
Kingsbrook Jewish Medical
Center
Speaks Spanish
Shapiro, Eugene, DPM
36841P
301 Ocean View Ave
Brooklyn, NY 11235
(718) 332-2582
New York Community Hospital
of Brooklyn
Speaks Russian
Shechter, David Z., DPM
49893P
3066 Brighton 6Th St
Brooklyn, NY 11235
(718) 743-0111
New York Hospital Medical
Center of Queens, St Joseph's
Hospital Division, CMC,
Wyckoff Heights Medical
Center
Shechter, Stuart B., DPM
49678P
Stuart B Shechter, MD
3066 Brighton 6Th St
Brooklyn, NY 11235
(718) 743-0111
Island Medical Center (NY)_
Sherman, Gary, DPM
M4643P
7902 Bay Pkwy
Brooklyn, NY 11214
(718) 236-7520
Maimonides Medical Center,
New York Downtown Hospital
(Beekman), SVCMC-St Vincents
Staten Island
Silberstein, Jeffrey, DPM
36639P
1367 51st St
Brooklyn, NY 11219
(718) 438-4305
Speaks YiddishSpanish
Silverstein, Alan B., DPM
36642P
1185 Dean St
Brooklyn, NY 11216
(718) 774-2740
Interfaith Medical Center
Spielfogel, William D.,
DPM
36935P
Hamilton Podiatry PC
369 93rd St
Brooklyn, NY 11209
(718) 680-6276
Columbia-Presbyterian
Medical Center
Spindler, Harlan, DPM
36541P
5412 Kings Plz
Brooklyn, NY 11234
(718) 377-1212
Peninsula Hospital Center,
Wyckoff Heights Medical
Center
Speaks
FrenchRussianSpanish
Stanimirov, Catherine,
DPM
112328P
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
137433P
Ida G Irael Comm Hlth Ctr
2201 Neptune Ave
Brooklyn, NY 11224
(718) 946-3400
Coney Island Hospital
Speaks Spanish
Steiner, Richard M., DPM
101731P
2811 Ocean Ave
Brooklyn, NY 11229
(718) 648-5609
SVCMC-St Vincents Manhattan
Stuto, Joseph C., DPM
36813P
100 Remsen St
Brooklyn, NY 11201
(718) 624-7537
Brooklyn Hospital Center
(Downtown Campus), Long
Island College Hospital, New
York Community Hospital of
Brooklyn
Tajerstein, Alan R., DPM
36951P
1335 54th St
Brooklyn, NY 11219
(718) 972-5000
Brooklyn Hospital Center
(Downtown Campus)
Speaks YiddishHebrew
Tanenbaum, Mark, DPM
36644P
1648 E 14th St
Brooklyn, NY 11229
(718) 627-0585
Tartack, Ira, DPM
187670P
Coney Island Hospital
2601 Ocean Pkwy
Brooklyn, NY 11235
(718) 616-4331
New York Community Hospital
of Brooklyn, Our Lady of Mercy
Medical Center
Speaks
ItalianSpanishRussian
Tavroff, Clifford D., DPM
P0038P
233 Nostrand Ave
Brooklyn, NY 11205
(718) 826-5900
Trepal, Michael J., DPM
183218P
115 Henry St
Brooklyn, NY 11201
(718) 624-8022
Long Island College Hospital,
Metropolitan Hospital Center,
New York Downtown Hospital
(Beekman), SVCMC-St Vincents
Manhattan
Trivlis, Maryann Z., DPM
216717P
248 Avenue P
Brooklyn, NY 11204
(718) 945-0770
Brooklyn Hospital Center
(Downtown Campus)
Speaks Greek, Modern
(1453-)
Unger, Leslie M., DPM
36470P
1405 46th St
Brooklyn, NY 11219
(718) 438-8717
49514P
Lesie M Unger, MD
2315 Mermaid Ave
Brooklyn, NY 11224
(718) 373-1820
Maimonides Medical Center
Speaks SpanishYiddish
Vader, Bonnie, DPM
36966P
621 Amboy St
Brooklyn, NY 11212
(718) 345-2935
Brookdale Hospital Medical
Center, Forest Hills Hospital
Speaks Spanish
Waiss, Samuel M., DPM
351219P
2223 Coney Island Ave
Brooklyn, NY 11223
(718) 375-6096
New York Community Hospital
of Brooklyn
Speaks HebrewYiddish
Board Certified
Male Female
Wheelchair Accessible
PODIATRY (Continued)
Wallach, Jacob B., DPM
15739P
2108 Avenue P
Brooklyn, NY 11229
(718) 951-6399
Maimonides Medical Center
Woltman, Robert T., DPM
205506P
Lyudmila Cavalier Physici
9014 Flatlands Ave
Brooklyn, NY 11236
(718) 209-5353
Long Island Jewish Medical
Center, New York Westchester
Square Me, Peninsula Hospital
Center
Zonenashvili, Merabi,
DPM
293458P
201 Kings Hwy
Brooklyn, NY 11223
(718) 621-1811
Staten Island University
Hosp-North
Speaks
RussianGeorgianSpanish
Zwiebel, Neil S., DPM
363102P
420 Fulton St
Brooklyn, NY 11201
(718) 797-3668
Cabrini Medical Center, Long
Island College Hospital
Kings
PODIATRY
Abeles, Jay, DPM
36958P
4136 Hicksville Rd
Bethpage, NY 11714
(516) 796-2900
Massapequa General Hospital,
New Island Hospital, Syosset
Hospital
Abrahamson, Hal, DPM
54152P
100 Manetto Hill Rd
Plainview, NY 11803
(516) 822-9595
Catholic Medical Center (NY),
Forest Hills Hospital
Speaks Hebrew
Alongi, Maryanne, DPM
36724P
226 7th St
Garden City, NY 11530
(516) 248-9680
Franklin Hospital ,
Massapequa General Hospital,
New Island Hospital
Amato, Richard, DPM
343044P
R.A. Podiatry, P.C.
2116 Merrick Ave
Merrick, NY 11566
(516) 378-9191
New Island Hospital
Axman, Wayne R., DPM
179959P
70 Maple Ave
Rockville Centre, NY 11570
(516) 536-3336
182388P
1420 Broadway
Hewlett, NY 11557
(516) 374-8600
Long Beach Memorial
Hospital, Long Island Jewish
Medical Center, Mount Sinai
Hospital, Mount Sinai of
Queens, New York Hospital
Medical, South Nassau
Communities Hospital
Speaks SpanishGreek,
Modern (1453-)
Bagner, Jerome E., DPM
36499P
30 Hempstead Ave
Rockville Centre, NY 11570
(516) 764-6800
49647P
165 N Village Ave
Rockville Centre, NY 11570
(516) 746-6800
New Island Hospital
Speaks
YiddishItalianJapaneseSpani
sh
Balboa, Henry M., DPM
36506P
100 Manetto Hill Rd
Plainview, NY 11803
(516) 822-9595
Forest Hills Hospital, New
Island Hospital, Syosset
Hospital
Barbaro, Thomas, DPM
36883P
706 Jericho Tpke
New Hyde Park, NY 11040
(516) 326-7979
Long Island Jewish Medical
Center, North Shore University
Hospital
Speaks Italian
Barkoff, Matthew W.,
DPM
36920P
2900 Hempstead Tpke
Levittown, NY 11756
(516) 579-2800
Glen Cove Hospital, New
Island Hospital, North Shore
University Hospital, Plainview
Hospital, Syosset Hospital
Speaks Spanish
Becker, Jack S., DPM
36551P
178 E Rockaway Rd
Hewlett, NY 11557
(516) 596-1700
49835P
Jack S Becker, MD
3000 Hempstead Tpke
Levittown, NY 11756
(516) 579-1700
Franklin Hospital, Franklin
Hospital , Nassau University
Medical Center, South Nassau
Communities Hosp., South
Nassau Communities Hospital
Bendeth, Marc L., DPM
36520P
1226 W Broadway
Hewlett, NY 11557
(516) 374-4444
Berlin, Kim, DPM
36650P
830 Atlantic Ave
Baldwin, NY 11510
(516) 623-4580
Long Beach Memorial
Hospital, South Nassau
Communities Hospital
Speaks Spanish
Biller, Bob S., DPM
M1057P
756 E Park Ave
Long Beach, NY 11561
(516) 432-7470
LONG BEACH MEMORIAL
MEDICAL CENTER, SAINT
JOHNS EPISCOPAL
HOSPITAL-SOUTH SHORE
Bilotti, Mary A., DPM
169106P
Long Island Podiatry Grp
2001 Marcus Ave
New Hyde Park, NY 11042
(516) 327-0074
M0911P
Long Island Podiatry Grp
375 N Central Ave
Valley Stream, NY 11580
(516) 825-4070
Franklin Hospital , Long Island
Jewish Medical Center
Speaks Spanish
Breitman, Debra, DPM
36886P
250 Broadway
Lawrence, NY 11559
(516) 239-4700
Peninsula Hospital Center, St
John's Episcopal Hospital, St
John's Episcopal Hospital -
Far Rockaway
Speaks Spanish
Bubbers, Linda A., DPM
36627P
Sunrise Foot Care
4880 Sunrise Highway
Massapequa Park, NY 11762
(516) 795-6255
Syosset Hospital
Speaks Spanish
Buenahora, Joseph A.,
DPM
M2238P
477 Newbridge Rd
East Meadow, NY 11554
(516) 679-1338
Brunswick General Hospital,
Brunswick Hospital Center Inc,
New Island Hospital, Plainview
Hospital, Syosset Hospital,
Wyckoff Heights Medical
Center
Speaks SpanishYiddish
Burzotta, John L., DPM
36762P
2419 Jericho Tpke
Garden City Park, NY 11040
(516) 294-9540
50161P
Pro Health Care
2800 Marcus Ave
Garden City Park, NY 11042
(516) 622-6040
Long Island Jewish Medical
Center, North Shore University
Hospital
Speaks Italian
Caimano, Francis X.,
DPM
300372P
Francis X Caimano
495 S Broadway
Hicksville, NY 11801
(914) 555-1212
P0014P
350 S Broadway
Hicksville, NY 11801
(516) 938-0100
Syosset Hospital
Speaks Spanish
Caprioli, Russell, DPM
359698P
1999 Marcus Ave
New Hyde Park, NY 11042
(516) 555-1212
36764P
Long Island Podiatry Grp
2001 Marcus Ave
New Hyde Park, NY 11042
(516) 327-0074
Franklin Hospital, Franklin
Hospital , Long Beach
Memorial Hospital, Long
Island Jewish Medical Center
Speaks ItalianSpanish
Chernick, Stephen B.,
DPM
50872P
175 Fulton Ave
Hempstead, NY 11550
(516) 489-2261
Parkway Hospital, St John's
Episcopal Hospital - Far
Rockaway
Speaks SpanishHebrew
Cohen, Robert J., DPM
36557P
72 Covert Ave
Garden City, NY 11530
(516) 354-7222
Our Lady of Mercy Medical
Center, Parkway Hospital
Speaks French
Davies, Daniel A., DPM
36889P
6 Scranton Ave
Lynbrook, NY 11563
(516) 596-0022
Cabrini Medical Center, Good
Samaritan Hospital, Good
Samaritan Hospital (West Islip)
Speaks Italian
Davies, Gregory F., DPM
36657P
Syosset Medical Building
175 Jericho Tpke
Syosset, NY 11791
(516) 496-7676
Glen Cove Hospital, North
Shore University Hospital,
Plainview Hospital, Syosset
Hospital
Speaks Spanish
DeCicco, John J., DPM
36618P
875 Old Country Rd
Plainview, NY 11803
(516) 681-8866
New Island Hospital, Plainview
Hospital, Syosset Hospital
Speaks SpanishGreek,
Modern (1453-)Italian
Dubov, Spencer F., DPM
383227P
New Island Hospital
4295 Hempstead Tpke
Bethpage, NY 11714
(631) 858-0011
Mary Immaculate Hospital,
Massapequa General Hospital
Inc., NY Hospital Medical
Center of Queens, Plainview
Hospital
Speaks
YiddishSpanishItalian
Feldman, Gary B., DPM
36826P
5 Sunrise Plz
Valley Stream, NY 11580
(516) 825-6825
St Joseph's Hospital Division,
CMC
Fiorenza, Dominic, DPM
P0048P
350 S Broadway
Hicksville, NY 11801
(516) 938-0100
Fox, Corey, DPM
37000P
Massapequa Podiatry Assoc
4160 Merrick Rd
Massapequa, NY 11758
(516) 541-9000
Brunswick General Hospital,
Brunswick Hospital Center Inc,
New Island Hospital, Plainview
Hospital, Syosset Hospital
Speaks
SpanishTagalogItalian
Fox, Roberta A., DPM
37003P
410 Lakeville Rd
New Hyde Park, NY 11042
(516) 488-5050
Long Island Jewish Medical
Center
Fuchs, David B., DPM
36704P
855 Cynthia Dr
East Meadow, NY 11554
(516) 292-2372
New Island Hospital, Syosset
Hospital
Garofalo, Gail F., DPM
37140P
NS Podiatric Med & Surger
410 Lakeville Rd
New Hyde Park, NY 11042
(516) 326-4709
Long Island Jewish Medical
Center, St Catherine of Siena,
St Catherine of Sienna Medical
Center, Winthrop University
Hospital, Winthrop-University
Hospital
Gasparini, Mark C., DPM
337162P
119 New York Ave
Massapequa, NY 11758
(516) 804-9038
Speaks Italian
George, Thomas, DPM
141475P
1029 Bellmore Rd
North Bellmore, NY 11710
(516) 679-4636
Hempstead General Hospital
Med Ctr., New York
Westchester Square Medical
Center
Gervasio, Joseph, DPM
36653P
1000 Park Blvd
Massapequa Park, NY 11762
(516) 799-0550
36654P
156 Post Ave
Westbury, NY 11590
(516) 334-8208
Massapequa General Hospital,
Massapequa General Hospital
Inc., New Island Hospital,
Plainview Hospital, Southside
Hospital
Goez, Emilio A., DPM
51027P
Long Island Foot Care
294 W Merrick Rd
Freeport, NY 11520
(516) 378-8383
Nassau University Medical
Center, Saint Catharines
General Hospital, St Barnabas
Hospital
Speaks Spanish
Golub, Cary M., DPM
37076P
854 E Broadway
Long Beach, NY 11561
(516) 889-2200
Long Beach Medical Center,
South Nassau Communities
Hospital
Speaks Hebrew
Gottlieb, Robert J., DPM
36579P
188 W Main St
Oyster Bay, NY 11771
(516) 922-0502
Glen Cove Hospital, Good
Samaritan Hospital (West Islip)
Speaks Spanish
Greenbaum, Mitchell A.,
DPM
36924P
111 Mineola Ave
Roslyn Heights, NY 11577
(516) 484-1444
36925P
525 Woodbury Rd
Plainview, NY 11803
(516) 433-3353
Glen Cove Hospital, Long
Island Jewish Medical Center,
New Island Hospital, North
Shore University Hospital,
Plainview Hospital, Syosset
Hospital
Speaks Spanish
Greiff, Lance, DPM
36988P
29 Barstow Rd
Great Neck, NY 11021
(516) 829-1028
Brooklyn Hospital Center
(Downtown Campus), New
York Flushing Hospital &
Medical Center, Parkway
Hospital
Grossman, Myles, DPM
36831P
2174 Hewlett Ave
Merrick, NY 11566
(516) 379-2560
41745P
156 Post Ave
Westbury, NY 11590
(516) 334-8208
New Island Hospital, Plainview
Hospital
Speaks SpanishHebrew
Herbert, Scott E., DPM
284145P
49 Church St
Freeport, NY 11520
(516) 378-0184
St Catherine of Siena
Hershey, Paul E., DPM
36462P
2110 Northern Blvd
Manhasset, NY 11030
(516) 627-5775
Long Island Jewish Medical
Center, Saint Francis Hospital -
Bronx
Speaks SpanishYiddish
Herzberg, Abraham, DPM
54315P
300 Franklin Ave
Valley Stream, NY 11580
(516) 561-1617
54316P
833 Northern Blvd
Great Neck, NY 11021
(516) 622-7900
Franklin Hospital, Jamaica
Hospital
Speaks Yiddish
Hickey, John, DPM
M4002P
2870 Hempstead Tpke
Levittown, NY 11756
(516) 735-4545
New Island Hospital, Plainview
Hospital, Syosset Hospital
Honore, Lesly S., DPM
132409P
Podiatry Services of New
905 Uniondale Ave
Uniondale, NY 11553
(516) 565-5666
132410P
981 Rosedale Rd
Valley Stream, NY 11581
(516) 295-6307
Cabrini Medical Center, Mercy
Medical Center,
Winthrop-University Hospital
Speaks
SpanishFrenchCreoles and
pidgins (Other)
Horl, Lawrence, DPM
36912P
61 N Park Ave
Rockville Centre, NY 11570
(516) 766-5550
Forest Hills Hospital,
Hempstead General Hospital
Med Ctr., Mercy Medical
Center, Peninsula Hospital
Center, South Nassau
Communities Hospital, St
John's Episcopal Hospital -
Far Rockaway
Speaks Spanish
Horowitz, Mitchell L.,
DPM
M2025P
2720 Jerusalem Ave
North Bellmore, NY 11710
(516) 679-2720
Irwin, Robert A., DPM
37172P
143 Merrick Ave
Merrick, NY 11566
(516) 623-2800
NY Hospital Medical Center of
Queens, New Island Hospital,
New York Hospital Medical
Center of Queens, Syosset
Hospital
Speaks SpanishItalianGreek,
Modern (1453-)
Jackalone, John A., DPM
277559P
Podiatry Offices
4295 Hempstead Tpke
Bethpage, NY 11714
(516) 579-3500
Catholic Medical Center (NY),
Forest Hills Hospital, Long
Beach Memorial Hospital, St
Vincents Medical Center Of
New York
Speaks Spanish
Jarbath, John A., DPM
155828P
50 Hempstead Ave
Lynbrook, NY 11563
(516) 599-0302
Forest Hills Hospital, New York
Hospital Medical Center of
Queens, Parkway Hospital,
Peninsula Hospital Center
Speaks FrenchCreoles and
pidgins, French-based
(Other)
Karpe, David E., DPM
160781P
Howard Kessler & Assoc PC
200 N Village Ave
Rockville Centre, NY 11570
(516) 764-0434
Franklin Hospital, Franklin
Hospital , Peninsula Hospital
Center, South Nassau Comm.
Hospital, South Nassau
Communities Hosp.
Speaks Spanish
Kashefsky, Helene P., DPM
37071P
2201 Hempstead Tpke
East Meadow, NY 11554
(516) 572-0123
Nassau University Medical
Center
Speaks Spanish
Kasminoff, June G.,
DPM
37044P
666 Old Bethpage Rd
Old Bethpage, NY 11804
(516) 777-3668
Massapequa General Hospital,
New Island Hospital, Syosset
Hospital
Kessler, Howard N., DPM
36570P
200 N Village Ave
Rockville Centre, NY 11570
(516) 764-0434
Franklin Hospital, Franklin
Hospital , Mercy Medical
Center, Nassau University
Medical Center, South Nassau
Communities Hosp., South
Nassau Communities Hospital
Kisberg, Stephen, DPM
36519P
11 Franklin Pl
Woodmere, NY 11598
(516) 295-2121
St John's Episcopal Hospital -
Far Rockaway
Kitton, Stuart E., DPM
36573P
41 Woods Dr
Roslyn, NY 11576
(516) 626-3999
MEADOWLANDS HOSPITAL
MEDICAL CENTER, Mount
Sinai Medical Center,
SVCMC-St Vincents
Manhattan, The Mount Sinai
Hospital of Queens
Speaks Spanish
Klein, Michael S., DPM
36893P
East Norwich Podiatry
898 Oyster Bay Rd
East Norwich, NY 11732
(516) 624-2101
36894P
Oceanside Podiatry
3105 Lawson Blvd
Oceanside, NY 11572
(516) 766-8500
Glen Cove Hospital, Long
Beach Memorial Hospital,
Syosset Hospital
Klirsfeld, Jeffrey S.,
DPM
36857P
2870 Hempstead Tpke
Levittown, NY 11756
(516) 731-3300
Massapequa General Hospital,
New Island Hospital, Syosset
Hospital
Speaks Spanish
Kohn, Arlene F., DPM
37113P
Family Footcare
120 Bethpage Rd
Hicksville, NY 11801
(516) 938-6000
Mercy Medical Center, New
Island Hospital, Syosset
Hospital
Speaks Spanish
Kolberg, John J., DPM
37222P
320 Post Ave
Westbury, NY 11590
(516) 338-8802
New Island Hospital
Speaks Spanish
Koslow, Paul M., DPM
50912P
Great Neck Podiatry Asso
29 Barstow Rd
Great Neck, NY 11021
(516) 829-1028
Maimonides Medical Center,
New York Hospital Medical
Center of Queens, New York
Methodist Hospital
LaRocca, Albert, DPM
36594P
2 Raemar Ct
Bethpage, NY 11714
(516) 935-0111
New Island Hospital
Speaks ItalianGerman
Landau, Laurence D., DPM
193059P
86 George St
Roslyn Heights, NY 11577
(516) 731-1900
38312P
160 Hicksville Rd
Bethpage, NY 11714
(516) 731-1900
New Island Hospital, Plainview
Hospital
Landy, Robert J., DPM
123448P
120 Bethpage Rd
Hicksville, NY 11801
(516) 827-4500
123481P
530 Hicksville Rd
Bethpage, NY 11714
(516) 937-5000
Massapequa General Hospital,
Our Lady of Mercy Medical
Center, Parkway Hospital,
Southside Hospital, Winthrop
University Hospital
Speaks Spanish
Larsen, Joseph A., DPM
50624P
National Foot Care
2419 Jericho Tpke
Garden City Park, NY 11040
(516) 294-9540
North Shore University
Hospital
Levine, Stanley, DPM
36477P
4725 Merrick Rd
Massapequa, NY 11758
(516) 799-8545
Brunswick General Hospital,
Brunswick Hospital Center Inc,
Hempstead General Hospital
Med Ctr., Massapequa General
Hospital, New Island Hospital,
Syosset Hospital
Speaks
SpanishGermanItalian
Levitsky, David A., DPM
301933P
161 Orchard St
Plainview, NY 11803
(516) 822-9666
Board Certified
Male Female
Wheelchair Accessible
Livingston, Douglas W.,
DPM
37180P
Livingston Foot Care Spec
1685 Newbridge Rd
North Bellmore, NY 11710
(516) 826-0103
Brunswick Hospital Center Inc,
Massapequa General Hospital
Inc., Nassau University Medical
Center, New Island Hospital,
Plainview Hospital, Syosset
Hospital
Livingston, Leon B., DPM
36486P
Livingston Foot Care Spec
1685 Newbridge Rd
North Bellmore, NY 11710
(516) 826-0103
New Island Hospital, Plainview
Hospital, Syosset Hospital
Livingston, Michael D.,
DPM
37064P
Livingston Foot Care Spec
1685 Newbridge Rd
Bellmore, NY 11710
(516) 826-0103
Brunswick Hospital Center Inc,
Nassau University Medical
Center, New Island Hospital,
Plainview Hospital, Syosset
Hospital
Lynn, Brian P., DPM
108081P
Comprehensive Podiatric
2110 Northern Blvd
Manhasset, NY 11030
(516) 627-5775
355143P
Comprehensive Podiatric
935 Northern Blvd
Great Neck, NY 11021
(516) 627-5775
Long Island Jewish Medical
Center, Montefiore Med Ctr
(Henry & Lucy Moses Div)
Speaks Spanish
Mahgerefteh, David, DPM
349786P
230 Middle Neck Rd
Great Neck, NY 11021
(516) 829-2560
Parkway Hospital
Speaks Yiddish
Marchese, Nicholas A.,
DPM
359291P
1000 Park Blvd
Massapequa Park, NY 11762
(516) 799-0550
New Island Hospital, Southside
Hospital
Masani, Farhan, DPM
37069P
530 Old Country Rd
Westbury, NY 11590
(516) 334-7642
Nassau University Medical
Center, Syosset Hospital,
Wyckoff Heights Medical
Center
Speaks
SpanishFrenchHindiUrdu
McElgun, Terence M.,
DPM
36861P
520 Franklin Ave
Garden City, NY 11530
(516) 746-4732
36862P
1135 N Broadway
Massapequa, NY 11758
(516) 756-0091
380037P
N. Shore Hosp., Plainview
888 Old Country Rd
Plainview, NY 11803
(516) 796-1313
New Island Hospital, Plainview
Hospital, Syosset Hospital
Speaks SpanishItalian
Mcshane, William J., DPM
36802P
Harbor Podiatry PC
131 Main St
East Rockaway, NY 11518
(516) 593-2233
36803P
54 Main St
Hempstead, NY 11550
(516) 538-4531
Franklin Hospital, Island
Medical Center (NY)_
Meshnick, Joel A., DPM
139939P
2574 Hewlett Ln
Bellmore, NY 11710
(516) 781-5440
Lutheran Medical Center,
Staten Island University
Hosp-North
Micallef, Joseph, DPM
36900P
101st Avenue Foot Care PC
287 Northern Blvd
Great Neck, NY 11021
(516) 773-4001
Brookdale Hospital Medical
Center, Forest Hills Hospital,
Jamaica Hospital, New York
Hospital Medical Center of
Queens
Moazen, Ali, DPM
P0033P
226 Clinton St
Hempstead, NY 11550
(516) 483-2020
Speaks Persian
Montag, Richard M.,
DPM
36509P
528 Bellmore Ave
East Meadow, NY 11554
(516) 483-7386
Island Medical Center (NY)_,
Plainview Hospital, Syosset
Hospital
Speaks Spanish
Nester, Elizabeth M., DPM
37243P
3 Walnut Rd
Glen Cove, NY 11542
(516) 674-9661
37244P
Nester Podiatry Associate
267 Lincoln Blvd
Long Beach, NY 11561
(516) 889-0969
57655P
East Coast Podiatry PLLC
680 Merrick Rd
Baldwin, NY 11510
(516) 889-0969
Glen Cove Hospital, Long
Beach Medical Center
Speaks Spanish
Nester, Matthew J., DPM
211451P
Nester Poadiatry Assoc
3227 Long Beach Rd
Oceanside, NY 11572
(516) 431-1600
50871P
Nester Podiatry Asso.
3 Walnut Rd
Glen Cove, NY 11542
(516) 674-9661
Long Beach Medical Center,
Long Beach Memorial
Hospital, St John's Episcopal
Hospital, St John's Episcopal
Hospital - Far Rockaway
Speaks Spanish
Nezaria, Yehuda, DPM
37236P
7 Franklin Ave
Lynbrook, NY 11563
(516) 887-2820
49675P
2053 Bellmore Ave
Bellmore, NY 11710
(516) 887-2820
Franklin Hospital, Franklin
Hospital , Huntington Hospital
Speaks Hebrew
Odinsky, Wayne Z., DPM
P0034P
2035 Lakeville Rd
New Hyde Park, NY 11040
(718) 343-0600
New York Hospital Medical
Center of Queens, Parkway
Hospital, Rockaway Beach
Hospital (closed)
Pedro, Helder F., DPM
54241P
Helder F. Pedro, DPM
1 Willow Pl
Albertson, NY 11507
(516) 621-3721
Long Island Jewish Medical
Center, Lutheran Medical
Center
Peterson, Donald T.,
DPM
36931P
8029 Jericho Tpke
Woodbury, NY 11797
(516) 496-0900
Plainview Hospital, Syosset
Hospital
Prince, Steven L., DPM
124780P
78 Marina Rd
Island Park, NY 11558
(516) 432-1332
Jamaica Hospital, V A Hospital
- St. Albans
Purvin, Jay M., DPM
36608P
467 Merrick Ave
East Meadow, NY 11554
(516) 489-1950
New Island Hospital, Plainview
Hospital
Richardson, Hugh L., DPM
195855P
L.I. Podiatric Grp
2001 Marcus Ave
New Hyde Park, NY 11042
(516) 327-0074
195856P
L.I. Podiatric Grp
375 N Central Ave
Valley Stream, NY 11580
(516) 825-4070
363220P
1999 Marcus Ave
New Hyde Park, NY 11042
(516) 555-1212
Franklin Hospital, Franklin
Hospital , Long Island Jewish
Medical Center, Long Island
Jewish, Manhasset (closed)
Speaks Spanish
Bronx Kings Nassau

Result number: 39

Message Number 234713

Re: Jeremy...Nike Shox, Z-Coil, or Spira for PF? View Thread
Posted by larrym on 8/21/07 at 12:25

Since Z-Coils are used to treat knee, hip and back pain, as well as foot pain, the makers of the shoe have a legitimate right to call that portion of the shoe the Z-Orthotic.
..................................................

Well I would point out that the links you provide are for specific devices to address specific conditions or diagnosis. Like an afo for foot drop or a thumb spic or a lumo-sacral corset.

That being said Z Coil CAN call it anything they want to. One could say that a tomato in a sandal treats everything from the foot to the cervical spine. I have a dentist that refers to me to balance feet to treat all the way up to TMJ or un-seven bite. So ANYTHING in a shoe, since a rock, marsmallow or pine needles could be argued to affect up the chain could be called orthotic

Sperry boat shoes and alpine hiking boots also affect up the chain. Not always good or bad and they are both polar opposite of each other. It is still mass produced and part of the design of the shoe and it is a generic shape. Similar to a Nike Shox, which is a bad shoes but you could say that also can treat the foot knee hip and back.

The z-coil shoe is just another angle and design on a shoe. I dont know if thay have tried to lobby to get a code for their orthotic shoe so it can be billed under acode. Interesting way to look at it but in a purest sense I would call the piece in there an orthotic myself

Result number: 40

Message Number 234318

Re: Surgeon is recommending a brace but offers no suggestions View Thread
Posted by larrym on 8/12/07 at 19:04

I would wager tht she is not a pronator. How many cases of multiple failed peroneal issues have you seen in a pronator? As for the orhtotic controlling it with the proper shoe, if it is done correctly you can. I would also have reservations about putting an afo on a diabetic. In fact I recently had a 60 y/o male with a minor grade II post tib tendon. Someone put him in b/l braces and billed his insurance almost 2k per side. he was also diabetic and in 2 days he broke down in the medial maleolus. I got him in a proper orhtotic and a new balance 926 and he was fine and straight as can be

Result number: 41

Message Number 234254

Re: footmaxx orthotics View Thread
Posted by Jeremy L, C Ped on 8/11/07 at 08:50

Z, that's to be completely expected. Studies have shown that weight bearing casting produces devices which allow for very high patient tolerance; however, this result was shown to be at a sacrifice for long-term positive results in the care of the original pathology.

As for what's been said of the use of library orthotic shells. There are some facilities I know that possess their own libraries of molds, which are well conceived and created. I still believe that this can be an effective means of care, just so long as they are dispensed and billed under appropriate non-custom treatment codes.

Result number: 42

Message Number 233156

Re: Kelly L, Michelle and Kate / Jobs??????????????????????? View Thread
Posted by LindaW on 7/18/07 at 17:40

Thank you Kate, I just got finished writing Kelly. I am a medical secretary/biller, but I do not like doing the billing part as far as AR/denials and appeals. I love doing the insurance eligibility and working with lawyers and I really like conversing with the patients. I still do stay intouch with people from my old job and they are keeping an ear/eye open for me. I hope your thyroid checks out fine and how are your feet doing? You had said that your PF is back. My PF is back only in the left foot, but it is tolerable. As far as my TTS, that is not so tolerable. My main problem right now is my back and my hip, but one thing I am not doing is when I go on an interview, I am not telling them about any physical problems that I am having. One interview that I went on last week was for a podiatrist and he noticed me feet without me even saying anything about them. They were really swollen and hurting real bad, but I think I put on a good front. He wanted me to make an appointment right then and there and I told him right now I do not have insurance and they are fealing fine.(I lied). Well thanks again to both of you. Hearing from you and Kelly made me feel a little bit better. LindaW

Result number: 43

Message Number 232857

Re: How to decrease TTS pain View Thread
Posted by mcurnett on 7/12/07 at 06:09

Juleen,

I also had (probably still do)have TTS bilaterally. I had surgery on both feet; but can't say I've felt much improvement. To make things worse I also have PN and PF bilaterally. As far as these TENS units go; I got mine right before Christmas last year. Let's put it this way, it was the best Christmas present I ever got. I find this very interesting that these units work great on the feet; I had mine perscribed for a herniated disc and lower back pain. After reading this, I;m going to try it on my feet. I have an EMPI and it's wonderful. But the cost blew me over; they billed my insurance company $725. I couldn't believe it and they paid for all of it. Thank goodness. I'd be interested in that sock. Just wanted to share my experience with my TENS unit. You probably won't regret it. Good luck and take care.

Michelle

Result number: 44

Message Number 232852

Re: How to decrease TTS pain View Thread
Posted by Dr. Wedemeyer on 7/11/07 at 23:34

As Dr. G stated the truth is TENS units are extremely inexpensive although what an insurer is billed and what they reimburse for these little items will raise an eyebrow. :)

Result number: 45

Message Number 231096

Re: Have a job View Thread
Posted by LindaW on 6/04/07 at 18:38

Jeannine I am sorry that you went to see him. He thought that he is the best Dr. in all of this universe. I am surprised that he did not tell you that there is no such thing as Bilateral TTS, because that is what he told me and another person that post on this board. He actually thinks that his you know what does not stink. I knew it was going to be a bad experience going to see him, but I did it at that time, because work had asked me to go to him as an IME. I still think that I had the best podiatrist in the state, but unfortunately he is not seeing me anymore, because there is nothing else that he can do for me, because it is out of him comfort zone now, but I am seeing a neurologist who I think is pretty good. I do not want to have anymore surgeries and I do need to go have an MRI and another EMG done, because I am in so much pain with my foot, hip and back. I also do not want to take any time out of work, because I think that had a lot to do with me getting released from my job, even though I did have enough time legally through FMLA, but the doctor that I had worked for was/is so cheap that he thought that he knew how much time I needed to have out of work. After my last release done, he wanted me to only be out for a week. He thought that it was enough time for a sit down job and he knew that what I did was not a sit down job. I'll give you an example on how cheap he was, I was the secretary for physical therapy and had to collect the co-pays which was fine, but everytime there was a cc, I had to go over to his side of the building to do the CC. He did not want to get another line in for my side, because it cost too much money (which was baloney) and now his secretary that he has is leaving next week due to him and a part time secretary that likes to screw around with everyone elses business by being a big mouth and spreading not true rumors about people, oh and she was another reason why I was let go. She had told him lies about me and he believed her and not me. Can you tell I am bitter. Well I guess I have to let it go and go on with my life as a medical biller for one of the largest billing company in New England. I wish the best to you Jeannine and maybe you, me and the other person should get together and have a nice talk and believe you me, we all have something in common. Talk to you soon. LindaW

Result number: 46
Searching file 22

Message Number 229225

Re: Jeremy a question please... View Thread
Posted by David G.Wedemeyer, DC on 5/07/07 at 01:00

Interesting Ralph, I'm a huge fan of learning as much as possible and trying new things. If you can remember where the thread is please let me know, I'm curious what materials etc were used.

In my practice custom means plaster casted or optically casted (CNC) in STJ neutral and made for that person to alleviate dysfunction in the foot which causes clinical symptoms.

I fear too many use the term to aid in selling prefabricated and customized products. Many prefab off-the-shelf inserts are actually good quality but when someone shells out $400 and up (or when an insurance company is billed for the service) the device should be designed for the individual and the need for medical necessity must be valid.

Just my two cents

DW

Result number: 47

Message Number 227543

to DR Z View Thread
Posted by past ESWT patient on 4/12/07 at 08:57

Name calling again Dr Z? Why do you always resort to name calling when you are cornered?

I paid the dpm directly, my insurance co. does not cover ESWT and I have no idea of who billed what to who. And what's more I don't care. Your fee's, Dr Z, are over the top especially since it is evident that you are collecting both the professional and technical fees.

By the way Dr Z - the reason I know about ultrasound or any other technology is simply none of your business.

Result number: 48

Message Number 227538

to Dr Z View Thread
Posted by past ESWT patient on 4/12/07 at 07:54

Name calling again Dr Z? Why do you always resort to name calling when you are cornered?

I paid the dpm directly, my insurance co. does not cover ESWT and I have no idea of who billed what to who. And what's more I don't care. Your fee's, Dr Z, are over the top especially since it is evident that you are collecting both the professional and technical fees.

By the way Dr Z - the reason I know about ultrasound or any other technology is simply none of your business.

Result number: 49

Message Number 227532

Re: Time to abandon the tendinitis "myth?" View Thread
Posted by past ESWT patient on 4/12/07 at 07:19

Name calling again Dr Z? Why do you always resort to name calling when you are cornered?

I paid the dpm directly, my insurance co. does not cover ESWT and I have no idea of who billed what to who. And what's more I don't care. Your fee's, Dr Z, are over the top especially since it is evident that you are collecting both the professional and technical fees.

By the way Dr Z - the reason I know about ultrasound or any other technology is simply none of your business.

Result number: 50

Message Number 227514

Re: Time to abandon the tendinitis "myth?" View Thread
Posted by Dr. Z on 4/11/07 at 21:11

Everyone that calls ESWT knows the fees and what is included. You would also know that the techinical fee is also included.
You are very specific with what you want us to know and you act like a idiot when you start talking about billing.
How could you knows so much about ultrasound and not know what was told to you when you stated you called my office and asked about fees. I doubt you did or you would know the fees
How could you not know the fees that was quoted when you called my office ?. How could you not know if your insurance company was billed for the treatment and you were also billed $500 dollars.
.

Result number: 51

Message Number 227512

Re: Time to abandon the tendinitis "myth?" View Thread
Posted by past ESWT patient on 4/11/07 at 20:22

I didn't say anything about $500- I mentioned 20%- so now we know that Dr Z charges the patient $2500 and probably bills for the technical also. Since he owns the company that provides the eqiupment is this double billing?

Second treatments were not discussed.

I have no knowledge as to the bill, if any, submitted to my insurance co.

I would assume that the normal office visit fees would have been billed but I did not return to the doctors office. I had god results, called the doc and that was it.

Result number: 52

Message Number 227369

Re: 2nd ESWT vs. cryo vs. ??? View Thread
Posted by Ralph on 4/10/07 at 16:44

No need to look because that subject has already been a topic for discussion when Dr. Goldstein first came to heelspurs.

How it's billed I don't know. Whether ESWT works or not has been the topic for pages and pages of discussion on this site and so has every study that has ever been published I think more then the number of people that have ever posted they were cured by that treatment.

Even if you go back and look at the results of the people from this site that went to Canada to get the Ossatron treatment I think only one saw some results. I don't think Scott R ever boasted about himself being cured by the treatment he received in Canada and Canada has been using ESWT longer then the states. I think there were 7 or 9 people that went from heelspurs.

I think you find better results treating elbows then P.F. with ESWT.

While you are correct that we don't see every case of ESWT that is done, it makes for a good sounding argument but it works both ways for those that we don't see that were cured we also don't see those that were not.
Ralph

Result number: 53

Message Number 227348

Re: 2nd ESWT vs. cryo vs. ??? View Thread
Posted by john on 4/10/07 at 13:41

Ralph,

I am not John h.

In terms of the success of ESWT. There are several double blind, placebo controlled studies that show that ESWT works. These studies were approved by the FDA and served as the basis for the approvals for the equipment. You cannot judge ESWT, or any procedure, by the self-selected people who post a board. You need to consider a typical group of patients and compare 'treated' vs 'not treated' where no one, including the doctor, knows who have been treated.

As far as I know, there are no FDA studies showing that cryosurgery works for plantar fasciitis. None!

I trust the studies since they were carefully controlled. I do not trust podiatrists who use cryosurgery off-label and then bill an inappropriate CPT code in order to get payment.

Call me fickle, but just because a podiatrist can get paid by an insurance company to do a procedure it does not mean that the procedure works. There is a large placebo effect in treating plantar fasciitis so double blind studies are really the only way to judge the success of a procedure.

Just for fun, why don't you look into cryosurgery, see if there are any double blind, plaecbo controlled studies showing it works for plantar fasciitis. You might also look into what CPT code is being billed and ask yourself if that CPT code is really appropriate. I think that you will find that using the CPT code for plantar fasciitis is a strech.

Result number: 54

Message Number 225480

Re: Question for the Dr's and Cped's View Thread
Posted by Dr. David S. Wander on 3/19/07 at 17:00

David,

Thanks for the clarification. I was wondering how you billed for the diabetic therapeutic shoe program? With all due respect to chiropractors, I didn't know that chiropractors were one of the providers that were 'allowed' to provide and/or dispense shoes under Medicare guidelines.

Result number: 55

Message Number 225228

Re: costs View Thread
Posted by Dr. David S. Wander on 3/15/07 at 19:40

Know Them,
You are obviously intelligent, but in this case I'm not sure that you are being fair in your attack against DPM's charging a specific fee for ESWT, while they are willing to accept a significantly lesser fee for a more time consuming procedure such as an EPF, that requires time away from the office at a surgical center or hospital, in addition to post operative visits/global fees, etc.

The reason is really very simple. With the EPF, the doctor must accept the fee due to his/her participation with insurance. With ESWT the doctor can charge whatever the patient is willing to pay and hopefully whatever is within reason.

My analogy will be a plastic surgeon, with all his/her years of training, may only make a small amount of money for performing a life changing cleft palate repair surgery when it is billed to an insurance carrier. This is obviously a complicated and important surgery, that requires amazing skill, time and follow up, yet does not remunerate the surgeon greatly. This same plastic surgeon get put in a pair of silicon boobs and charge a woman $7,500 for 1.5 hours of 'work'. How does this plastic surgeon justifiy this fee? The logic is no different from the EPF/ESWT scenario. So you can't always limit your attacks to podiatry, even though it seems to be convenient.

As far as the $300 fee goes, that seems a little low, considering overhead and other factors. I fully understand that in 'your' country that fee may be outrageous, but in 'your' country the fee I pay for malpractice is probably more than the average doctor makes in at least 1-2 years of practice. So let's be realistic and understand the entire picture, not just pieces. The cost of rent, workmen's compensation insurance for my employees, liability insurance for my office in addition to all other normal overhead issues are probably costs that aren't even known in 'your' country.

So let's keep this conversation civil and realistic, and my original fee quoted earlier remains the fee I would charge in the United States, where I presently practice.

Result number: 56

Message Number 225178

Re: to Dr Z and other docs View Thread
Posted by Dr. Ed on 3/15/07 at 12:21

know them:

I am not sure which country you speak of -- I don't think you would be giving up the ship to mention it. I have done the arithmetic. Taking into account lease payments on the machine, physician and staff time, treatment supplies ( I may use analgesics including nitrous oxide), rent, insurance (prof. liability + gen. liability), marketing costs, administrative supplies (dictation/transcription/charts/telephone/letters) my break even point came to about $340 per low energy treatment allowing a profit of $60 if $400 was paid up front by cash or check. Credit cards involve a fee from 1.75 to 3%. The cost also go up if the patient does not pay up front but wants to be billed (cost of statements/collections) or make payments.

Dr. Ed

Result number: 57

Message Number 224938

Re: "insurance bandits" -- Who is "know them?" Peter R., Archie B. View Thread
Posted by Lisa on 3/11/07 at 20:18

I have not been following in on this very much, but I know for a fact that insurance plays a very big role on where things are done, and it does NOT matter if it is done at the most cost effective facility. Reimbursement is a very big issue, and if the docs are not being reumbursed for what they are doing- then why would they continue doing it in their office?
Case in point- there has been changes in Medicare payments in regards to chemotherapy adminstered in an outpatient setting. There is no question that we can and do give the drugs cheaper and easier to the patients in an office setting. However, Medicare is not reimbursing the doctors on certain drugs at even the cost of what we are paying for the medication. This is forcing the patient to go into the hospital to receive their drug, which is billed under a different set of guidelines, and adds thousands of dollars to the patients bill. More and more stuff is ending up like this, where treatments are going to a more expensive setting.

And people are forgetting, that medicine is a business- I am sorry but it is. Everyone would like to heal everyone that comes to them regardless of finaces or their abilty to pay. But in reality, the doctor has to make a profit in order to pay their bills, pay their insurance, pay their overhead, buy the drugs etc. People would be VERY VERY surprised to see the true profit margin that a physician makes, it is not as much as one thinks. This is not the 1980's where everyone could just bill free-will, and bring in tons of money.

So, it is not as simple as many think. If it was, then why are so many doctors going broke, or why are so many doctors leaving the field. I know I will take grief for this, but it does take someone who has seen it from both sides in order to get a better picture of what is really going on. I am sorry for budding in.... just my thoughts on the matter!

Result number: 58

Message Number 224707

Re: NO imaging with orthospec View Thread
Posted by Dr. David S. Wander on 3/09/07 at 07:31

Know Them,
I just read the code, and I believe I have to agree with Dr. Z's interpretation. And remember, when I do perform ESWT, I DO use the Dornier with Ultrasound.

As the code reads, I believe if you read it carefully, it is stating that when you bill for ESWT, ultrasound guidance is NOT mandatory with this code, but is billed WITH this code. Therefore, IF you perform ultrasound as a portion of the ESWT or with a separate ultrasound unit, you can NOT unbundle the ultrasound component and bill separately. Therefore, this code is an all encompassing code that includes the ESWT AND the ultrasound components IF both are performed together, but it does NOT necessarily mean that ultrasound MUST be performed for the procedure code to be billed.

Therefore, if a doctor (of ANY degree) bills this code without performing ultrasound, it would NOT be fraud.

Result number: 59

Message Number 224659

Re: orthospec vs ossatron View Thread
Posted by know them on 3/08/07 at 16:33

Why are insurance companies paying for ESWT with the Orthospec when billed with cpt code 28890? 28890 specifies that the procedure is to be performed with ultrasound imaging. Is it stupid ins co's or more dpm and equipment provider flim flam?

Result number: 60

Message Number 224658

NO imaging with orthospec View Thread
Posted by know them on 3/08/07 at 16:32

Why are insurance companies paying for ESWT with the Orthospec when billed with cpt code 28890? 28890 specifies that the procedure is to be performed with ultrasound imaging. Is it stupid ins co's or more dpm and equipment provider flim flam?

Result number: 61

Message Number 224342

Re: "1000% markup" ??? View Thread
Posted by Jeremy L on 3/06/07 at 13:28

Ralph, in a way you're not all that far off. Custom can mean a variety of things, based upon what the stated procedure is. As examples:

Custom Functional Orthotic - This is a device which is molded to a positive model of the patient's foot. More often then not, this model is modified in shape in comparison to the original cast in order to achieve an orthopedic, therapeutic element. There is no description on what materials must be used in the construction of this kind of device. So the shell can be as rigid as carbon-fiberglass or as soft as 35 durometer EVA foam. There is also not a requirement on additions to the shell. This is solely at the discretion of the practitioner, based on his/her experiences in treating a particular condition as it relates to the individual's level and type of regular activity.

Direct Molded orthotic - This is also a custom device, as material is being shaped specifically to a patient's needs. The difference here is that the shell is made by molding it directly to the patient, rather than to a model of the patient. The typical fee schedule for this kind of device is also less than for a functional orthotic, as it takes less overall time to construct. The materials are also usually less expensive, although not always so.

Full Contact Custom Orthoses - Here is something, more or less, in the middle. The Medicare script states that this is to be constructed from a patient model; however, with this being a completely accommodative device there are typically no functionally corrective elements included. That is why this is a method prescribed for insensate diabetic patients.

Long story, short ... it's up to the practitioner to determine what he/she feels is the route that will likely offer the best outcome for the patient. It would be ignorant to assume that every professional given the authority to evaluate, cast, and create custom devices practices under this kind of broad umbrella in treatment. Even with the variety I employ there are treatment options I typically don't use because in my personal experience I may have found them less than satisfactory. It all depends on the experience and exposure to varied treatment and construction options available to the practitioner. The only crime is if a treatment is being billed as custom (even undr it's variety of meanings), and the resulting device was not created under the standardized description.

Result number: 62

Message Number 223917

Re: Why insurance won't pay for spinal decompression View Thread
Posted by know them on 3/01/07 at 09:03

Lasik surgery, being elective, is almost never a covered treatment. Therefore the cost is contolled by basic economic factors. You want it- you pay the going price or the public can rebel and drive down the price. You can be sure that the lasik company lawyers have covered the companys butts in regard to their relationship with ophthamologists. $5-6k for Lasik that takes 15-20 min. is not much different that th $5-6k that insurance companies have been billed for ESWT.

Result number: 63

Message Number 223732

Why insurance won't pay for spinal decompression View Thread
Posted by Oma Z on 2/27/07 at 10:29

http://www.ucg.com/specialreport/

You need to scroll down further in the report. It says that Medicare needs to re-evaluate this. Medicare hasn't looked at it for ten years. Their claim and insurance companies that it is experiemental couldn't be further from the truth. There's been plenty of studies out since 1996 but they have not revisted it since. Insurance followed the way of Medicare and is getting quite agressive with doctors that billed insurance and demanding their money back. Maybe if they weren't paying their CEO's billions (United Health Care CEO had to step down in December as he was being investigated for his $1.42B stock options.) Insurance companies have a fudiciary responsiblity to the one paying the premiums (employer or patient) but they're more concerned about their bottom line. Don't complain to your provider because he won't take your insurance for spinal decompression. He doesn't want to be made an example of like the five providers in GA. Complain to your state legislators.

The Five VAXD providers indicted in GA billed for spinal decompression with some surgical codes. There has just been so much confusion with the coding to use. I guess it was guerilla warfare trying to get paid in the insurance racketeering. It was in 2005 that several insurance companies were made to settle with doctors for conspiring together to not pay claims and there was the Wellpoint Settlement. It's the insurance companies that are as corrupt as you can get. It's all about Deny, Delay, Defend. A former insider said that most people will just accept their tiny payment.

This was on CNN last night.

http://www.cnn.com/2007/US/02/09/insurance.hardball/index.html

http://www.scpilaw.com/2007/02/insurance_compa.html

Result number: 64

Message Number 223370

Re: DRX9000 View Thread
Posted by TAWD on 2/22/07 at 14:54

In many cases it's called "double dipping" (non legal term), but it is illegal as well.
The patient needs to report this to the insurance company.
If they are being charged cash for a service that is later billed to insurance, the patient should recieve the insurance payment NOT the provider.

Result number: 65

Message Number 223359

Re: DRX9000 and Axiom's $5,000,000 lawsuit - why?? View Thread
Posted by bc on 2/22/07 at 12:51

Dr. Khoury,

Although interesting, that news story is old news. I realize that the indictments were only recently announced (2/20/07), however, it is the same federal prosecutor that brought and won charges against the two chiropractors in Georgia last year. If you read the indictment charges, the surgeon and four chiropractors fradulently billed Blue Cross Blue Shield of Georgia for "surgical decompression" for VAX-D treatment. In other words, the same federal prosecutor probably has a list of healthcare providers who all used surgical decompression for their decompression treatment. I can only assume this was common practice for VAX-D providers back in 2003-2004. Thats why I say....old news. Bottom line, you can't cheat the insurance company because it will come back to haunt you! I imagine after these 5 doctors are in jail (probably for 2 years like the previous two chiropractors that got busted), they'll go after the next group.

Result number: 66

Message Number 223281

Re: DRX9000 and Axiom's $5,000,000 lawsuit - why?? View Thread
Posted by Dr Khoury on 2/21/07 at 19:48

I truly feel for your husband. I was wondering your take on this?

FULTON COUNTY

Four chiropractors, surgeon charged

In two separate indictments, a federal grand jury on Tuesday charged five health care providers —- an orthopedic surgeon and four chiropractors —- with fraudulently billing insurance companies $6 million.

Dr. Howard Berkowitz, 59, of Atlanta, and chiropractors Arthur Hargraves, 66, of Douglasville, and Daniel Puffenberger, 51, of Kissimmee, Fla., were each charged with five counts of health care fraud.

According to the indictment, as the owners of Douglasville-based Associated Spinal Care Network, the three men fraudulently billed Blue Cross/Blue Shield of Georgia for more than $3 million relating to a procedure known as VAX-D. The nonsurgical back pain procedure uses a mechanical table to stretch a patient's spine.

In the second indictment, chiropractors Williams Stearns, 45, of Marietta, and Steven Levine, 50, of Roswell, were charged, as owners of Marietta-based Comprehensive Care Medical Group (CCMG) with fraudulently billing Blue Cross/Blue Shield for about $1.8 million for the VAX-D procedure.

Stearns, also allegedly submitted $1.5 million in fraudulent bills through CCMG to Blue Cross relating to a procedure know as HAKO-MED, in which an electrical stimulation machine is attached to the surface of a patient's body.

Stearns and Levine were also charged with money laundering.

The health care and money laundering charges carry a maximum sentence of 10 years in prison and fines up to $250,000 per count.

God Bless

Result number: 67

Message Number 221543

Re: Average cost of custom orthotics View Thread
Posted by larrym on 2/04/07 at 09:42

Sorry if I offended anyone. Perhaps slime was too strong. I voiced this after seeing patient that was charged for a premade/modified insert and was charged $550 and it was billed under a UCBL code.They were given no instruction and the same Dr performed a bunionectomy on the ptent and she was wearing terrible shoes that were too small and narow and he told her nothing about any of that I know what most labs charge and they dont adjust their rates depending on zip code of provider. Dr Z seems reasonable and I am sure Dr Wander also provides proper fit and follow up, Jeremy as well

I am targeting ones that just hand a patient an orthotic and told them to get some good shoes and thats it. Just as a test ask your patients that had orthotics if they were given break in instructions or had their foot measured and their footwear evaluated and many will say "NO" to all of the above

Result number: 68

Message Number 221068

Re: Surgery at a Dellon Institute View Thread
Posted by Dr. David S. Wander on 1/29/07 at 17:52

No one is holding a gun to anyone's head to make these patients pay Dr. Dellon $15,000. It is the patient's choice. A patient can opt to have one of the Dellon trained physicians perform the procedure(s) and the procedure(s) will be covered by/billed to the insurance. However, if a patient insists on having the procedure actually performed by Dr. Dellon himself, he commands a fee of $15,000. That's the price of fame and the price one must pay if they want "the man". Regardless of whether you think it's ridiculous or not, no one is holding a gun to these patients to pay him for the procedure, it's the patient's choice.

Just like it's a patient's choice to pay $15,000-20,000 for a face lift, etc. It's simply called supply and demand. There's obviously an audience out there willing to pay.

Result number: 69
Searching file 21

Message Number 218798

Re: Starting to get nervous - already! View Thread
Posted by Kate on 1/03/07 at 16:18

Good to know but I suspected as much. I wonder why it doesn't trigger an inflammatory response from the immune system? More than being creepy, the stuff is kind of fascinating. I'm referring to it as a soda straw which my HMO better not hear or they will issue a therapeutic substitution. I'll be lucky to end up with a conduit of macaroni!

Do any of you feel like you spend more time at the drug store than at home? I know all the pharmacists and techs at Target by their first names! They don't even ask me my name anymore. This is just silly. I'm there at least once a week. My out of pocket costs (drugs and medical services) in 2006 were over $5,000. No wonder I'm broke all the time! Billed charges were over $135,000! Yikes! I'm sorry I opened that statement.

Oh well - the sun is shining, it is over 45 degrees in January and there is nary a speck of snow. Life is not bad at all!

Result number: 70

Message Number 214987

Re: I get to have both TT re-released View Thread
Posted by MUF on 11/05/06 at 12:56

I'm getting the Neurowrap - cryo is not covered by insurance. ESWT is also not covered. Come to think of it - not much is covered!

I am refusing to worry about this stuff until I have an appointment/date. I have projects at work and home to deal with and they will keep me busy.

I think that when he said the he was amputating someone's foot later that evening that I took notice. He said treat my feet like a diabetic's feet to prevent any infections or cuts. This Neurawrap better be as good as it is billed to be!

Result number: 71

Message Number 214206

Re: Republicans Slash Mobility for folks With Disabilities View Thread
Posted by larrym on 10/25/06 at 05:05

Your choice for the title of this thread is far reaching and factually dishonest. I could make the equal and opposing title "Democrats in favor of some people stealing millions of your tax dollars in medicare reimbursements"

Should like some factual insight, please take a moment to read these few links and see just how wrong you are.
http://www.usdoj.gov/usao/txn/PressRel04/scooter_ind_pr.html

According to the indictments, the wheelchair suppliers and the physician submitted fraudulent claims to Medicare for reimbursement for motorized wheelchairs, concealed the submission of the fraudulent claims, and diverted the funds they received from Medicare for their own personal use and benefit. If any medical equipment was delivered to the Medicare beneficiaries, it was a substantially less expensive scooter, while a claim for the more expensive motorized wheelchair was submitted. Typically Medicare was billed from $8000 - $10,000 for the motorized wheelchairs. For each claim they submitted, the wheelchair suppliers would receive approximately $5000 from Medicare.

Often older individuals were approached by recruiters who offered them "free" scooters. The recruiters told the Medicare beneficiaries that in exchange for their Medicare information, they could receive free scooters and electric wheelchairs. Medicare beneficiaries would give their name and Medicare information to the recruiters who would then use them to file the fraudulent claims.

Some of the Medicare beneficiaries believed they were getting scooters, and actually received scooters, but the wheelchair suppliers billed Medicare for the more expensive motorized wheelchairs. Sometimes Medicare beneficiaries received written notification from Medicare that they had received a motorized wheelchair when, in fact, they had never asked for one nor received one.

All defendants are charged in the indictments with one count of health care fraud which carries a maximum penalty of 10 years imprisonment and a $250,000 fine upon conviction. Most of the defendants are also charged with at least one count of money laundering which also carries the same maximum penalty upon conviction. One defendant was also charged with mail fraud which carries a maximum penalty of 20 years imprisonment and a $250,000 fine per count upon conviction. Restitution could be ordered for all the defendants.

In addition, most of the indictments include forfeiture allegations. In total, 12 vehicles, including several luxury vehicles, and $7 million in proceeds the defendants acquired in the fraud will be forfeited upon conviction.

Special Agent in Charge Menke said, "If you're going to steal taxpayers' dollars from Medicare by fraudulently billing wheelchairs or scooters, be on notice. The U.S. Department of Health and Human Services, Office of Inspector General, will continue to conduct operations like this and follow leads wherever they take us."

Result number: 72

Message Number 214186

Re: Republicans Slash Mobility for folks With Disabilities View Thread
Posted by larrym on 10/24/06 at 20:50

I think I will not engage you much longer. Your post was just as I called it and you cant defend it with facts. I know you would like pics of Cheney throwing cripples off their crutches and telling them to rot in hell before they get a motorized scooter.

The fact is, and remains that one of the biggest medicaide/insurance scams is motorized scooters. There are mills that send morons to staff booths at health fairs, flower shows and camper rv shows. They hand out brochures and run ads and tell people "if they qualify, they can have a scooter at no cost"

These things can be billed for thousands of dollars and soke are nothing more than a motorized shopping cart. So again you cant stick to facts but cut n paste away

Result number: 73

Message Number 213704

Re: Orthotripsy Management Co, Marietta, Ga View Thread
Posted by Dr. Z on 10/19/06 at 08:55

Hi Dan,
It us very unusual for an ESWT company to contract with a hospital and bill for services. The typical arrangment is for the hospital to bill for the facility/technical portion of the procedure.The hospital pays the ESWT company a rental for the use of the equipment. The doctor will bill separately. So in a nut shell I really am not sure why the hospital hasn't billed and received payment. Payment to the hospital could take at least 90 days for a reply from the insurance company. I don't know the specifics of your insurance policy so it is different to determine if you have coverage for ESWT in a hospital setting. With additional information I would be very happy to discuss this you either online or at foot.care at verizon.net.

Result number: 74

Message Number 213138

Re: NYS Audit View Thread
Posted by Dr. David S. Wander on 10/12/06 at 18:39

First, to make things PERFECTLY clear, I have never used OSW, Rapid Recovery or any of that company's services in ANY way, shape or form. However, while I was telling my patients in Philadelphia that ESWT was not covered by insurance companies, I was losing some of those patients to my competitors who were advertising in the local papers that they were performing ESWT and is WAS covered by insurance.

I know for a FACT that several of my "former" patients had ESWT performed by these doctors and these doctors were using the protocol of several low dose treatments, billed to the insurance carrier with NO out of pocket expense to the patient. The company involved was Rapid Recovery or whatever name they were using at the time. The doctors collected a handsome fee, and naturally the patients were happy that they had no out of pocket expense. And of course, I looked foolish since I informed the patient that ESWT was NOT covered by their insurance since I was actually following "the rules" and was "kosher".

My question is whether it's simply the corporation that will be hung out to dry or whether the doctors that were involved and made quite a bit of money performing the ESWT will also have some type of legal issues or will have to refund any money. It seems that they've also participated in the fraud and they should also be responsible for writing some checks back to the insurance companies.

Result number: 75

Message Number 213122

Re: NYS Audit View Thread
Posted by Advocate for ESWT on 10/12/06 at 16:01

Let's clear this all up in one reply...OSW went out because of the BCBS scam, Rapid recovery is now out because of the UHC scam, now we have Rapid Recovery America lurking in the wings looking for the next insurance company,DPM or Orthopod that has not become educated enough in the world of who to do business with when it comes to procedures in ESWT. Yes, doctors have let them do their billing...yes they are all suffering for it now..yes this is where the audit to all doctors who have billed for ESWT has come from...Yes in a way he is still in business although with limited equipment...yes he started his own seperate billing company...yes he has been sued by doctors for these practices...yes he has had them thrown out of court...Yes he is at his ninth live...Yes in a recent survey of doctors in NY they still use him..WHY??? I guess a lesson learned has to be done the hard way.How sad that the few legitimate companies currently in business both large and small are suffering from this issue for pre-approvals and payment.

Result number: 76

Message Number 213074

Re: NYS Audit View Thread
Posted by know them on 10/12/06 at 08:26

Rapid Recovery, formaly Orthoshockwave, pulled the same scam on Blue Cross and went under because of huge recalled payments. At that time it was even worse as they used a false CPT code. They used low energy treatments and billed multiple times for high energy. Another scam now by the same bunch of thieves. Why any physician would let an outside company bill for medical services using their provider ID is a puzzle to me- Wait a minute- I know why- it's called GREEEEEEEEEEEEEEEEEED unbridled GREEEEEEEEEEEEEEED. DR. Cohen should lose his license to practice medicine and spend some time in the GREY BAR HOTEL as should all the docs involved in the fraud. A good part of the $15,000 year I pay for health insurance goes to cover the GREEEEEEEEEEED of medical thieves like this one. You can be sure that this is not the only billing scam he's involved in.

Hey Dr Z- how clean is your nose? I'll bet you have some insurance time bombs clicking away in your ESWT closet. I'll bet that the ESWT halo that you claim orbits your head has more than one clinker in it.

Result number: 77

Message Number 211495

Re: ESWT and insurance View Thread
Posted by know them on 9/27/06 at 12:27

Medical insurance companies have a very low opinion of podiatric medicine. They have been over billed and scammed by podiatrists for years with excessive claims for special shoes, orthotics, unecessary injections, etc. Now they are fighting back by elimnating coverages and reducing payments for services. They have been conditioned like the mother of a whiny child who now says NO immediately after hearing the child say "MOM can I...?"

As far as Dr. Z's claim of excellant coverage in his area I say exagerated BS. Horizon BCBS covers ESWT, some misc unions and loacal town and village self pay plans cover it but the major ins co's like United Health Care(they did and will stop) Oxford, Aetna, Empire BCBS, AND MOST OF THE OTHER BCBS plans say NO.
Anthem BCBS said no back in 2004. Some who do cover the procedure will pay almost nothing.

Result number: 78

Message Number 210974

Re: Long term wearing of Night Splint View Thread
Posted by Dr. David S. Wander on 9/22/06 at 15:01

Although Dr. Goldstein doesn't consider the Strassburg Sock a "true" night splint, I'm not sure of his reason. I know it can't be billed under the code for a night splint for insurance purposes, but I don't bill for the product, I simply recommend it for patients.

Regardless of what anyone wants to call the Strassburg Sock, in my practice, my patients have received greater results than with any other "night" splint that I have tried, and I have tried dozens.

The majority of my patients find it more comfortable, though it does take getting used to since it dorsiflexes the toes more, which is why I believe it works better. It increases the "windlass" effect. If a patient initially feels the toes are being pulled too much he/she can simply loosen the sock.

I recommend a "modification" when applying the Strassburg Sock that seems to help most patients. When applying the sock, I recommend that patients maximally dorsiflex their ankles BEFORE they tighten the strap. This allows for more ANKLE dorsiflexion and less toe dorsiflexion and usually results in greater comfort.

The Strassburg Sock also allows patients to walk on it if they have to get up at night to go to the bathroom. However, just like any product, it's not for everyone and that's why they make chocolate and vanilla.

Result number: 79
Searching file 20

Message Number 207973

disappearing posts View Thread
Posted by know them on 8/20/06 at 16:43

this seemed to have vanished so I reposted itRe: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:17

I agree- ban Gary H for being an a**hole and attacking a new poster.

1

Message Number 207907
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:16

I agree- ban Gary H for being an a**hole and attacking a new poster.

2

Message Number 207885
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by footman on 8/19/06 at 21:20

I agree that Gary H is a first class as*hole for being nasty to eswt tech. I think that scott should kick his stupid insulting butt out of here. Maybe eswt tech has something good to add. Dr Z- I'll ask you the same ? as know them- did you ever meet "eswt tech" in 2004 as he said you did?

3

Message Number 207877
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/19/06 at 19:58

Who the f*** is this Gary H as*hole dumping on somebody who is afraid to get involved because of posters like him? Gary- I hope you have the worst incurable painful case of PF anybody ever experienced. I hope the pain is so bad it drives you to jump off a bridge into a cesspool.

Hey Dr Z- do you know who posted as "eswt tech"?

4

Message Number 207794
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/19/06 at 07:32

Dr Z will know who I am. Dr Z we met in A/C in 2004 at the region 3 convetion at the Taj Mahal. I visited you at your booth, you came to the booth my company had and we also had a very nice conversation in the hospitality suite that the region 3 group set up. Thses people are absolutely the meanest people I have ever run into. I wonder if foot pain makes you mean.

5

Message Number 207673
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Driver Wilde on 8/18/06 at 08:54

As a matter of fact, Ralph. Many of the patients treated in the FDA study for the Ossatron were done with a regional anesthetic only. Yes, it is very uncomfortable for the patient and not practical due to the huge amounts of lidocaine needed to numb the foot sufficiently (bordering on toxic doses).

The main reason the Ossatron must be used in the Surgery Center is because Healthtronics/Sanuwave have required that it be used in a surgery center. They have spent years claiming that high energy ESWT has to be done in an ASC or hospital so they could keep differentiate between ASC reimbursement and office reimbursement. Another problem with the Ossatron is that it is 700 lbs and 7 feet long. It won't fit in most doctors' treatment rooms.

Now that Sanuwave's contract with UHC is going down the toilet they are again offering to do treatments in a doctor's office. Good luck with that. Usually an Ossatron procedure is about 6 minutes under general or MAC.... under local it could take well over an hour and a lot of tears from the patient.

Point is.... the FDA says it's safe and effective to ues on humans but does not mandate it be used in an ASC.

-DW

6

Message Number 207671
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/18/06 at 08:24

I'd replace the word "putz" in your post with "guy" and eliminate the word "jerk". Name calling isn't necessary to get a point across.

7

Message Number 207631
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Gary H. on 8/17/06 at 20:09

Doctor Z,

I DO NOT believe that putz is an ESWT tech. I think he is full of himself. We will talk about that jerk at lunch next time. Let me read the board for 3 more years first.

8

Message Number 207624
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

9

Message Number 207623
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

10

Message Number 207622
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

11

Message Number 207621
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

12

Message Number 207620
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 17:07

Judy,
You've got to laugh at that post. It tore me up. The guy refuses to post and correct information he calls "ignorance and misinformation"

Now tells us we will be penalized and deprived forever because he's leaving the board.

Maybe had he posted sooner and told us what he had learned in his "previous scientific profession" we would have known the guy was around in the first place. He admits he had 4 years to do it.

I don't know about you but sad as I may be I'll carry one somehow one day at a time. I know you'll get by too. We've got to hang in there.

Like they say "when the going gets tough the tough get going" I'm going to dinner.

13

Message Number 207618
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by judy on 8/17/06 at 16:17

what is with the threats?

14

Message Number 207617
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:57

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

15

Message Number 207616
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:56

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

16

Message Number 207588
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 10:48

If you found this site so appalling you had two choices.
1. Leave the site and stop viewing it.
2. Post constructive information to correct what you call "ignorance and misinformation I constantly see".

You've done neither. So I guess who you know or what you know or who you met doesn't matter.

You get credit for recognizing the infighting. At times it does remind me of a wolf den.

17

Message Number 207548
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

18

Message Number 207547
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

19

Message Number 207544
correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:23

I have been reading this board for 3 years and have never posted until now. I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I would never expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

20

Message Number 207542
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:01

I have been reading this board, and have never posted until now, for 3 years and I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I have would expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

21

Message Number 207532
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 18:58

I think we'll be seeing many more of these machines used in these settings. The real question is will they help the athletes.

I wonder what they do with athletes training in Colorado hoping to make the Olympic teams if they get P.F. It would be interesting to see if they have an ESWT machine at that training facility.

22

Message Number 207517
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 17:41

thanks for long explenation. I didn't get any anesthesia so it was a lower power machine. I had one week between each session. it was a private clinic with ordinary general practice doctors but with extra knowledge of athlete injuries so I call it sport clinic. Athletes from the cities elite soccer team and track/field goes there.
In the end, ESWT didn't do anything for me so I'm glad I didn't pay too much. ART looks to do more help for me now.

23

Message Number 207514
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 17:17

I'll try not to be as rude as you "know them", but I was looking at the bill from the Surgery Center and Dr. The Dr. is also a part owner. I know that they paid quite a bit of the bill but I can't tell you the exact amount because it was a long time ago. I was cleaning out my old bills when I found it the other day. The point was that it was billed for that amount, period!

24

Message Number 207507
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 16:15

Good point,
What was the amount the doctor received.? It is possible that they did receive $6,000. I know that some certified mobile providers have received more then that amount for three low energy ESWT procedure. I guess that is why UHC is gone. Would you know anything about that Know them?

25

Message Number 207462
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 11:36

The difference in cost is most often related to the location where the ESWT under FDA guideline must be performed.

The Osstron ESWT machine must be used in an Outpatient Surgical Center or Hospital.

The Dornier Machine can be used in Mobile Trailers or in doctors offices.

Each of these machines suggest that one treatment does the trick however, a second treatment may be necessary. The treatments are not give in a daily or weekly series they are spread apart.

From what you described the ESWT treatment you received was with a machine that provides 3 treatments closely together. These machines are often considered lower power machines hence 3 treatments are needed to equal one of the others. Please realize that when I use the word equal its in very "general terms" and not "scientific" meaning that if compared the amount of shock wave ability may not be truely "equal" but for my reply I'm just using the term equal as described above. You'd have to compare several things to determine the true equality of these machines.

The type of machine you had obviously wasn't required by the FDA to be used in an Outpatient Surgical Center or hospital and possibly it might have been even used off label meaning that the machine itself isn't FDA approved specifically for treating P.F. "Specifically" is the important word here. It can be used off label.

It is well known that these type of machines cost less to purchase and the treatments also cost less. I believe in Canada these machines have become very popular and possibly are becoming more popular in the U.S. because of lower cost treatments.

Right now you must remember that the prices of getting an ESWT treatment is in the hands of the doctors because there is very little insurance coverage. They can raise or lower prices as they see fit but feel that the cost of the machine, up keep, over head and their services etc are worth more than the $300 you paid.

This is expecially true with the Ossatron machine that must be used in a hospital or Outpatient surgical Center with an anesthesiologist and anesthesia. Add those costs to the doctors fee and even without paying the doctor a dime you are already well over $300.

In your case the machine used, the fact that it was done in a sports clinic and the decision of the doctor to charge only $300 made the difference in what you paid.

26

Message Number 207452
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 10:05

I went to a sports clinic, used by elite athletes, and the ESWT treatment was not covered by anything for me so I paid 300$ for three sessions. Experienced doctor did the procedure. don't understand the 1000$ per session thing.

27

Message Number 207447
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 09:46

You did not pay anything near that amount, nor did the doctor or equipment provider collect anywhere near that amount. Do you have any idea what a Dornier EPOS costs? Do you have any idea what it costs to keep a mobile unit in the field? A vehicle, techs salary and benefits, insurance,fuel, maintainance on the EPOS and the vehicle, depreciation, back office and support staff expense. depericiation, debt service on any business loans, - I could go on for 10 more lines. The total cost to campaign a mobile ESWT operation running 5 days a week is probably around $200,000.

You looked at the EOB you received for the amount billed and decided to make a big splash here quoting that $ amount. Now look at that same EOB and tell us, truthfully if you can, what the insurance company actually paid the provider and the doctor. I'de be suprised if it came to more that 30% of what was billed.

Are you one of those socialist who feel that free enterprise should listen to your rules as to how profitable they should be? Well if you are then you must accept that I can tell you how much you should earn.

28

Message Number 207441
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 08:51

Bill, I had ESWT with the Donier Machine. It was around $6,000. My insurance paid for most of it. It didn't work for me but I really believe that it does for some. I'd definately do it before Surgery, which I did, and am sooooo sorry I did the surgery.

29

Message Number 207431
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 06:21

Pick the right provider and if your doctor is not the typically greedy practioner you will find that ESWT can be suprisingly affordable despite the current trend of non-coverage by the insurance bandits.

30

Message Number 207413
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 21:23

Just make certain that you are not left with a huge co-pay that your insurance co. forgot to tell you about or the doctor didn't mention.

Let us know how you do following treatment. We are waiting to hear more positive results. I hope you are one of them

31

Message Number 207405
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:31

Ralph,

Thanks for the follow-ups! I have been quoted a price waaaay higher than these. BUT, it looks like my insurance may pay for the treatment (and I doubt their reimbursement is anywhere near the quoted price). So, I plan to go ahead and trust/hope that whatever the insurance company works out with the provider will be socially fair and efficient!

32

Message Number 207404
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:27

Scottr,

First, this is classic PF: 'first step' pain really bad and tender to modest pressure at the insertion of the PF to the heel on the inner part of the heel. Worsening for about 9 months; ibuprofen, icing, stretching, use of night splint when watching TV, etc.

The fiest two times I did the halogen I did not have sun glasses, so averted my eyes and was using the red food coloring in the water. I have done about 6 more treatments now using sunglasses. I will now switch to using non-colored water (my understanding from my sampling of your prior posts is that the red coloring makes for less heat at skin surface (which has not been a problem}, but I had not understod that clear light was more powerful).

Just prior to the first halogen treatment my 'first step' pain was off the charts and lasted for a couple of blocks. However, this was elvated somewhat because I had recently had to be on my feet a good deal. Some combination of the halogen and natural recovery from the elevated level brought my pain down consistently for a few days. However, I continue to experience some re-tearing while walking (I wonder if my orthotics need adjusting, although I am not sure which way the adjustment should go. BTW I was 10 years and untold orthotics on my other foot before doing the surgery and typically have a god sense of how to adjust orthotics. As mentioned in a different post, the surgery helped the PF but led to foot instability and occasional cuboid problems.)

Also, the 'runner's stretch' seems to irritate (re-tear) sometimes even though I am careful with the mechanics-my calf is not real tight; but the PF sure is.

I have seen some definite benefits from the halogen, and will continue to apply, and now with 'clear' light. However, I am a teacher and with classes starting soon I wanted to be pro-active regarding the ESWR-especially if my insurance will pay some. With 10 years of PF on my other foot-and going from atheletic to overweight and untoned- I want to do everything possible to resolve this foot much earlier!

Thanks so much for your research and site; I will keep you posted on both the halogen and ESWT.

For now,
Bill

33

Message Number 207386
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by scott r on 8/15/06 at 18:00

Bill, was the halogen you're using a flood or a spot? Is it to bright to look at your skin where it shines if you don't use the red coloring? I'm wanting to investigate every failed instance of using the halogen to see if i need to modify my instructions. Can you tell us more about your symptoms (pain location, when it occurs), history, and possible initial causes?

34

Message Number 207382
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 17:08

Bill,
Here is a post I found from last year. Don't know if fees have been raised or not but this gives you a good idea of possible medicare value assignments.

Posted by Steve W on 11/08/05 at 13:01
I just received the relative values assigned to ESWT by Medicare. This is second hand but a reliable source. Medicare has apparently assigned the following values:

ESWT performed in a facility:
Professional Fee - $210.
Facility/Technical Fee - $1,000

ESWT performed in physician's office:
Professional fee - $350
NO TECHNICAL/FACILITY FEE

I'm hearing same very negative comments from some companies including the real possibility of going out of business. The insurance mafia strikes again!!!

35

Message Number 207379
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:16

Bill,
Just read this article. It may interest you. Another machine is in town.

Can A Portable ESWT Device Provide Easier Treatment?
5. Orthospec (Medispec). Although extracorporeal shockwave therapy (ESWT) is a noninvasive option for various painful conditions, many ESWT devices are large and mostly available in hospitals and surgery centers due to the cost of the devices. The Orthospec, which recently gained FDA approval, is a more portable device that one can use in the office.

The Orthospec is a portable extracorporeal shockwave therapy device. Its portability and one-time treatment option are key benefits, according to John Hollander, DPM.

Such portability poses several advantages, according to John Hollander, DPM, who has been using Orthospec for a year. The fact that DPMs can have ESWT units in their offices makes for a cost savings since patients do not need to go to hospitals, according to Dr. Hollander, who practices in Santa Rosa, Calif. He also notes that he can perform the procedure with no anesthesia.
Dr. Hollander has used the device to treat plantar fasciitis, retrocalcaneal pain, Achilles tendonopathy and intermetatarsal neuromas.
Another advantage of the device, according to Medispec, is the one-time, 25-minute treatment whereas other ESWT devices usually involve multiple treatments. The company says that unlike with other ESWT devices, the Orthospec does not require an imaging device and one can use the Orthospec to treat a wide area.

36

Message Number 207378
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:14

Humor

37

Message Number 207376
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 16:03

Ralph,

Thanks so much for your thoughtful remarks! I couldn't help but notice your intial response 'how much dust it collects.' Was this just a good attempt at humore, or are you in general not a fan/believer in ESWT?

Thanks again!

38

Message Number 207374
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 15:27

How much dust it collects. Actually the Ossatron ESWT machines are used in Outpatient Surgical Centers and generally with the use of an anesthsiologist and anesthesia along with your treating doctor. The treatment with this machine has on occassion been done with foot blocks and relaxation instead of putting the patient out.

When you add up the Surgical Center cost, the charges to the Anesthesiologist, the medication and charges by your treating doctor the costs are usually higher than ESWT treatments performed in doctors offices or in mobile units that travel to multiple doctors offices. I think you'll find most doctors using mobile units or units in their office are using a Dornier ESWT machine.

Additionally there are a few doctors who use a low power machine off label to treat Plantar Fasciitis. Their treatments are done in their offices and usually consists of three separate sessions. This type of ESWT treatment is usually the cheapest.

Recently medicare approved payment to doctors for performing ESWT but the payments are so low that many doctors hesitate to treat medicare patients. Personally I think it's because they fear accepting what they think are lower than standard fees. Doing so may set a precedent for future payments by other insurance companies if and when they decide to cover ESWT. Two years after the fact doctors are still holding out hope that it will eventually come.

It's my opinion at this point doctors need to decide if they want their machines to collect, lower their fees, or offer attractive payment plans to patients.

Shopping around will more than likely get you the best deal. Some doctors like the Ossatron machine and others like the Dornier and still others like the low power one done with three treatments. Each will sell you what they like and use.

39

Message Number 207371
what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 14:19


There seem to be a lot of different prices for ESWST out there. Does it vary with the machine used, or what? What is reasonable?

1

Message Number 207908
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:17

I agree- ban Gary H for being an a**hole and attacking a new poster.

2

Message Number 207907
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:16

I agree- ban Gary H for being an a**hole and attacking a new poster.

3

Message Number 207885
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by footman on 8/19/06 at 21:20

I agree that Gary H is a first class as*hole for being nasty to eswt tech. I think that scott should kick his stupid insulting butt out of here. Maybe eswt tech has something good to add. Dr Z- I'll ask you the same ? as know them- did you ever meet "eswt tech" in 2004 as he said you did?

4

Message Number 207877
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/19/06 at 19:58

Who the f*** is this Gary H as*hole dumping on somebody who is afraid to get involved because of posters like him? Gary- I hope you have the worst incurable painful case of PF anybody ever experienced. I hope the pain is so bad it drives you to jump off a bridge into a cesspool.

Hey Dr Z- do you know who posted as "eswt tech"?

5

Message Number 207794
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/19/06 at 07:32

Dr Z will know who I am. Dr Z we met in A/C in 2004 at the region 3 convetion at the Taj Mahal. I visited you at your booth, you came to the booth my company had and we also had a very nice conversation in the hospitality suite that the region 3 group set up. Thses people are absolutely the meanest people I have ever run into. I wonder if foot pain makes you mean.

6

Message Number 207673
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Driver Wilde on 8/18/06 at 08:54

As a matter of fact, Ralph. Many of the patients treated in the FDA study for the Ossatron were done with a regional anesthetic only. Yes, it is very uncomfortable for the patient and not practical due to the huge amounts of lidocaine needed to numb the foot sufficiently (bordering on toxic doses).

The main reason the Ossatron must be used in the Surgery Center is because Healthtronics/Sanuwave have required that it be used in a surgery center. They have spent years claiming that high energy ESWT has to be done in an ASC or hospital so they could keep differentiate between ASC reimbursement and office reimbursement. Another problem with the Ossatron is that it is 700 lbs and 7 feet long. It won't fit in most doctors' treatment rooms.

Now that Sanuwave's contract with UHC is going down the toilet they are again offering to do treatments in a doctor's office. Good luck with that. Usually an Ossatron procedure is about 6 minutes under general or MAC.... under local it could take well over an hour and a lot of tears from the patient.

Point is.... the FDA says it's safe and effective to ues on humans but does not mandate it be used in an ASC.

-DW

7

Message Number 207671
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/18/06 at 08:24

I'd replace the word "putz" in your post with "guy" and eliminate the word "jerk". Name calling isn't necessary to get a point across.

8

Message Number 207631
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Gary H. on 8/17/06 at 20:09

Doctor Z,

I DO NOT believe that putz is an ESWT tech. I think he is full of himself. We will talk about that jerk at lunch next time. Let me read the board for 3 more years first.

9

Message Number 207624
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

10

Message Number 207623
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

11

Message Number 207622
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

12

Message Number 207621
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

13

Message Number 207620
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 17:07

Judy,
You've got to laugh at that post. It tore me up. The guy refuses to post and correct information he calls "ignorance and misinformation"

Now tells us we will be penalized and deprived forever because he's leaving the board.

Maybe had he posted sooner and told us what he had learned in his "previous scientific profession" we would have known the guy was around in the first place. He admits he had 4 years to do it.

I don't know about you but sad as I may be I'll carry one somehow one day at a time. I know you'll get by too. We've got to hang in there.

Like they say "when the going gets tough the tough get going" I'm going to dinner.

14

Message Number 207618
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by judy on 8/17/06 at 16:17

what is with the threats?

15

Message Number 207617
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:57

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

16

Message Number 207616
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:56

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

17

Message Number 207588
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 10:48

If you found this site so appalling you had two choices.
1. Leave the site and stop viewing it.
2. Post constructive information to correct what you call "ignorance and misinformation I constantly see".

You've done neither. So I guess who you know or what you know or who you met doesn't matter.

You get credit for recognizing the infighting. At times it does remind me of a wolf den.

18

Message Number 207548
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

19

Message Number 207547
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

20

Message Number 207544
correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:23

I have been reading this board for 3 years and have never posted until now. I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I would never expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

21

Message Number 207542
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:01

I have been reading this board, and have never posted until now, for 3 years and I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I have would expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

22

Message Number 207532
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 18:58

I think we'll be seeing many more of these machines used in these settings. The real question is will they help the athletes.

I wonder what they do with athletes training in Colorado hoping to make the Olympic teams if they get P.F. It would be interesting to see if they have an ESWT machine at that training facility.

23

Message Number 207517
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 17:41

thanks for long explenation. I didn't get any anesthesia so it was a lower power machine. I had one week between each session. it was a private clinic with ordinary general practice doctors but with extra knowledge of athlete injuries so I call it sport clinic. Athletes from the cities elite soccer team and track/field goes there.
In the end, ESWT didn't do anything for me so I'm glad I didn't pay too much. ART looks to do more help for me now.

24

Message Number 207514
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 17:17

I'll try not to be as rude as you "know them", but I was looking at the bill from the Surgery Center and Dr. The Dr. is also a part owner. I know that they paid quite a bit of the bill but I can't tell you the exact amount because it was a long time ago. I was cleaning out my old bills when I found it the other day. The point was that it was billed for that amount, period!

25

Message Number 207507
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 16:15

Good point,
What was the amount the doctor received.? It is possible that they did receive $6,000. I know that some certified mobile providers have received more then that amount for three low energy ESWT procedure. I guess that is why UHC is gone. Would you know anything about that Know them?

26

Message Number 207462
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 11:36

The difference in cost is most often related to the location where the ESWT under FDA guideline must be performed.

The Osstron ESWT machine must be used in an Outpatient Surgical Center or Hospital.

The Dornier Machine can be used in Mobile Trailers or in doctors offices.

Each of these machines suggest that one treatment does the trick however, a second treatment may be necessary. The treatments are not give in a daily or weekly series they are spread apart.

From what you described the ESWT treatment you received was with a machine that provides 3 treatments closely together. These machines are often considered lower power machines hence 3 treatments are needed to equal one of the others. Please realize that when I use the word equal its in very "general terms" and not "scientific" meaning that if compared the amount of shock wave ability may not be truely "equal" but for my reply I'm just using the term equal as described above. You'd have to compare several things to determine the true equality of these machines.

The type of machine you had obviously wasn't required by the FDA to be used in an Outpatient Surgical Center or hospital and possibly it might have been even used off label meaning that the machine itself isn't FDA approved specifically for treating P.F. "Specifically" is the important word here. It can be used off label.

It is well known that these type of machines cost less to purchase and the treatments also cost less. I believe in Canada these machines have become very popular and possibly are becoming more popular in the U.S. because of lower cost treatments.

Right now you must remember that the prices of getting an ESWT treatment is in the hands of the doctors because there is very little insurance coverage. They can raise or lower prices as they see fit but feel that the cost of the machine, up keep, over head and their services etc are worth more than the $300 you paid.

This is expecially true with the Ossatron machine that must be used in a hospital or Outpatient surgical Center with an anesthesiologist and anesthesia. Add those costs to the doctors fee and even without paying the doctor a dime you are already well over $300.

In your case the machine used, the fact that it was done in a sports clinic and the decision of the doctor to charge only $300 made the difference in what you paid.

27

Message Number 207452
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 10:05

I went to a sports clinic, used by elite athletes, and the ESWT treatment was not covered by anything for me so I paid 300$ for three sessions. Experienced doctor did the procedure. don't understand the 1000$ per session thing.

28

Message Number 207447
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 09:46

You did not pay anything near that amount, nor did the doctor or equipment provider collect anywhere near that amount. Do you have any idea what a Dornier EPOS costs? Do you have any idea what it costs to keep a mobile unit in the field? A vehicle, techs salary and benefits, insurance,fuel, maintainance on the EPOS and the vehicle, depreciation, back office and support staff expense. depericiation, debt service on any business loans, - I could go on for 10 more lines. The total cost to campaign a mobile ESWT operation running 5 days a week is probably around $200,000.

You looked at the EOB you received for the amount billed and decided to make a big splash here quoting that $ amount. Now look at that same EOB and tell us, truthfully if you can, what the insurance company actually paid the provider and the doctor. I'de be suprised if it came to more that 30% of what was billed.

Are you one of those socialist who feel that free enterprise should listen to your rules as to how profitable they should be? Well if you are then you must accept that I can tell you how much you should earn.

29

Message Number 207441
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 08:51

Bill, I had ESWT with the Donier Machine. It was around $6,000. My insurance paid for most of it. It didn't work for me but I really believe that it does for some. I'd definately do it before Surgery, which I did, and am sooooo sorry I did the surgery.

30

Message Number 207431
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 06:21

Pick the right provider and if your doctor is not the typically greedy practioner you will find that ESWT can be suprisingly affordable despite the current trend of non-coverage by the insurance bandits.

31

Message Number 207413
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 21:23

Just make certain that you are not left with a huge co-pay that your insurance co. forgot to tell you about or the doctor didn't mention.

Let us know how you do following treatment. We are waiting to hear more positive results. I hope you are one of them

32

Message Number 207405
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:31

Ralph,

Thanks for the follow-ups! I have been quoted a price waaaay higher than these. BUT, it looks like my insurance may pay for the treatment (and I doubt their reimbursement is anywhere near the quoted price). So, I plan to go ahead and trust/hope that whatever the insurance company works out with the provider will be socially fair and efficient!

33

Message Number 207404
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:27

Scottr,

First, this is classic PF: 'first step' pain really bad and tender to modest pressure at the insertion of the PF to the heel on the inner part of the heel. Worsening for about 9 months; ibuprofen, icing, stretching, use of night splint when watching TV, etc.

The fiest two times I did the halogen I did not have sun glasses, so averted my eyes and was using the red food coloring in the water. I have done about 6 more treatments now using sunglasses. I will now switch to using non-colored water (my understanding from my sampling of your prior posts is that the red coloring makes for less heat at skin surface (which has not been a problem}, but I had not understod that clear light was more powerful).

Just prior to the first halogen treatment my 'first step' pain was off the charts and lasted for a couple of blocks. However, this was elvated somewhat because I had recently had to be on my feet a good deal. Some combination of the halogen and natural recovery from the elevated level brought my pain down consistently for a few days. However, I continue to experience some re-tearing while walking (I wonder if my orthotics need adjusting, although I am not sure which way the adjustment should go. BTW I was 10 years and untold orthotics on my other foot before doing the surgery and typically have a god sense of how to adjust orthotics. As mentioned in a different post, the surgery helped the PF but led to foot instability and occasional cuboid problems.)

Also, the 'runner's stretch' seems to irritate (re-tear) sometimes even though I am careful with the mechanics-my calf is not real tight; but the PF sure is.

I have seen some definite benefits from the halogen, and will continue to apply, and now with 'clear' light. However, I am a teacher and with classes starting soon I wanted to be pro-active regarding the ESWR-especially if my insurance will pay some. With 10 years of PF on my other foot-and going from atheletic to overweight and untoned- I want to do everything possible to resolve this foot much earlier!

Thanks so much for your research and site; I will keep you posted on both the halogen and ESWT.

For now,
Bill

34

Message Number 207386
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by scott r on 8/15/06 at 18:00

Bill, was the halogen you're using a flood or a spot? Is it to bright to look at your skin where it shines if you don't use the red coloring? I'm wanting to investigate every failed instance of using the halogen to see if i need to modify my instructions. Can you tell us more about your symptoms (pain location, when it occurs), history, and possible initial causes?

35

Message Number 207382
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 17:08

Bill,
Here is a post I found from last year. Don't know if fees have been raised or not but this gives you a good idea of possible medicare value assignments.

Posted by Steve W on 11/08/05 at 13:01
I just received the relative values assigned to ESWT by Medicare. This is second hand but a reliable source. Medicare has apparently assigned the following values:

ESWT performed in a facility:
Professional Fee - $210.
Facility/Technical Fee - $1,000

ESWT performed in physician's office:
Professional fee - $350
NO TECHNICAL/FACILITY FEE

I'm hearing same very negative comments from some companies including the real possibility of going out of business. The insurance mafia strikes again!!!

36

Message Number 207379
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:16

Bill,
Just read this article. It may interest you. Another machine is in town.

Can A Portable ESWT Device Provide Easier Treatment?
5. Orthospec (Medispec). Although extracorporeal shockwave therapy (ESWT) is a noninvasive option for various painful conditions, many ESWT devices are large and mostly available in hospitals and surgery centers due to the cost of the devices. The Orthospec, which recently gained FDA approval, is a more portable device that one can use in the office.

The Orthospec is a portable extracorporeal shockwave therapy device. Its portability and one-time treatment option are key benefits, according to John Hollander, DPM.

Such portability poses several advantages, according to John Hollander, DPM, who has been using Orthospec for a year. The fact that DPMs can have ESWT units in their offices makes for a cost savings since patients do not need to go to hospitals, according to Dr. Hollander, who practices in Santa Rosa, Calif. He also notes that he can perform the procedure with no anesthesia.
Dr. Hollander has used the device to treat plantar fasciitis, retrocalcaneal pain, Achilles tendonopathy and intermetatarsal neuromas.
Another advantage of the device, according to Medispec, is the one-time, 25-minute treatment whereas other ESWT devices usually involve multiple treatments. The company says that unlike with other ESWT devices, the Orthospec does not require an imaging device and one can use the Orthospec to treat a wide area.

37

Message Number 207378
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:14

Humor

38

Message Number 207376
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 16:03

Ralph,

Thanks so much for your thoughtful remarks! I couldn't help but notice your intial response 'how much dust it collects.' Was this just a good attempt at humore, or are you in general not a fan/believer in ESWT?

Thanks again!

39

Message Number 207374
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 15:27

How much dust it collects. Actually the Ossatron ESWT machines are used in Outpatient Surgical Centers and generally with the use of an anesthsiologist and anesthesia along with your treating doctor. The treatment with this machine has on occassion been done with foot blocks and relaxation instead of putting the patient out.

When you add up the Surgical Center cost, the charges to the Anesthesiologist, the medication and charges by your treating doctor the costs are usually higher than ESWT treatments performed in doctors offices or in mobile units that travel to multiple doctors offices. I think you'll find most doctors using mobile units or units in their office are using a Dornier ESWT machine.

Additionally there are a few doctors who use a low power machine off label to treat Plantar Fasciitis. Their treatments are done in their offices and usually consists of three separate sessions. This type of ESWT treatment is usually the cheapest.

Recently medicare approved payment to doctors for performing ESWT but the payments are so low that many doctors hesitate to treat medicare patients. Personally I think it's because they fear accepting what they think are lower than standard fees. Doing so may set a precedent for future payments by other insurance companies if and when they decide to cover ESWT. Two years after the fact doctors are still holding out hope that it will eventually come.

It's my opinion at this point doctors need to decide if they want their machines to collect, lower their fees, or offer attractive payment plans to patients.

Shopping around will more than likely get you the best deal. Some doctors like the Ossatron machine and others like the Dornier and still others like the low power one done with three treatments. Each will sell you what they like and use.

40

Message Number 207371
what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 14:19


There seem to be a lot of different prices for ESWST out there. Does it vary with the machine used, or what? What is reasonable?

Result number: 80

Message Number 207972

disappearing posts View Thread
Posted by know them on 8/20/06 at 16:43

this seemed to have vanished so I reposted itRe: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:17

I agree- ban Gary H for being an a**hole and attacking a new poster.

1

Message Number 207907
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:16

I agree- ban Gary H for being an a**hole and attacking a new poster.

2

Message Number 207885
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by footman on 8/19/06 at 21:20

I agree that Gary H is a first class as*hole for being nasty to eswt tech. I think that scott should kick his stupid insulting butt out of here. Maybe eswt tech has something good to add. Dr Z- I'll ask you the same ? as know them- did you ever meet "eswt tech" in 2004 as he said you did?

3

Message Number 207877
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/19/06 at 19:58

Who the f*** is this Gary H as*hole dumping on somebody who is afraid to get involved because of posters like him? Gary- I hope you have the worst incurable painful case of PF anybody ever experienced. I hope the pain is so bad it drives you to jump off a bridge into a cesspool.

Hey Dr Z- do you know who posted as "eswt tech"?

4

Message Number 207794
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/19/06 at 07:32

Dr Z will know who I am. Dr Z we met in A/C in 2004 at the region 3 convetion at the Taj Mahal. I visited you at your booth, you came to the booth my company had and we also had a very nice conversation in the hospitality suite that the region 3 group set up. Thses people are absolutely the meanest people I have ever run into. I wonder if foot pain makes you mean.

5

Message Number 207673
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Driver Wilde on 8/18/06 at 08:54

As a matter of fact, Ralph. Many of the patients treated in the FDA study for the Ossatron were done with a regional anesthetic only. Yes, it is very uncomfortable for the patient and not practical due to the huge amounts of lidocaine needed to numb the foot sufficiently (bordering on toxic doses).

The main reason the Ossatron must be used in the Surgery Center is because Healthtronics/Sanuwave have required that it be used in a surgery center. They have spent years claiming that high energy ESWT has to be done in an ASC or hospital so they could keep differentiate between ASC reimbursement and office reimbursement. Another problem with the Ossatron is that it is 700 lbs and 7 feet long. It won't fit in most doctors' treatment rooms.

Now that Sanuwave's contract with UHC is going down the toilet they are again offering to do treatments in a doctor's office. Good luck with that. Usually an Ossatron procedure is about 6 minutes under general or MAC.... under local it could take well over an hour and a lot of tears from the patient.

Point is.... the FDA says it's safe and effective to ues on humans but does not mandate it be used in an ASC.

-DW

6

Message Number 207671
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/18/06 at 08:24

I'd replace the word "putz" in your post with "guy" and eliminate the word "jerk". Name calling isn't necessary to get a point across.

7

Message Number 207631
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Gary H. on 8/17/06 at 20:09

Doctor Z,

I DO NOT believe that putz is an ESWT tech. I think he is full of himself. We will talk about that jerk at lunch next time. Let me read the board for 3 more years first.

8

Message Number 207624
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

9

Message Number 207623
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

10

Message Number 207622
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

11

Message Number 207621
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

12

Message Number 207620
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 17:07

Judy,
You've got to laugh at that post. It tore me up. The guy refuses to post and correct information he calls "ignorance and misinformation"

Now tells us we will be penalized and deprived forever because he's leaving the board.

Maybe had he posted sooner and told us what he had learned in his "previous scientific profession" we would have known the guy was around in the first place. He admits he had 4 years to do it.

I don't know about you but sad as I may be I'll carry one somehow one day at a time. I know you'll get by too. We've got to hang in there.

Like they say "when the going gets tough the tough get going" I'm going to dinner.

13

Message Number 207618
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by judy on 8/17/06 at 16:17

what is with the threats?

14

Message Number 207617
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:57

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

15

Message Number 207616
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:56

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

16

Message Number 207588
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 10:48

If you found this site so appalling you had two choices.
1. Leave the site and stop viewing it.
2. Post constructive information to correct what you call "ignorance and misinformation I constantly see".

You've done neither. So I guess who you know or what you know or who you met doesn't matter.

You get credit for recognizing the infighting. At times it does remind me of a wolf den.

17

Message Number 207548
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

18

Message Number 207547
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

19

Message Number 207544
correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:23

I have been reading this board for 3 years and have never posted until now. I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I would never expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

20

Message Number 207542
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:01

I have been reading this board, and have never posted until now, for 3 years and I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I have would expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

21

Message Number 207532
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 18:58

I think we'll be seeing many more of these machines used in these settings. The real question is will they help the athletes.

I wonder what they do with athletes training in Colorado hoping to make the Olympic teams if they get P.F. It would be interesting to see if they have an ESWT machine at that training facility.

22

Message Number 207517
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 17:41

thanks for long explenation. I didn't get any anesthesia so it was a lower power machine. I had one week between each session. it was a private clinic with ordinary general practice doctors but with extra knowledge of athlete injuries so I call it sport clinic. Athletes from the cities elite soccer team and track/field goes there.
In the end, ESWT didn't do anything for me so I'm glad I didn't pay too much. ART looks to do more help for me now.

23

Message Number 207514
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 17:17

I'll try not to be as rude as you "know them", but I was looking at the bill from the Surgery Center and Dr. The Dr. is also a part owner. I know that they paid quite a bit of the bill but I can't tell you the exact amount because it was a long time ago. I was cleaning out my old bills when I found it the other day. The point was that it was billed for that amount, period!

24

Message Number 207507
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 16:15

Good point,
What was the amount the doctor received.? It is possible that they did receive $6,000. I know that some certified mobile providers have received more then that amount for three low energy ESWT procedure. I guess that is why UHC is gone. Would you know anything about that Know them?

25

Message Number 207462
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 11:36

The difference in cost is most often related to the location where the ESWT under FDA guideline must be performed.

The Osstron ESWT machine must be used in an Outpatient Surgical Center or Hospital.

The Dornier Machine can be used in Mobile Trailers or in doctors offices.

Each of these machines suggest that one treatment does the trick however, a second treatment may be necessary. The treatments are not give in a daily or weekly series they are spread apart.

From what you described the ESWT treatment you received was with a machine that provides 3 treatments closely together. These machines are often considered lower power machines hence 3 treatments are needed to equal one of the others. Please realize that when I use the word equal its in very "general terms" and not "scientific" meaning that if compared the amount of shock wave ability may not be truely "equal" but for my reply I'm just using the term equal as described above. You'd have to compare several things to determine the true equality of these machines.

The type of machine you had obviously wasn't required by the FDA to be used in an Outpatient Surgical Center or hospital and possibly it might have been even used off label meaning that the machine itself isn't FDA approved specifically for treating P.F. "Specifically" is the important word here. It can be used off label.

It is well known that these type of machines cost less to purchase and the treatments also cost less. I believe in Canada these machines have become very popular and possibly are becoming more popular in the U.S. because of lower cost treatments.

Right now you must remember that the prices of getting an ESWT treatment is in the hands of the doctors because there is very little insurance coverage. They can raise or lower prices as they see fit but feel that the cost of the machine, up keep, over head and their services etc are worth more than the $300 you paid.

This is expecially true with the Ossatron machine that must be used in a hospital or Outpatient surgical Center with an anesthesiologist and anesthesia. Add those costs to the doctors fee and even without paying the doctor a dime you are already well over $300.

In your case the machine used, the fact that it was done in a sports clinic and the decision of the doctor to charge only $300 made the difference in what you paid.

26

Message Number 207452
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 10:05

I went to a sports clinic, used by elite athletes, and the ESWT treatment was not covered by anything for me so I paid 300$ for three sessions. Experienced doctor did the procedure. don't understand the 1000$ per session thing.

27

Message Number 207447
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 09:46

You did not pay anything near that amount, nor did the doctor or equipment provider collect anywhere near that amount. Do you have any idea what a Dornier EPOS costs? Do you have any idea what it costs to keep a mobile unit in the field? A vehicle, techs salary and benefits, insurance,fuel, maintainance on the EPOS and the vehicle, depreciation, back office and support staff expense. depericiation, debt service on any business loans, - I could go on for 10 more lines. The total cost to campaign a mobile ESWT operation running 5 days a week is probably around $200,000.

You looked at the EOB you received for the amount billed and decided to make a big splash here quoting that $ amount. Now look at that same EOB and tell us, truthfully if you can, what the insurance company actually paid the provider and the doctor. I'de be suprised if it came to more that 30% of what was billed.

Are you one of those socialist who feel that free enterprise should listen to your rules as to how profitable they should be? Well if you are then you must accept that I can tell you how much you should earn.

28

Message Number 207441
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 08:51

Bill, I had ESWT with the Donier Machine. It was around $6,000. My insurance paid for most of it. It didn't work for me but I really believe that it does for some. I'd definately do it before Surgery, which I did, and am sooooo sorry I did the surgery.

29

Message Number 207431
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 06:21

Pick the right provider and if your doctor is not the typically greedy practioner you will find that ESWT can be suprisingly affordable despite the current trend of non-coverage by the insurance bandits.

30

Message Number 207413
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 21:23

Just make certain that you are not left with a huge co-pay that your insurance co. forgot to tell you about or the doctor didn't mention.

Let us know how you do following treatment. We are waiting to hear more positive results. I hope you are one of them

31

Message Number 207405
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:31

Ralph,

Thanks for the follow-ups! I have been quoted a price waaaay higher than these. BUT, it looks like my insurance may pay for the treatment (and I doubt their reimbursement is anywhere near the quoted price). So, I plan to go ahead and trust/hope that whatever the insurance company works out with the provider will be socially fair and efficient!

32

Message Number 207404
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:27

Scottr,

First, this is classic PF: 'first step' pain really bad and tender to modest pressure at the insertion of the PF to the heel on the inner part of the heel. Worsening for about 9 months; ibuprofen, icing, stretching, use of night splint when watching TV, etc.

The fiest two times I did the halogen I did not have sun glasses, so averted my eyes and was using the red food coloring in the water. I have done about 6 more treatments now using sunglasses. I will now switch to using non-colored water (my understanding from my sampling of your prior posts is that the red coloring makes for less heat at skin surface (which has not been a problem}, but I had not understod that clear light was more powerful).

Just prior to the first halogen treatment my 'first step' pain was off the charts and lasted for a couple of blocks. However, this was elvated somewhat because I had recently had to be on my feet a good deal. Some combination of the halogen and natural recovery from the elevated level brought my pain down consistently for a few days. However, I continue to experience some re-tearing while walking (I wonder if my orthotics need adjusting, although I am not sure which way the adjustment should go. BTW I was 10 years and untold orthotics on my other foot before doing the surgery and typically have a god sense of how to adjust orthotics. As mentioned in a different post, the surgery helped the PF but led to foot instability and occasional cuboid problems.)

Also, the 'runner's stretch' seems to irritate (re-tear) sometimes even though I am careful with the mechanics-my calf is not real tight; but the PF sure is.

I have seen some definite benefits from the halogen, and will continue to apply, and now with 'clear' light. However, I am a teacher and with classes starting soon I wanted to be pro-active regarding the ESWR-especially if my insurance will pay some. With 10 years of PF on my other foot-and going from atheletic to overweight and untoned- I want to do everything possible to resolve this foot much earlier!

Thanks so much for your research and site; I will keep you posted on both the halogen and ESWT.

For now,
Bill

33

Message Number 207386
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by scott r on 8/15/06 at 18:00

Bill, was the halogen you're using a flood or a spot? Is it to bright to look at your skin where it shines if you don't use the red coloring? I'm wanting to investigate every failed instance of using the halogen to see if i need to modify my instructions. Can you tell us more about your symptoms (pain location, when it occurs), history, and possible initial causes?

34

Message Number 207382
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 17:08

Bill,
Here is a post I found from last year. Don't know if fees have been raised or not but this gives you a good idea of possible medicare value assignments.

Posted by Steve W on 11/08/05 at 13:01
I just received the relative values assigned to ESWT by Medicare. This is second hand but a reliable source. Medicare has apparently assigned the following values:

ESWT performed in a facility:
Professional Fee - $210.
Facility/Technical Fee - $1,000

ESWT performed in physician's office:
Professional fee - $350
NO TECHNICAL/FACILITY FEE

I'm hearing same very negative comments from some companies including the real possibility of going out of business. The insurance mafia strikes again!!!

35

Message Number 207379
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:16

Bill,
Just read this article. It may interest you. Another machine is in town.

Can A Portable ESWT Device Provide Easier Treatment?
5. Orthospec (Medispec). Although extracorporeal shockwave therapy (ESWT) is a noninvasive option for various painful conditions, many ESWT devices are large and mostly available in hospitals and surgery centers due to the cost of the devices. The Orthospec, which recently gained FDA approval, is a more portable device that one can use in the office.

The Orthospec is a portable extracorporeal shockwave therapy device. Its portability and one-time treatment option are key benefits, according to John Hollander, DPM.

Such portability poses several advantages, according to John Hollander, DPM, who has been using Orthospec for a year. The fact that DPMs can have ESWT units in their offices makes for a cost savings since patients do not need to go to hospitals, according to Dr. Hollander, who practices in Santa Rosa, Calif. He also notes that he can perform the procedure with no anesthesia.
Dr. Hollander has used the device to treat plantar fasciitis, retrocalcaneal pain, Achilles tendonopathy and intermetatarsal neuromas.
Another advantage of the device, according to Medispec, is the one-time, 25-minute treatment whereas other ESWT devices usually involve multiple treatments. The company says that unlike with other ESWT devices, the Orthospec does not require an imaging device and one can use the Orthospec to treat a wide area.

36

Message Number 207378
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:14

Humor

37

Message Number 207376
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 16:03

Ralph,

Thanks so much for your thoughtful remarks! I couldn't help but notice your intial response 'how much dust it collects.' Was this just a good attempt at humore, or are you in general not a fan/believer in ESWT?

Thanks again!

38

Message Number 207374
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 15:27

How much dust it collects. Actually the Ossatron ESWT machines are used in Outpatient Surgical Centers and generally with the use of an anesthsiologist and anesthesia along with your treating doctor. The treatment with this machine has on occassion been done with foot blocks and relaxation instead of putting the patient out.

When you add up the Surgical Center cost, the charges to the Anesthesiologist, the medication and charges by your treating doctor the costs are usually higher than ESWT treatments performed in doctors offices or in mobile units that travel to multiple doctors offices. I think you'll find most doctors using mobile units or units in their office are using a Dornier ESWT machine.

Additionally there are a few doctors who use a low power machine off label to treat Plantar Fasciitis. Their treatments are done in their offices and usually consists of three separate sessions. This type of ESWT treatment is usually the cheapest.

Recently medicare approved payment to doctors for performing ESWT but the payments are so low that many doctors hesitate to treat medicare patients. Personally I think it's because they fear accepting what they think are lower than standard fees. Doing so may set a precedent for future payments by other insurance companies if and when they decide to cover ESWT. Two years after the fact doctors are still holding out hope that it will eventually come.

It's my opinion at this point doctors need to decide if they want their machines to collect, lower their fees, or offer attractive payment plans to patients.

Shopping around will more than likely get you the best deal. Some doctors like the Ossatron machine and others like the Dornier and still others like the low power one done with three treatments. Each will sell you what they like and use.

39

Message Number 207371
what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 14:19


There seem to be a lot of different prices for ESWST out there. Does it vary with the machine used, or what? What is reasonable?

1

Message Number 207908
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:17

I agree- ban Gary H for being an a**hole and attacking a new poster.

2

Message Number 207907
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:16

I agree- ban Gary H for being an a**hole and attacking a new poster.

3

Message Number 207885
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by footman on 8/19/06 at 21:20

I agree that Gary H is a first class as*hole for being nasty to eswt tech. I think that scott should kick his stupid insulting butt out of here. Maybe eswt tech has something good to add. Dr Z- I'll ask you the same ? as know them- did you ever meet "eswt tech" in 2004 as he said you did?

4

Message Number 207877
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/19/06 at 19:58

Who the f*** is this Gary H as*hole dumping on somebody who is afraid to get involved because of posters like him? Gary- I hope you have the worst incurable painful case of PF anybody ever experienced. I hope the pain is so bad it drives you to jump off a bridge into a cesspool.

Hey Dr Z- do you know who posted as "eswt tech"?

5

Message Number 207794
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/19/06 at 07:32

Dr Z will know who I am. Dr Z we met in A/C in 2004 at the region 3 convetion at the Taj Mahal. I visited you at your booth, you came to the booth my company had and we also had a very nice conversation in the hospitality suite that the region 3 group set up. Thses people are absolutely the meanest people I have ever run into. I wonder if foot pain makes you mean.

6

Message Number 207673
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Driver Wilde on 8/18/06 at 08:54

As a matter of fact, Ralph. Many of the patients treated in the FDA study for the Ossatron were done with a regional anesthetic only. Yes, it is very uncomfortable for the patient and not practical due to the huge amounts of lidocaine needed to numb the foot sufficiently (bordering on toxic doses).

The main reason the Ossatron must be used in the Surgery Center is because Healthtronics/Sanuwave have required that it be used in a surgery center. They have spent years claiming that high energy ESWT has to be done in an ASC or hospital so they could keep differentiate between ASC reimbursement and office reimbursement. Another problem with the Ossatron is that it is 700 lbs and 7 feet long. It won't fit in most doctors' treatment rooms.

Now that Sanuwave's contract with UHC is going down the toilet they are again offering to do treatments in a doctor's office. Good luck with that. Usually an Ossatron procedure is about 6 minutes under general or MAC.... under local it could take well over an hour and a lot of tears from the patient.

Point is.... the FDA says it's safe and effective to ues on humans but does not mandate it be used in an ASC.

-DW

7

Message Number 207671
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/18/06 at 08:24

I'd replace the word "putz" in your post with "guy" and eliminate the word "jerk". Name calling isn't necessary to get a point across.

8

Message Number 207631
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Gary H. on 8/17/06 at 20:09

Doctor Z,

I DO NOT believe that putz is an ESWT tech. I think he is full of himself. We will talk about that jerk at lunch next time. Let me read the board for 3 more years first.

9

Message Number 207624
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

10

Message Number 207623
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

11

Message Number 207622
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

12

Message Number 207621
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

13

Message Number 207620
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 17:07

Judy,
You've got to laugh at that post. It tore me up. The guy refuses to post and correct information he calls "ignorance and misinformation"

Now tells us we will be penalized and deprived forever because he's leaving the board.

Maybe had he posted sooner and told us what he had learned in his "previous scientific profession" we would have known the guy was around in the first place. He admits he had 4 years to do it.

I don't know about you but sad as I may be I'll carry one somehow one day at a time. I know you'll get by too. We've got to hang in there.

Like they say "when the going gets tough the tough get going" I'm going to dinner.

14

Message Number 207618
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by judy on 8/17/06 at 16:17

what is with the threats?

15

Message Number 207617
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:57

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

16

Message Number 207616
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:56

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

17

Message Number 207588
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 10:48

If you found this site so appalling you had two choices.
1. Leave the site and stop viewing it.
2. Post constructive information to correct what you call "ignorance and misinformation I constantly see".

You've done neither. So I guess who you know or what you know or who you met doesn't matter.

You get credit for recognizing the infighting. At times it does remind me of a wolf den.

18

Message Number 207548
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

19

Message Number 207547
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

20

Message Number 207544
correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:23

I have been reading this board for 3 years and have never posted until now. I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I would never expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

21

Message Number 207542
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:01

I have been reading this board, and have never posted until now, for 3 years and I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I have would expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

22

Message Number 207532
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 18:58

I think we'll be seeing many more of these machines used in these settings. The real question is will they help the athletes.

I wonder what they do with athletes training in Colorado hoping to make the Olympic teams if they get P.F. It would be interesting to see if they have an ESWT machine at that training facility.

23

Message Number 207517
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 17:41

thanks for long explenation. I didn't get any anesthesia so it was a lower power machine. I had one week between each session. it was a private clinic with ordinary general practice doctors but with extra knowledge of athlete injuries so I call it sport clinic. Athletes from the cities elite soccer team and track/field goes there.
In the end, ESWT didn't do anything for me so I'm glad I didn't pay too much. ART looks to do more help for me now.

24

Message Number 207514
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 17:17

I'll try not to be as rude as you "know them", but I was looking at the bill from the Surgery Center and Dr. The Dr. is also a part owner. I know that they paid quite a bit of the bill but I can't tell you the exact amount because it was a long time ago. I was cleaning out my old bills when I found it the other day. The point was that it was billed for that amount, period!

25

Message Number 207507
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 16:15

Good point,
What was the amount the doctor received.? It is possible that they did receive $6,000. I know that some certified mobile providers have received more then that amount for three low energy ESWT procedure. I guess that is why UHC is gone. Would you know anything about that Know them?

26

Message Number 207462
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 11:36

The difference in cost is most often related to the location where the ESWT under FDA guideline must be performed.

The Osstron ESWT machine must be used in an Outpatient Surgical Center or Hospital.

The Dornier Machine can be used in Mobile Trailers or in doctors offices.

Each of these machines suggest that one treatment does the trick however, a second treatment may be necessary. The treatments are not give in a daily or weekly series they are spread apart.

From what you described the ESWT treatment you received was with a machine that provides 3 treatments closely together. These machines are often considered lower power machines hence 3 treatments are needed to equal one of the others. Please realize that when I use the word equal its in very "general terms" and not "scientific" meaning that if compared the amount of shock wave ability may not be truely "equal" but for my reply I'm just using the term equal as described above. You'd have to compare several things to determine the true equality of these machines.

The type of machine you had obviously wasn't required by the FDA to be used in an Outpatient Surgical Center or hospital and possibly it might have been even used off label meaning that the machine itself isn't FDA approved specifically for treating P.F. "Specifically" is the important word here. It can be used off label.

It is well known that these type of machines cost less to purchase and the treatments also cost less. I believe in Canada these machines have become very popular and possibly are becoming more popular in the U.S. because of lower cost treatments.

Right now you must remember that the prices of getting an ESWT treatment is in the hands of the doctors because there is very little insurance coverage. They can raise or lower prices as they see fit but feel that the cost of the machine, up keep, over head and their services etc are worth more than the $300 you paid.

This is expecially true with the Ossatron machine that must be used in a hospital or Outpatient surgical Center with an anesthesiologist and anesthesia. Add those costs to the doctors fee and even without paying the doctor a dime you are already well over $300.

In your case the machine used, the fact that it was done in a sports clinic and the decision of the doctor to charge only $300 made the difference in what you paid.

27

Message Number 207452
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 10:05

I went to a sports clinic, used by elite athletes, and the ESWT treatment was not covered by anything for me so I paid 300$ for three sessions. Experienced doctor did the procedure. don't understand the 1000$ per session thing.

28

Message Number 207447
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 09:46

You did not pay anything near that amount, nor did the doctor or equipment provider collect anywhere near that amount. Do you have any idea what a Dornier EPOS costs? Do you have any idea what it costs to keep a mobile unit in the field? A vehicle, techs salary and benefits, insurance,fuel, maintainance on the EPOS and the vehicle, depreciation, back office and support staff expense. depericiation, debt service on any business loans, - I could go on for 10 more lines. The total cost to campaign a mobile ESWT operation running 5 days a week is probably around $200,000.

You looked at the EOB you received for the amount billed and decided to make a big splash here quoting that $ amount. Now look at that same EOB and tell us, truthfully if you can, what the insurance company actually paid the provider and the doctor. I'de be suprised if it came to more that 30% of what was billed.

Are you one of those socialist who feel that free enterprise should listen to your rules as to how profitable they should be? Well if you are then you must accept that I can tell you how much you should earn.

29

Message Number 207441
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 08:51

Bill, I had ESWT with the Donier Machine. It was around $6,000. My insurance paid for most of it. It didn't work for me but I really believe that it does for some. I'd definately do it before Surgery, which I did, and am sooooo sorry I did the surgery.

30

Message Number 207431
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 06:21

Pick the right provider and if your doctor is not the typically greedy practioner you will find that ESWT can be suprisingly affordable despite the current trend of non-coverage by the insurance bandits.

31

Message Number 207413
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 21:23

Just make certain that you are not left with a huge co-pay that your insurance co. forgot to tell you about or the doctor didn't mention.

Let us know how you do following treatment. We are waiting to hear more positive results. I hope you are one of them

32

Message Number 207405
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:31

Ralph,

Thanks for the follow-ups! I have been quoted a price waaaay higher than these. BUT, it looks like my insurance may pay for the treatment (and I doubt their reimbursement is anywhere near the quoted price). So, I plan to go ahead and trust/hope that whatever the insurance company works out with the provider will be socially fair and efficient!

33

Message Number 207404
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:27

Scottr,

First, this is classic PF: 'first step' pain really bad and tender to modest pressure at the insertion of the PF to the heel on the inner part of the heel. Worsening for about 9 months; ibuprofen, icing, stretching, use of night splint when watching TV, etc.

The fiest two times I did the halogen I did not have sun glasses, so averted my eyes and was using the red food coloring in the water. I have done about 6 more treatments now using sunglasses. I will now switch to using non-colored water (my understanding from my sampling of your prior posts is that the red coloring makes for less heat at skin surface (which has not been a problem}, but I had not understod that clear light was more powerful).

Just prior to the first halogen treatment my 'first step' pain was off the charts and lasted for a couple of blocks. However, this was elvated somewhat because I had recently had to be on my feet a good deal. Some combination of the halogen and natural recovery from the elevated level brought my pain down consistently for a few days. However, I continue to experience some re-tearing while walking (I wonder if my orthotics need adjusting, although I am not sure which way the adjustment should go. BTW I was 10 years and untold orthotics on my other foot before doing the surgery and typically have a god sense of how to adjust orthotics. As mentioned in a different post, the surgery helped the PF but led to foot instability and occasional cuboid problems.)

Also, the 'runner's stretch' seems to irritate (re-tear) sometimes even though I am careful with the mechanics-my calf is not real tight; but the PF sure is.

I have seen some definite benefits from the halogen, and will continue to apply, and now with 'clear' light. However, I am a teacher and with classes starting soon I wanted to be pro-active regarding the ESWR-especially if my insurance will pay some. With 10 years of PF on my other foot-and going from atheletic to overweight and untoned- I want to do everything possible to resolve this foot much earlier!

Thanks so much for your research and site; I will keep you posted on both the halogen and ESWT.

For now,
Bill

34

Message Number 207386
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by scott r on 8/15/06 at 18:00

Bill, was the halogen you're using a flood or a spot? Is it to bright to look at your skin where it shines if you don't use the red coloring? I'm wanting to investigate every failed instance of using the halogen to see if i need to modify my instructions. Can you tell us more about your symptoms (pain location, when it occurs), history, and possible initial causes?

35

Message Number 207382
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 17:08

Bill,
Here is a post I found from last year. Don't know if fees have been raised or not but this gives you a good idea of possible medicare value assignments.

Posted by Steve W on 11/08/05 at 13:01
I just received the relative values assigned to ESWT by Medicare. This is second hand but a reliable source. Medicare has apparently assigned the following values:

ESWT performed in a facility:
Professional Fee - $210.
Facility/Technical Fee - $1,000

ESWT performed in physician's office:
Professional fee - $350
NO TECHNICAL/FACILITY FEE

I'm hearing same very negative comments from some companies including the real possibility of going out of business. The insurance mafia strikes again!!!

36

Message Number 207379
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:16

Bill,
Just read this article. It may interest you. Another machine is in town.

Can A Portable ESWT Device Provide Easier Treatment?
5. Orthospec (Medispec). Although extracorporeal shockwave therapy (ESWT) is a noninvasive option for various painful conditions, many ESWT devices are large and mostly available in hospitals and surgery centers due to the cost of the devices. The Orthospec, which recently gained FDA approval, is a more portable device that one can use in the office.

The Orthospec is a portable extracorporeal shockwave therapy device. Its portability and one-time treatment option are key benefits, according to John Hollander, DPM.

Such portability poses several advantages, according to John Hollander, DPM, who has been using Orthospec for a year. The fact that DPMs can have ESWT units in their offices makes for a cost savings since patients do not need to go to hospitals, according to Dr. Hollander, who practices in Santa Rosa, Calif. He also notes that he can perform the procedure with no anesthesia.
Dr. Hollander has used the device to treat plantar fasciitis, retrocalcaneal pain, Achilles tendonopathy and intermetatarsal neuromas.
Another advantage of the device, according to Medispec, is the one-time, 25-minute treatment whereas other ESWT devices usually involve multiple treatments. The company says that unlike with other ESWT devices, the Orthospec does not require an imaging device and one can use the Orthospec to treat a wide area.

37

Message Number 207378
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:14

Humor

38

Message Number 207376
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 16:03

Ralph,

Thanks so much for your thoughtful remarks! I couldn't help but notice your intial response 'how much dust it collects.' Was this just a good attempt at humore, or are you in general not a fan/believer in ESWT?

Thanks again!

39

Message Number 207374
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 15:27

How much dust it collects. Actually the Ossatron ESWT machines are used in Outpatient Surgical Centers and generally with the use of an anesthsiologist and anesthesia along with your treating doctor. The treatment with this machine has on occassion been done with foot blocks and relaxation instead of putting the patient out.

When you add up the Surgical Center cost, the charges to the Anesthesiologist, the medication and charges by your treating doctor the costs are usually higher than ESWT treatments performed in doctors offices or in mobile units that travel to multiple doctors offices. I think you'll find most doctors using mobile units or units in their office are using a Dornier ESWT machine.

Additionally there are a few doctors who use a low power machine off label to treat Plantar Fasciitis. Their treatments are done in their offices and usually consists of three separate sessions. This type of ESWT treatment is usually the cheapest.

Recently medicare approved payment to doctors for performing ESWT but the payments are so low that many doctors hesitate to treat medicare patients. Personally I think it's because they fear accepting what they think are lower than standard fees. Doing so may set a precedent for future payments by other insurance companies if and when they decide to cover ESWT. Two years after the fact doctors are still holding out hope that it will eventually come.

It's my opinion at this point doctors need to decide if they want their machines to collect, lower their fees, or offer attractive payment plans to patients.

Shopping around will more than likely get you the best deal. Some doctors like the Ossatron machine and others like the Dornier and still others like the low power one done with three treatments. Each will sell you what they like and use.

40

Message Number 207371
what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 14:19


There seem to be a lot of different prices for ESWST out there. Does it vary with the machine used, or what? What is reasonable?

Result number: 81

Message Number 207971

disappearing posts View Thread
Posted by know them on 8/20/06 at 16:42

this seemed to have vanished so I reposted itRe: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:17

I agree- ban Gary H for being an a**hole and attacking a new poster.

1

Message Number 207907
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:16

I agree- ban Gary H for being an a**hole and attacking a new poster.

2

Message Number 207885
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by footman on 8/19/06 at 21:20

I agree that Gary H is a first class as*hole for being nasty to eswt tech. I think that scott should kick his stupid insulting butt out of here. Maybe eswt tech has something good to add. Dr Z- I'll ask you the same ? as know them- did you ever meet "eswt tech" in 2004 as he said you did?

3

Message Number 207877
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/19/06 at 19:58

Who the f*** is this Gary H as*hole dumping on somebody who is afraid to get involved because of posters like him? Gary- I hope you have the worst incurable painful case of PF anybody ever experienced. I hope the pain is so bad it drives you to jump off a bridge into a cesspool.

Hey Dr Z- do you know who posted as "eswt tech"?

4

Message Number 207794
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/19/06 at 07:32

Dr Z will know who I am. Dr Z we met in A/C in 2004 at the region 3 convetion at the Taj Mahal. I visited you at your booth, you came to the booth my company had and we also had a very nice conversation in the hospitality suite that the region 3 group set up. Thses people are absolutely the meanest people I have ever run into. I wonder if foot pain makes you mean.

5

Message Number 207673
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Driver Wilde on 8/18/06 at 08:54

As a matter of fact, Ralph. Many of the patients treated in the FDA study for the Ossatron were done with a regional anesthetic only. Yes, it is very uncomfortable for the patient and not practical due to the huge amounts of lidocaine needed to numb the foot sufficiently (bordering on toxic doses).

The main reason the Ossatron must be used in the Surgery Center is because Healthtronics/Sanuwave have required that it be used in a surgery center. They have spent years claiming that high energy ESWT has to be done in an ASC or hospital so they could keep differentiate between ASC reimbursement and office reimbursement. Another problem with the Ossatron is that it is 700 lbs and 7 feet long. It won't fit in most doctors' treatment rooms.

Now that Sanuwave's contract with UHC is going down the toilet they are again offering to do treatments in a doctor's office. Good luck with that. Usually an Ossatron procedure is about 6 minutes under general or MAC.... under local it could take well over an hour and a lot of tears from the patient.

Point is.... the FDA says it's safe and effective to ues on humans but does not mandate it be used in an ASC.

-DW

6

Message Number 207671
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/18/06 at 08:24

I'd replace the word "putz" in your post with "guy" and eliminate the word "jerk". Name calling isn't necessary to get a point across.

7

Message Number 207631
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Gary H. on 8/17/06 at 20:09

Doctor Z,

I DO NOT believe that putz is an ESWT tech. I think he is full of himself. We will talk about that jerk at lunch next time. Let me read the board for 3 more years first.

8

Message Number 207624
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

9

Message Number 207623
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

10

Message Number 207622
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

11

Message Number 207621
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

12

Message Number 207620
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 17:07

Judy,
You've got to laugh at that post. It tore me up. The guy refuses to post and correct information he calls "ignorance and misinformation"

Now tells us we will be penalized and deprived forever because he's leaving the board.

Maybe had he posted sooner and told us what he had learned in his "previous scientific profession" we would have known the guy was around in the first place. He admits he had 4 years to do it.

I don't know about you but sad as I may be I'll carry one somehow one day at a time. I know you'll get by too. We've got to hang in there.

Like they say "when the going gets tough the tough get going" I'm going to dinner.

13

Message Number 207618
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by judy on 8/17/06 at 16:17

what is with the threats?

14

Message Number 207617
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:57

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

15

Message Number 207616
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:56

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

16

Message Number 207588
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 10:48

If you found this site so appalling you had two choices.
1. Leave the site and stop viewing it.
2. Post constructive information to correct what you call "ignorance and misinformation I constantly see".

You've done neither. So I guess who you know or what you know or who you met doesn't matter.

You get credit for recognizing the infighting. At times it does remind me of a wolf den.

17

Message Number 207548
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

18

Message Number 207547
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

19

Message Number 207544
correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:23

I have been reading this board for 3 years and have never posted until now. I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I would never expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

20

Message Number 207542
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:01

I have been reading this board, and have never posted until now, for 3 years and I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I have would expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

21

Message Number 207532
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 18:58

I think we'll be seeing many more of these machines used in these settings. The real question is will they help the athletes.

I wonder what they do with athletes training in Colorado hoping to make the Olympic teams if they get P.F. It would be interesting to see if they have an ESWT machine at that training facility.

22

Message Number 207517
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 17:41

thanks for long explenation. I didn't get any anesthesia so it was a lower power machine. I had one week between each session. it was a private clinic with ordinary general practice doctors but with extra knowledge of athlete injuries so I call it sport clinic. Athletes from the cities elite soccer team and track/field goes there.
In the end, ESWT didn't do anything for me so I'm glad I didn't pay too much. ART looks to do more help for me now.

23

Message Number 207514
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 17:17

I'll try not to be as rude as you "know them", but I was looking at the bill from the Surgery Center and Dr. The Dr. is also a part owner. I know that they paid quite a bit of the bill but I can't tell you the exact amount because it was a long time ago. I was cleaning out my old bills when I found it the other day. The point was that it was billed for that amount, period!

24

Message Number 207507
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 16:15

Good point,
What was the amount the doctor received.? It is possible that they did receive $6,000. I know that some certified mobile providers have received more then that amount for three low energy ESWT procedure. I guess that is why UHC is gone. Would you know anything about that Know them?

25

Message Number 207462
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 11:36

The difference in cost is most often related to the location where the ESWT under FDA guideline must be performed.

The Osstron ESWT machine must be used in an Outpatient Surgical Center or Hospital.

The Dornier Machine can be used in Mobile Trailers or in doctors offices.

Each of these machines suggest that one treatment does the trick however, a second treatment may be necessary. The treatments are not give in a daily or weekly series they are spread apart.

From what you described the ESWT treatment you received was with a machine that provides 3 treatments closely together. These machines are often considered lower power machines hence 3 treatments are needed to equal one of the others. Please realize that when I use the word equal its in very "general terms" and not "scientific" meaning that if compared the amount of shock wave ability may not be truely "equal" but for my reply I'm just using the term equal as described above. You'd have to compare several things to determine the true equality of these machines.

The type of machine you had obviously wasn't required by the FDA to be used in an Outpatient Surgical Center or hospital and possibly it might have been even used off label meaning that the machine itself isn't FDA approved specifically for treating P.F. "Specifically" is the important word here. It can be used off label.

It is well known that these type of machines cost less to purchase and the treatments also cost less. I believe in Canada these machines have become very popular and possibly are becoming more popular in the U.S. because of lower cost treatments.

Right now you must remember that the prices of getting an ESWT treatment is in the hands of the doctors because there is very little insurance coverage. They can raise or lower prices as they see fit but feel that the cost of the machine, up keep, over head and their services etc are worth more than the $300 you paid.

This is expecially true with the Ossatron machine that must be used in a hospital or Outpatient surgical Center with an anesthesiologist and anesthesia. Add those costs to the doctors fee and even without paying the doctor a dime you are already well over $300.

In your case the machine used, the fact that it was done in a sports clinic and the decision of the doctor to charge only $300 made the difference in what you paid.

26

Message Number 207452
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 10:05

I went to a sports clinic, used by elite athletes, and the ESWT treatment was not covered by anything for me so I paid 300$ for three sessions. Experienced doctor did the procedure. don't understand the 1000$ per session thing.

27

Message Number 207447
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 09:46

You did not pay anything near that amount, nor did the doctor or equipment provider collect anywhere near that amount. Do you have any idea what a Dornier EPOS costs? Do you have any idea what it costs to keep a mobile unit in the field? A vehicle, techs salary and benefits, insurance,fuel, maintainance on the EPOS and the vehicle, depreciation, back office and support staff expense. depericiation, debt service on any business loans, - I could go on for 10 more lines. The total cost to campaign a mobile ESWT operation running 5 days a week is probably around $200,000.

You looked at the EOB you received for the amount billed and decided to make a big splash here quoting that $ amount. Now look at that same EOB and tell us, truthfully if you can, what the insurance company actually paid the provider and the doctor. I'de be suprised if it came to more that 30% of what was billed.

Are you one of those socialist who feel that free enterprise should listen to your rules as to how profitable they should be? Well if you are then you must accept that I can tell you how much you should earn.

28

Message Number 207441
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 08:51

Bill, I had ESWT with the Donier Machine. It was around $6,000. My insurance paid for most of it. It didn't work for me but I really believe that it does for some. I'd definately do it before Surgery, which I did, and am sooooo sorry I did the surgery.

29

Message Number 207431
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 06:21

Pick the right provider and if your doctor is not the typically greedy practioner you will find that ESWT can be suprisingly affordable despite the current trend of non-coverage by the insurance bandits.

30

Message Number 207413
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 21:23

Just make certain that you are not left with a huge co-pay that your insurance co. forgot to tell you about or the doctor didn't mention.

Let us know how you do following treatment. We are waiting to hear more positive results. I hope you are one of them

31

Message Number 207405
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:31

Ralph,

Thanks for the follow-ups! I have been quoted a price waaaay higher than these. BUT, it looks like my insurance may pay for the treatment (and I doubt their reimbursement is anywhere near the quoted price). So, I plan to go ahead and trust/hope that whatever the insurance company works out with the provider will be socially fair and efficient!

32

Message Number 207404
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:27

Scottr,

First, this is classic PF: 'first step' pain really bad and tender to modest pressure at the insertion of the PF to the heel on the inner part of the heel. Worsening for about 9 months; ibuprofen, icing, stretching, use of night splint when watching TV, etc.

The fiest two times I did the halogen I did not have sun glasses, so averted my eyes and was using the red food coloring in the water. I have done about 6 more treatments now using sunglasses. I will now switch to using non-colored water (my understanding from my sampling of your prior posts is that the red coloring makes for less heat at skin surface (which has not been a problem}, but I had not understod that clear light was more powerful).

Just prior to the first halogen treatment my 'first step' pain was off the charts and lasted for a couple of blocks. However, this was elvated somewhat because I had recently had to be on my feet a good deal. Some combination of the halogen and natural recovery from the elevated level brought my pain down consistently for a few days. However, I continue to experience some re-tearing while walking (I wonder if my orthotics need adjusting, although I am not sure which way the adjustment should go. BTW I was 10 years and untold orthotics on my other foot before doing the surgery and typically have a god sense of how to adjust orthotics. As mentioned in a different post, the surgery helped the PF but led to foot instability and occasional cuboid problems.)

Also, the 'runner's stretch' seems to irritate (re-tear) sometimes even though I am careful with the mechanics-my calf is not real tight; but the PF sure is.

I have seen some definite benefits from the halogen, and will continue to apply, and now with 'clear' light. However, I am a teacher and with classes starting soon I wanted to be pro-active regarding the ESWR-especially if my insurance will pay some. With 10 years of PF on my other foot-and going from atheletic to overweight and untoned- I want to do everything possible to resolve this foot much earlier!

Thanks so much for your research and site; I will keep you posted on both the halogen and ESWT.

For now,
Bill

33

Message Number 207386
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by scott r on 8/15/06 at 18:00

Bill, was the halogen you're using a flood or a spot? Is it to bright to look at your skin where it shines if you don't use the red coloring? I'm wanting to investigate every failed instance of using the halogen to see if i need to modify my instructions. Can you tell us more about your symptoms (pain location, when it occurs), history, and possible initial causes?

34

Message Number 207382
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 17:08

Bill,
Here is a post I found from last year. Don't know if fees have been raised or not but this gives you a good idea of possible medicare value assignments.

Posted by Steve W on 11/08/05 at 13:01
I just received the relative values assigned to ESWT by Medicare. This is second hand but a reliable source. Medicare has apparently assigned the following values:

ESWT performed in a facility:
Professional Fee - $210.
Facility/Technical Fee - $1,000

ESWT performed in physician's office:
Professional fee - $350
NO TECHNICAL/FACILITY FEE

I'm hearing same very negative comments from some companies including the real possibility of going out of business. The insurance mafia strikes again!!!

35

Message Number 207379
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:16

Bill,
Just read this article. It may interest you. Another machine is in town.

Can A Portable ESWT Device Provide Easier Treatment?
5. Orthospec (Medispec). Although extracorporeal shockwave therapy (ESWT) is a noninvasive option for various painful conditions, many ESWT devices are large and mostly available in hospitals and surgery centers due to the cost of the devices. The Orthospec, which recently gained FDA approval, is a more portable device that one can use in the office.

The Orthospec is a portable extracorporeal shockwave therapy device. Its portability and one-time treatment option are key benefits, according to John Hollander, DPM.

Such portability poses several advantages, according to John Hollander, DPM, who has been using Orthospec for a year. The fact that DPMs can have ESWT units in their offices makes for a cost savings since patients do not need to go to hospitals, according to Dr. Hollander, who practices in Santa Rosa, Calif. He also notes that he can perform the procedure with no anesthesia.
Dr. Hollander has used the device to treat plantar fasciitis, retrocalcaneal pain, Achilles tendonopathy and intermetatarsal neuromas.
Another advantage of the device, according to Medispec, is the one-time, 25-minute treatment whereas other ESWT devices usually involve multiple treatments. The company says that unlike with other ESWT devices, the Orthospec does not require an imaging device and one can use the Orthospec to treat a wide area.

36

Message Number 207378
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:14

Humor

37

Message Number 207376
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 16:03

Ralph,

Thanks so much for your thoughtful remarks! I couldn't help but notice your intial response 'how much dust it collects.' Was this just a good attempt at humore, or are you in general not a fan/believer in ESWT?

Thanks again!

38

Message Number 207374
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 15:27

How much dust it collects. Actually the Ossatron ESWT machines are used in Outpatient Surgical Centers and generally with the use of an anesthsiologist and anesthesia along with your treating doctor. The treatment with this machine has on occassion been done with foot blocks and relaxation instead of putting the patient out.

When you add up the Surgical Center cost, the charges to the Anesthesiologist, the medication and charges by your treating doctor the costs are usually higher than ESWT treatments performed in doctors offices or in mobile units that travel to multiple doctors offices. I think you'll find most doctors using mobile units or units in their office are using a Dornier ESWT machine.

Additionally there are a few doctors who use a low power machine off label to treat Plantar Fasciitis. Their treatments are done in their offices and usually consists of three separate sessions. This type of ESWT treatment is usually the cheapest.

Recently medicare approved payment to doctors for performing ESWT but the payments are so low that many doctors hesitate to treat medicare patients. Personally I think it's because they fear accepting what they think are lower than standard fees. Doing so may set a precedent for future payments by other insurance companies if and when they decide to cover ESWT. Two years after the fact doctors are still holding out hope that it will eventually come.

It's my opinion at this point doctors need to decide if they want their machines to collect, lower their fees, or offer attractive payment plans to patients.

Shopping around will more than likely get you the best deal. Some doctors like the Ossatron machine and others like the Dornier and still others like the low power one done with three treatments. Each will sell you what they like and use.

39

Message Number 207371
what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 14:19


There seem to be a lot of different prices for ESWST out there. Does it vary with the machine used, or what? What is reasonable?

1

Message Number 207908
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:17

I agree- ban Gary H for being an a**hole and attacking a new poster.

2

Message Number 207907
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:16

I agree- ban Gary H for being an a**hole and attacking a new poster.

3

Message Number 207885
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by footman on 8/19/06 at 21:20

I agree that Gary H is a first class as*hole for being nasty to eswt tech. I think that scott should kick his stupid insulting butt out of here. Maybe eswt tech has something good to add. Dr Z- I'll ask you the same ? as know them- did you ever meet "eswt tech" in 2004 as he said you did?

4

Message Number 207877
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/19/06 at 19:58

Who the f*** is this Gary H as*hole dumping on somebody who is afraid to get involved because of posters like him? Gary- I hope you have the worst incurable painful case of PF anybody ever experienced. I hope the pain is so bad it drives you to jump off a bridge into a cesspool.

Hey Dr Z- do you know who posted as "eswt tech"?

5

Message Number 207794
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/19/06 at 07:32

Dr Z will know who I am. Dr Z we met in A/C in 2004 at the region 3 convetion at the Taj Mahal. I visited you at your booth, you came to the booth my company had and we also had a very nice conversation in the hospitality suite that the region 3 group set up. Thses people are absolutely the meanest people I have ever run into. I wonder if foot pain makes you mean.

6

Message Number 207673
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Driver Wilde on 8/18/06 at 08:54

As a matter of fact, Ralph. Many of the patients treated in the FDA study for the Ossatron were done with a regional anesthetic only. Yes, it is very uncomfortable for the patient and not practical due to the huge amounts of lidocaine needed to numb the foot sufficiently (bordering on toxic doses).

The main reason the Ossatron must be used in the Surgery Center is because Healthtronics/Sanuwave have required that it be used in a surgery center. They have spent years claiming that high energy ESWT has to be done in an ASC or hospital so they could keep differentiate between ASC reimbursement and office reimbursement. Another problem with the Ossatron is that it is 700 lbs and 7 feet long. It won't fit in most doctors' treatment rooms.

Now that Sanuwave's contract with UHC is going down the toilet they are again offering to do treatments in a doctor's office. Good luck with that. Usually an Ossatron procedure is about 6 minutes under general or MAC.... under local it could take well over an hour and a lot of tears from the patient.

Point is.... the FDA says it's safe and effective to ues on humans but does not mandate it be used in an ASC.

-DW

7

Message Number 207671
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/18/06 at 08:24

I'd replace the word "putz" in your post with "guy" and eliminate the word "jerk". Name calling isn't necessary to get a point across.

8

Message Number 207631
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Gary H. on 8/17/06 at 20:09

Doctor Z,

I DO NOT believe that putz is an ESWT tech. I think he is full of himself. We will talk about that jerk at lunch next time. Let me read the board for 3 more years first.

9

Message Number 207624
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

10

Message Number 207623
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

11

Message Number 207622
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

12

Message Number 207621
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

13

Message Number 207620
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 17:07

Judy,
You've got to laugh at that post. It tore me up. The guy refuses to post and correct information he calls "ignorance and misinformation"

Now tells us we will be penalized and deprived forever because he's leaving the board.

Maybe had he posted sooner and told us what he had learned in his "previous scientific profession" we would have known the guy was around in the first place. He admits he had 4 years to do it.

I don't know about you but sad as I may be I'll carry one somehow one day at a time. I know you'll get by too. We've got to hang in there.

Like they say "when the going gets tough the tough get going" I'm going to dinner.

14

Message Number 207618
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by judy on 8/17/06 at 16:17

what is with the threats?

15

Message Number 207617
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:57

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

16

Message Number 207616
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:56

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

17

Message Number 207588
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 10:48

If you found this site so appalling you had two choices.
1. Leave the site and stop viewing it.
2. Post constructive information to correct what you call "ignorance and misinformation I constantly see".

You've done neither. So I guess who you know or what you know or who you met doesn't matter.

You get credit for recognizing the infighting. At times it does remind me of a wolf den.

18

Message Number 207548
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

19

Message Number 207547
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

20

Message Number 207544
correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:23

I have been reading this board for 3 years and have never posted until now. I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I would never expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

21

Message Number 207542
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:01

I have been reading this board, and have never posted until now, for 3 years and I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I have would expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

22

Message Number 207532
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 18:58

I think we'll be seeing many more of these machines used in these settings. The real question is will they help the athletes.

I wonder what they do with athletes training in Colorado hoping to make the Olympic teams if they get P.F. It would be interesting to see if they have an ESWT machine at that training facility.

23

Message Number 207517
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 17:41

thanks for long explenation. I didn't get any anesthesia so it was a lower power machine. I had one week between each session. it was a private clinic with ordinary general practice doctors but with extra knowledge of athlete injuries so I call it sport clinic. Athletes from the cities elite soccer team and track/field goes there.
In the end, ESWT didn't do anything for me so I'm glad I didn't pay too much. ART looks to do more help for me now.

24

Message Number 207514
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 17:17

I'll try not to be as rude as you "know them", but I was looking at the bill from the Surgery Center and Dr. The Dr. is also a part owner. I know that they paid quite a bit of the bill but I can't tell you the exact amount because it was a long time ago. I was cleaning out my old bills when I found it the other day. The point was that it was billed for that amount, period!

25

Message Number 207507
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 16:15

Good point,
What was the amount the doctor received.? It is possible that they did receive $6,000. I know that some certified mobile providers have received more then that amount for three low energy ESWT procedure. I guess that is why UHC is gone. Would you know anything about that Know them?

26

Message Number 207462
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 11:36

The difference in cost is most often related to the location where the ESWT under FDA guideline must be performed.

The Osstron ESWT machine must be used in an Outpatient Surgical Center or Hospital.

The Dornier Machine can be used in Mobile Trailers or in doctors offices.

Each of these machines suggest that one treatment does the trick however, a second treatment may be necessary. The treatments are not give in a daily or weekly series they are spread apart.

From what you described the ESWT treatment you received was with a machine that provides 3 treatments closely together. These machines are often considered lower power machines hence 3 treatments are needed to equal one of the others. Please realize that when I use the word equal its in very "general terms" and not "scientific" meaning that if compared the amount of shock wave ability may not be truely "equal" but for my reply I'm just using the term equal as described above. You'd have to compare several things to determine the true equality of these machines.

The type of machine you had obviously wasn't required by the FDA to be used in an Outpatient Surgical Center or hospital and possibly it might have been even used off label meaning that the machine itself isn't FDA approved specifically for treating P.F. "Specifically" is the important word here. It can be used off label.

It is well known that these type of machines cost less to purchase and the treatments also cost less. I believe in Canada these machines have become very popular and possibly are becoming more popular in the U.S. because of lower cost treatments.

Right now you must remember that the prices of getting an ESWT treatment is in the hands of the doctors because there is very little insurance coverage. They can raise or lower prices as they see fit but feel that the cost of the machine, up keep, over head and their services etc are worth more than the $300 you paid.

This is expecially true with the Ossatron machine that must be used in a hospital or Outpatient surgical Center with an anesthesiologist and anesthesia. Add those costs to the doctors fee and even without paying the doctor a dime you are already well over $300.

In your case the machine used, the fact that it was done in a sports clinic and the decision of the doctor to charge only $300 made the difference in what you paid.

27

Message Number 207452
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 10:05

I went to a sports clinic, used by elite athletes, and the ESWT treatment was not covered by anything for me so I paid 300$ for three sessions. Experienced doctor did the procedure. don't understand the 1000$ per session thing.

28

Message Number 207447
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 09:46

You did not pay anything near that amount, nor did the doctor or equipment provider collect anywhere near that amount. Do you have any idea what a Dornier EPOS costs? Do you have any idea what it costs to keep a mobile unit in the field? A vehicle, techs salary and benefits, insurance,fuel, maintainance on the EPOS and the vehicle, depreciation, back office and support staff expense. depericiation, debt service on any business loans, - I could go on for 10 more lines. The total cost to campaign a mobile ESWT operation running 5 days a week is probably around $200,000.

You looked at the EOB you received for the amount billed and decided to make a big splash here quoting that $ amount. Now look at that same EOB and tell us, truthfully if you can, what the insurance company actually paid the provider and the doctor. I'de be suprised if it came to more that 30% of what was billed.

Are you one of those socialist who feel that free enterprise should listen to your rules as to how profitable they should be? Well if you are then you must accept that I can tell you how much you should earn.

29

Message Number 207441
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 08:51

Bill, I had ESWT with the Donier Machine. It was around $6,000. My insurance paid for most of it. It didn't work for me but I really believe that it does for some. I'd definately do it before Surgery, which I did, and am sooooo sorry I did the surgery.

30

Message Number 207431
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 06:21

Pick the right provider and if your doctor is not the typically greedy practioner you will find that ESWT can be suprisingly affordable despite the current trend of non-coverage by the insurance bandits.

31

Message Number 207413
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 21:23

Just make certain that you are not left with a huge co-pay that your insurance co. forgot to tell you about or the doctor didn't mention.

Let us know how you do following treatment. We are waiting to hear more positive results. I hope you are one of them

32

Message Number 207405
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:31

Ralph,

Thanks for the follow-ups! I have been quoted a price waaaay higher than these. BUT, it looks like my insurance may pay for the treatment (and I doubt their reimbursement is anywhere near the quoted price). So, I plan to go ahead and trust/hope that whatever the insurance company works out with the provider will be socially fair and efficient!

33

Message Number 207404
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:27

Scottr,

First, this is classic PF: 'first step' pain really bad and tender to modest pressure at the insertion of the PF to the heel on the inner part of the heel. Worsening for about 9 months; ibuprofen, icing, stretching, use of night splint when watching TV, etc.

The fiest two times I did the halogen I did not have sun glasses, so averted my eyes and was using the red food coloring in the water. I have done about 6 more treatments now using sunglasses. I will now switch to using non-colored water (my understanding from my sampling of your prior posts is that the red coloring makes for less heat at skin surface (which has not been a problem}, but I had not understod that clear light was more powerful).

Just prior to the first halogen treatment my 'first step' pain was off the charts and lasted for a couple of blocks. However, this was elvated somewhat because I had recently had to be on my feet a good deal. Some combination of the halogen and natural recovery from the elevated level brought my pain down consistently for a few days. However, I continue to experience some re-tearing while walking (I wonder if my orthotics need adjusting, although I am not sure which way the adjustment should go. BTW I was 10 years and untold orthotics on my other foot before doing the surgery and typically have a god sense of how to adjust orthotics. As mentioned in a different post, the surgery helped the PF but led to foot instability and occasional cuboid problems.)

Also, the 'runner's stretch' seems to irritate (re-tear) sometimes even though I am careful with the mechanics-my calf is not real tight; but the PF sure is.

I have seen some definite benefits from the halogen, and will continue to apply, and now with 'clear' light. However, I am a teacher and with classes starting soon I wanted to be pro-active regarding the ESWR-especially if my insurance will pay some. With 10 years of PF on my other foot-and going from atheletic to overweight and untoned- I want to do everything possible to resolve this foot much earlier!

Thanks so much for your research and site; I will keep you posted on both the halogen and ESWT.

For now,
Bill

34

Message Number 207386
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by scott r on 8/15/06 at 18:00

Bill, was the halogen you're using a flood or a spot? Is it to bright to look at your skin where it shines if you don't use the red coloring? I'm wanting to investigate every failed instance of using the halogen to see if i need to modify my instructions. Can you tell us more about your symptoms (pain location, when it occurs), history, and possible initial causes?

35

Message Number 207382
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 17:08

Bill,
Here is a post I found from last year. Don't know if fees have been raised or not but this gives you a good idea of possible medicare value assignments.

Posted by Steve W on 11/08/05 at 13:01
I just received the relative values assigned to ESWT by Medicare. This is second hand but a reliable source. Medicare has apparently assigned the following values:

ESWT performed in a facility:
Professional Fee - $210.
Facility/Technical Fee - $1,000

ESWT performed in physician's office:
Professional fee - $350
NO TECHNICAL/FACILITY FEE

I'm hearing same very negative comments from some companies including the real possibility of going out of business. The insurance mafia strikes again!!!

36

Message Number 207379
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:16

Bill,
Just read this article. It may interest you. Another machine is in town.

Can A Portable ESWT Device Provide Easier Treatment?
5. Orthospec (Medispec). Although extracorporeal shockwave therapy (ESWT) is a noninvasive option for various painful conditions, many ESWT devices are large and mostly available in hospitals and surgery centers due to the cost of the devices. The Orthospec, which recently gained FDA approval, is a more portable device that one can use in the office.

The Orthospec is a portable extracorporeal shockwave therapy device. Its portability and one-time treatment option are key benefits, according to John Hollander, DPM.

Such portability poses several advantages, according to John Hollander, DPM, who has been using Orthospec for a year. The fact that DPMs can have ESWT units in their offices makes for a cost savings since patients do not need to go to hospitals, according to Dr. Hollander, who practices in Santa Rosa, Calif. He also notes that he can perform the procedure with no anesthesia.
Dr. Hollander has used the device to treat plantar fasciitis, retrocalcaneal pain, Achilles tendonopathy and intermetatarsal neuromas.
Another advantage of the device, according to Medispec, is the one-time, 25-minute treatment whereas other ESWT devices usually involve multiple treatments. The company says that unlike with other ESWT devices, the Orthospec does not require an imaging device and one can use the Orthospec to treat a wide area.

37

Message Number 207378
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:14

Humor

38

Message Number 207376
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 16:03

Ralph,

Thanks so much for your thoughtful remarks! I couldn't help but notice your intial response 'how much dust it collects.' Was this just a good attempt at humore, or are you in general not a fan/believer in ESWT?

Thanks again!

39

Message Number 207374
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 15:27

How much dust it collects. Actually the Ossatron ESWT machines are used in Outpatient Surgical Centers and generally with the use of an anesthsiologist and anesthesia along with your treating doctor. The treatment with this machine has on occassion been done with foot blocks and relaxation instead of putting the patient out.

When you add up the Surgical Center cost, the charges to the Anesthesiologist, the medication and charges by your treating doctor the costs are usually higher than ESWT treatments performed in doctors offices or in mobile units that travel to multiple doctors offices. I think you'll find most doctors using mobile units or units in their office are using a Dornier ESWT machine.

Additionally there are a few doctors who use a low power machine off label to treat Plantar Fasciitis. Their treatments are done in their offices and usually consists of three separate sessions. This type of ESWT treatment is usually the cheapest.

Recently medicare approved payment to doctors for performing ESWT but the payments are so low that many doctors hesitate to treat medicare patients. Personally I think it's because they fear accepting what they think are lower than standard fees. Doing so may set a precedent for future payments by other insurance companies if and when they decide to cover ESWT. Two years after the fact doctors are still holding out hope that it will eventually come.

It's my opinion at this point doctors need to decide if they want their machines to collect, lower their fees, or offer attractive payment plans to patients.

Shopping around will more than likely get you the best deal. Some doctors like the Ossatron machine and others like the Dornier and still others like the low power one done with three treatments. Each will sell you what they like and use.

40

Message Number 207371
what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 14:19


There seem to be a lot of different prices for ESWST out there. Does it vary with the machine used, or what? What is reasonable?

Result number: 82

Message Number 207935

repost View Thread
Posted by know them on 8/20/06 at 11:46

this seemed to have vanished so I reposted itRe: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:17

I agree- ban Gary H for being an a**hole and attacking a new poster.

1

Message Number 207907
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/20/06 at 08:16

I agree- ban Gary H for being an a**hole and attacking a new poster.

2

Message Number 207885
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by footman on 8/19/06 at 21:20

I agree that Gary H is a first class as*hole for being nasty to eswt tech. I think that scott should kick his stupid insulting butt out of here. Maybe eswt tech has something good to add. Dr Z- I'll ask you the same ? as know them- did you ever meet "eswt tech" in 2004 as he said you did?

3

Message Number 207877
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/19/06 at 19:58

Who the f*** is this Gary H as*hole dumping on somebody who is afraid to get involved because of posters like him? Gary- I hope you have the worst incurable painful case of PF anybody ever experienced. I hope the pain is so bad it drives you to jump off a bridge into a cesspool.

Hey Dr Z- do you know who posted as "eswt tech"?

4

Message Number 207794
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/19/06 at 07:32

Dr Z will know who I am. Dr Z we met in A/C in 2004 at the region 3 convetion at the Taj Mahal. I visited you at your booth, you came to the booth my company had and we also had a very nice conversation in the hospitality suite that the region 3 group set up. Thses people are absolutely the meanest people I have ever run into. I wonder if foot pain makes you mean.

5

Message Number 207673
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Driver Wilde on 8/18/06 at 08:54

As a matter of fact, Ralph. Many of the patients treated in the FDA study for the Ossatron were done with a regional anesthetic only. Yes, it is very uncomfortable for the patient and not practical due to the huge amounts of lidocaine needed to numb the foot sufficiently (bordering on toxic doses).

The main reason the Ossatron must be used in the Surgery Center is because Healthtronics/Sanuwave have required that it be used in a surgery center. They have spent years claiming that high energy ESWT has to be done in an ASC or hospital so they could keep differentiate between ASC reimbursement and office reimbursement. Another problem with the Ossatron is that it is 700 lbs and 7 feet long. It won't fit in most doctors' treatment rooms.

Now that Sanuwave's contract with UHC is going down the toilet they are again offering to do treatments in a doctor's office. Good luck with that. Usually an Ossatron procedure is about 6 minutes under general or MAC.... under local it could take well over an hour and a lot of tears from the patient.

Point is.... the FDA says it's safe and effective to ues on humans but does not mandate it be used in an ASC.

-DW

6

Message Number 207671
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/18/06 at 08:24

I'd replace the word "putz" in your post with "guy" and eliminate the word "jerk". Name calling isn't necessary to get a point across.

7

Message Number 207631
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Gary H. on 8/17/06 at 20:09

Doctor Z,

I DO NOT believe that putz is an ESWT tech. I think he is full of himself. We will talk about that jerk at lunch next time. Let me read the board for 3 more years first.

8

Message Number 207624
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

9

Message Number 207623
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:42

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

10

Message Number 207622
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

11

Message Number 207621
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Z on 8/17/06 at 17:41

I would love to have your experience on this board. If I took your view I would have left a long time ago. Come on help out. Its fun and very rewarding to both patient and your ESWT Tech.
Here is a question I have Do you use the dornier and it so what is position you place the foot. Is the patient on their side or on the tummy ?

12

Message Number 207620
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 17:07

Judy,
You've got to laugh at that post. It tore me up. The guy refuses to post and correct information he calls "ignorance and misinformation"

Now tells us we will be penalized and deprived forever because he's leaving the board.

Maybe had he posted sooner and told us what he had learned in his "previous scientific profession" we would have known the guy was around in the first place. He admits he had 4 years to do it.

I don't know about you but sad as I may be I'll carry one somehow one day at a time. I know you'll get by too. We've got to hang in there.

Like they say "when the going gets tough the tough get going" I'm going to dinner.

13

Message Number 207618
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by judy on 8/17/06 at 16:17

what is with the threats?

14

Message Number 207617
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:57

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

15

Message Number 207616
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/17/06 at 15:56

This is the last post that I will put here. Ralph, you are one of the reasons I won't post anything. It is the venimous posts and the personal attacks that have conviced me not to get involved. It is a shame that I must do this and thus deprive this board of all I have learned in my previous scientific profession and what I have learned performing over 2500 ESWT procedures in the past 4 years.

16

Message Number 207588
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/17/06 at 10:48

If you found this site so appalling you had two choices.
1. Leave the site and stop viewing it.
2. Post constructive information to correct what you call "ignorance and misinformation I constantly see".

You've done neither. So I guess who you know or what you know or who you met doesn't matter.

You get credit for recognizing the infighting. At times it does remind me of a wolf den.

17

Message Number 207548
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

18

Message Number 207547
Re: correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 21:40

So what information do you have to offer.? Why post now ? I am not even involved with this thread. Come on get involved . Contribute. Three years of not posting. ?????????????? Answer some questions. Help out ! A professional is someone who offers and doesn't stand on the side lines.

19

Message Number 207544
correction Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:23

I have been reading this board for 3 years and have never posted until now. I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I would never expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

20

Message Number 207542
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by eswt tech on 8/16/06 at 21:01

I have been reading this board, and have never posted until now, for 3 years and I am appaled at the ignorance and misinformation I constantly see. Because I am a professional I have would expose myself to this infighting by posting information or getting involved in a discussion.
I have met you Dr.Z and I am very suprised at the situations you allow yourself to get involved in.

21

Message Number 207532
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 18:58

I think we'll be seeing many more of these machines used in these settings. The real question is will they help the athletes.

I wonder what they do with athletes training in Colorado hoping to make the Olympic teams if they get P.F. It would be interesting to see if they have an ESWT machine at that training facility.

22

Message Number 207517
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 17:41

thanks for long explenation. I didn't get any anesthesia so it was a lower power machine. I had one week between each session. it was a private clinic with ordinary general practice doctors but with extra knowledge of athlete injuries so I call it sport clinic. Athletes from the cities elite soccer team and track/field goes there.
In the end, ESWT didn't do anything for me so I'm glad I didn't pay too much. ART looks to do more help for me now.

23

Message Number 207514
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 17:17

I'll try not to be as rude as you "know them", but I was looking at the bill from the Surgery Center and Dr. The Dr. is also a part owner. I know that they paid quite a bit of the bill but I can't tell you the exact amount because it was a long time ago. I was cleaning out my old bills when I found it the other day. The point was that it was billed for that amount, period!

24

Message Number 207507
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Dr. Zuckerman on 8/16/06 at 16:15

Good point,
What was the amount the doctor received.? It is possible that they did receive $6,000. I know that some certified mobile providers have received more then that amount for three low energy ESWT procedure. I guess that is why UHC is gone. Would you know anything about that Know them?

25

Message Number 207462
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/16/06 at 11:36

The difference in cost is most often related to the location where the ESWT under FDA guideline must be performed.

The Osstron ESWT machine must be used in an Outpatient Surgical Center or Hospital.

The Dornier Machine can be used in Mobile Trailers or in doctors offices.

Each of these machines suggest that one treatment does the trick however, a second treatment may be necessary. The treatments are not give in a daily or weekly series they are spread apart.

From what you described the ESWT treatment you received was with a machine that provides 3 treatments closely together. These machines are often considered lower power machines hence 3 treatments are needed to equal one of the others. Please realize that when I use the word equal its in very "general terms" and not "scientific" meaning that if compared the amount of shock wave ability may not be truely "equal" but for my reply I'm just using the term equal as described above. You'd have to compare several things to determine the true equality of these machines.

The type of machine you had obviously wasn't required by the FDA to be used in an Outpatient Surgical Center or hospital and possibly it might have been even used off label meaning that the machine itself isn't FDA approved specifically for treating P.F. "Specifically" is the important word here. It can be used off label.

It is well known that these type of machines cost less to purchase and the treatments also cost less. I believe in Canada these machines have become very popular and possibly are becoming more popular in the U.S. because of lower cost treatments.

Right now you must remember that the prices of getting an ESWT treatment is in the hands of the doctors because there is very little insurance coverage. They can raise or lower prices as they see fit but feel that the cost of the machine, up keep, over head and their services etc are worth more than the $300 you paid.

This is expecially true with the Ossatron machine that must be used in a hospital or Outpatient surgical Center with an anesthesiologist and anesthesia. Add those costs to the doctors fee and even without paying the doctor a dime you are already well over $300.

In your case the machine used, the fact that it was done in a sports clinic and the decision of the doctor to charge only $300 made the difference in what you paid.

26

Message Number 207452
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by LV on 8/16/06 at 10:05

I went to a sports clinic, used by elite athletes, and the ESWT treatment was not covered by anything for me so I paid 300$ for three sessions. Experienced doctor did the procedure. don't understand the 1000$ per session thing.

27

Message Number 207447
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 09:46

You did not pay anything near that amount, nor did the doctor or equipment provider collect anywhere near that amount. Do you have any idea what a Dornier EPOS costs? Do you have any idea what it costs to keep a mobile unit in the field? A vehicle, techs salary and benefits, insurance,fuel, maintainance on the EPOS and the vehicle, depreciation, back office and support staff expense. depericiation, debt service on any business loans, - I could go on for 10 more lines. The total cost to campaign a mobile ESWT operation running 5 days a week is probably around $200,000.

You looked at the EOB you received for the amount billed and decided to make a big splash here quoting that $ amount. Now look at that same EOB and tell us, truthfully if you can, what the insurance company actually paid the provider and the doctor. I'de be suprised if it came to more that 30% of what was billed.

Are you one of those socialist who feel that free enterprise should listen to your rules as to how profitable they should be? Well if you are then you must accept that I can tell you how much you should earn.

28

Message Number 207441
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 08:51

Bill, I had ESWT with the Donier Machine. It was around $6,000. My insurance paid for most of it. It didn't work for me but I really believe that it does for some. I'd definately do it before Surgery, which I did, and am sooooo sorry I did the surgery.

29

Message Number 207431
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 06:21

Pick the right provider and if your doctor is not the typically greedy practioner you will find that ESWT can be suprisingly affordable despite the current trend of non-coverage by the insurance bandits.

30

Message Number 207413
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 21:23

Just make certain that you are not left with a huge co-pay that your insurance co. forgot to tell you about or the doctor didn't mention.

Let us know how you do following treatment. We are waiting to hear more positive results. I hope you are one of them

31

Message Number 207405
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:31

Ralph,

Thanks for the follow-ups! I have been quoted a price waaaay higher than these. BUT, it looks like my insurance may pay for the treatment (and I doubt their reimbursement is anywhere near the quoted price). So, I plan to go ahead and trust/hope that whatever the insurance company works out with the provider will be socially fair and efficient!

32

Message Number 207404
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 20:27

Scottr,

First, this is classic PF: 'first step' pain really bad and tender to modest pressure at the insertion of the PF to the heel on the inner part of the heel. Worsening for about 9 months; ibuprofen, icing, stretching, use of night splint when watching TV, etc.

The fiest two times I did the halogen I did not have sun glasses, so averted my eyes and was using the red food coloring in the water. I have done about 6 more treatments now using sunglasses. I will now switch to using non-colored water (my understanding from my sampling of your prior posts is that the red coloring makes for less heat at skin surface (which has not been a problem}, but I had not understod that clear light was more powerful).

Just prior to the first halogen treatment my 'first step' pain was off the charts and lasted for a couple of blocks. However, this was elvated somewhat because I had recently had to be on my feet a good deal. Some combination of the halogen and natural recovery from the elevated level brought my pain down consistently for a few days. However, I continue to experience some re-tearing while walking (I wonder if my orthotics need adjusting, although I am not sure which way the adjustment should go. BTW I was 10 years and untold orthotics on my other foot before doing the surgery and typically have a god sense of how to adjust orthotics. As mentioned in a different post, the surgery helped the PF but led to foot instability and occasional cuboid problems.)

Also, the 'runner's stretch' seems to irritate (re-tear) sometimes even though I am careful with the mechanics-my calf is not real tight; but the PF sure is.

I have seen some definite benefits from the halogen, and will continue to apply, and now with 'clear' light. However, I am a teacher and with classes starting soon I wanted to be pro-active regarding the ESWR-especially if my insurance will pay some. With 10 years of PF on my other foot-and going from atheletic to overweight and untoned- I want to do everything possible to resolve this foot much earlier!

Thanks so much for your research and site; I will keep you posted on both the halogen and ESWT.

For now,
Bill

33

Message Number 207386
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by scott r on 8/15/06 at 18:00

Bill, was the halogen you're using a flood or a spot? Is it to bright to look at your skin where it shines if you don't use the red coloring? I'm wanting to investigate every failed instance of using the halogen to see if i need to modify my instructions. Can you tell us more about your symptoms (pain location, when it occurs), history, and possible initial causes?

34

Message Number 207382
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 17:08

Bill,
Here is a post I found from last year. Don't know if fees have been raised or not but this gives you a good idea of possible medicare value assignments.

Posted by Steve W on 11/08/05 at 13:01
I just received the relative values assigned to ESWT by Medicare. This is second hand but a reliable source. Medicare has apparently assigned the following values:

ESWT performed in a facility:
Professional Fee - $210.
Facility/Technical Fee - $1,000

ESWT performed in physician's office:
Professional fee - $350
NO TECHNICAL/FACILITY FEE

I'm hearing same very negative comments from some companies including the real possibility of going out of business. The insurance mafia strikes again!!!

35

Message Number 207379
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:16

Bill,
Just read this article. It may interest you. Another machine is in town.

Can A Portable ESWT Device Provide Easier Treatment?
5. Orthospec (Medispec). Although extracorporeal shockwave therapy (ESWT) is a noninvasive option for various painful conditions, many ESWT devices are large and mostly available in hospitals and surgery centers due to the cost of the devices. The Orthospec, which recently gained FDA approval, is a more portable device that one can use in the office.

The Orthospec is a portable extracorporeal shockwave therapy device. Its portability and one-time treatment option are key benefits, according to John Hollander, DPM.

Such portability poses several advantages, according to John Hollander, DPM, who has been using Orthospec for a year. The fact that DPMs can have ESWT units in their offices makes for a cost savings since patients do not need to go to hospitals, according to Dr. Hollander, who practices in Santa Rosa, Calif. He also notes that he can perform the procedure with no anesthesia.
Dr. Hollander has used the device to treat plantar fasciitis, retrocalcaneal pain, Achilles tendonopathy and intermetatarsal neuromas.
Another advantage of the device, according to Medispec, is the one-time, 25-minute treatment whereas other ESWT devices usually involve multiple treatments. The company says that unlike with other ESWT devices, the Orthospec does not require an imaging device and one can use the Orthospec to treat a wide area.

36

Message Number 207378
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 16:14

Humor

37

Message Number 207376
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 16:03

Ralph,

Thanks so much for your thoughtful remarks! I couldn't help but notice your intial response 'how much dust it collects.' Was this just a good attempt at humore, or are you in general not a fan/believer in ESWT?

Thanks again!

38

Message Number 207374
Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Ralph on 8/15/06 at 15:27

How much dust it collects. Actually the Ossatron ESWT machines are used in Outpatient Surgical Centers and generally with the use of an anesthsiologist and anesthesia along with your treating doctor. The treatment with this machine has on occassion been done with foot blocks and relaxation instead of putting the patient out.

When you add up the Surgical Center cost, the charges to the Anesthesiologist, the medication and charges by your treating doctor the costs are usually higher than ESWT treatments performed in doctors offices or in mobile units that travel to multiple doctors offices. I think you'll find most doctors using mobile units or units in their office are using a Dornier ESWT machine.

Additionally there are a few doctors who use a low power machine off label to treat Plantar Fasciitis. Their treatments are done in their offices and usually consists of three separate sessions. This type of ESWT treatment is usually the cheapest.

Recently medicare approved payment to doctors for performing ESWT but the payments are so low that many doctors hesitate to treat medicare patients. Personally I think it's because they fear accepting what they think are lower than standard fees. Doing so may set a precedent for future payments by other insurance companies if and when they decide to cover ESWT. Two years after the fact doctors are still holding out hope that it will eventually come.

It's my opinion at this point doctors need to decide if they want their machines to collect, lower their fees, or offer attractive payment plans to patients.

Shopping around will more than likely get you the best deal. Some doctors like the Ossatron machine and others like the Dornier and still others like the low power one done with three treatments. Each will sell you what they like and use.

39

Message Number 207371
what is a reasobale charge per foot with ESWT? View Thread
Posted by BillL on 8/15/06 at 14:19


There seem to be a lot of different prices for ESWST out there. Does it vary with the machine used, or what? What is reasonable?

Result number: 83

Message Number 207818

Re: powerstep pro View Thread
Posted by Jeremy L on 8/19/06 at 10:25

I would be very surprised if your podiatrist would refuse to sell you a second pair of those inserts without a billed office visit. Give a call, and see.

Result number: 84

Message Number 207514

Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by Shari R on 8/16/06 at 17:17

I'll try not to be as rude as you "know them", but I was looking at the bill from the Surgery Center and Dr. The Dr. is also a part owner. I know that they paid quite a bit of the bill but I can't tell you the exact amount because it was a long time ago. I was cleaning out my old bills when I found it the other day. The point was that it was billed for that amount, period!

Result number: 85

Message Number 207447

Re: what is a reasobale charge per foot with ESWT? View Thread
Posted by know them on 8/16/06 at 09:46

You did not pay anything near that amount, nor did the doctor or equipment provider collect anywhere near that amount. Do you have any idea what a Dornier EPOS costs? Do you have any idea what it costs to keep a mobile unit in the field? A vehicle, techs salary and benefits, insurance,fuel, maintainance on the EPOS and the vehicle, depreciation, back office and support staff expense. depericiation, debt service on any business loans, - I could go on for 10 more lines. The total cost to campaign a mobile ESWT operation running 5 days a week is probably around $200,000.

You looked at the EOB you received for the amount billed and decided to make a big splash here quoting that $ amount. Now look at that same EOB and tell us, truthfully if you can, what the insurance company actually paid the provider and the doctor. I'de be suprised if it came to more that 30% of what was billed.

Are you one of those socialist who feel that free enterprise should listen to your rules as to how profitable they should be? Well if you are then you must accept that I can tell you how much you should earn.

Result number: 86

Message Number 207368

Re: 2nd pair of custome orthotics View Thread
Posted by Jane on 8/15/06 at 13:12

Richard, C.Ped,
Looked at all my eobs regarding the orthotics. The Pod billed the insurance $1395. My out of pocket was $350. Insurance paid $561. For amusement sake, he billed $84 ov and $250 EACH the day I picked the orthotics up.He billed $125 the day he called me in "to talk about my feet" after I wrote him a letter complaing about the orthotics. He billed $84 ov and an additional $350 for casting. The reat of the charges were billed for droppong off and picking up the orthotics alledgedly trying to modify them.

Result number: 87

Message Number 207327

Re: Won't be doing ESWT! Insurance doesn't cover it View Thread
Posted by know them on 8/15/06 at 07:51

If your podiatrist is asking $1000/foot you are being gouged. The treatment is available for probably 1/2 of that amount. If you really want to have ESWT put your e-mail up and you'll get an e-mail from someone who can help you.

If you paid $6000- was the doc wearing a mask and holding a gun to your head or is that what the provider billed and never collected?

Result number: 88

Message Number 207261

Re: 2nd pair of custome orthotics View Thread
Posted by Jane on 8/14/06 at 12:06

Not sure if your last post was directed to my comment regarding my Pod charging $1,100 for a pair of orthotics. Sorry, but can you please elaborate?
Here is what I was charged: $1,100 was to cover the casting, the office visit for the casting, the orthotics themselves, gait analysis ( didn't happen) and some kind of muscle test (which also din't happen). This charge did NOT include the office visit to pick them up. He billed my insurance for the $1,100 and my out-of-pocket was considerably less. I firmly believe that billing an insurance company an outragous amount is the same as billing ALL of us an outragous amount. It is never OK just because someone else pays. We are at one time or another the "someone else".
Nevertheless, I am serioulsy considering a small claims court action against this Pod. It's tough, I really like him and have given him every chance to to reach an agreement, but he won't even address my concerns. Maybe it's time for someone else to decide.

Result number: 89

Message Number 206348

Re: I'm Sorry I'm Sorry But So Munch Pain!!!!! View Thread
Posted by Oma Z on 8/04/06 at 21:42

Dear Michael:

There is a machine that we sell to doctors. It is electro-analgesic. It has clinical studies that showed 200 knee osteoarthtitis patients went off their pain meds, mainly for long term, up to three years. It is the most amazing equipment I've ever seen. I treated a friend that had his knee torn up 20 years ago and 3 treatments later he was pain free. IT is used for all pain. I call our demo unit, "Jesus in a Box". I hope that doesn't sound sacraligous. I don't know where you live but I could probalby find a doctor or talk to your doctor about it. My husband separated his shoulder, was in horrible pain for 3+ months, after three treatments, no more pain. Four months later he had to do another series of three treatments. It costs $33,000, (the machine to the doctor) can be billed. Wonderful for circulation. Some doctors have used it to save limbs from amputation as it increases blood flow. The contraindications are localized baterial infection (it could cause it to spread), hemmoraging (increases blood flow), pacemaker (electro-medicine), pregnant uterus, cancer (the inventor from Germany, told us that it only works on Europeans as they use it to treat cancer in Europe, but it's a no-no here.) He brought interferential therapy (short term electro-medicine treatment).

The Mayo Clinic-Scottsdale PT is getting one since all three of their PT staff were pain free at the end of their first treatment. The one gal with the "80 year old knees needing surgery" was still pain free 6 weeks later and still not limping. It spreads the pain chemicals out so that they are not at the threshhold to feel pain. It works on the biochemical and bioelectrical components of the cell - depolarizing them. It is most incredible. It's called Horizontal Therapy since it uses the fm frequency and not the am like most short term electrostim. Carpal tunnel patients have avoided surgery. They then had my husband speak to all of the PT clinics monthly meeting in Phoenix. I have no doubt it will work for you. God Bless.

Result number: 90

Message Number 206018

Re: BC/BS colonoscopy coverage View Thread
Posted by Lisa on 8/02/06 at 07:48

I work in an oncology office that is facing a lot of cuts from insurance companies. Sadly, there are many drugs that are not being reimbursed by some insurances at rates even close to what we have to pay for the drug.
There is a lot of disparity with what is being billed and what is being covered. Look at your insurance EOB next time you get it if you want a good chuckle. Your doctor can bill what ever they want, but that does not mean that is what they are going to get. If you have an insurance policy, you have a contracted rate about what is going to be paid, and usually it is a very small percentage of what is actually billed or what it cost the provider.
When a provider bills for a service, they are not only billing for that particular service. They must cover their overhead, and in medical fields their overhead is increasing daily. Malpractice, insurance, utilities, drugs, staffing, write-offs, bad debt etc. Insurance really plays a bigger role in practices, much more than people realize.
Ralph-about your MRI. There is a code that the facility can utilize to get some of their money back, not all of it-right or wrong, as they do have it arranged to have coverage for human error. Insurance will start looking at the facility and audit them if that occurs to frequently. If they did not place that over-rider on your bill, you might have a problem when you go get a repeat MRI done again depending on how close to the time of your original messed up one was.

Result number: 91

Message Number 205961

Re: BC/BS colonoscopy coverage View Thread
Posted by autumn on 8/01/06 at 15:45

I think insurance companies are clueless and bottom line just don't care. It is all a business. I remember my husband was reading a fiction novel about how a little girl with cancer died because the insurance company didn't want to pay for her treatments. The sad thing is, some of that kind of stuff does happen. I think other countries have better systems, like where my husband grew up. Doctors are more accessible and there is no bureaucracy telling you what you can and cannot do for your health. I saw a bill once, that my doctor had billed my insurance company about $350 for a 15 minute appointment where she basically did nothing! I think it is ridiculous how expensive and inaccessible doctors and medicines are to so many of us in this country. Having worked in the aging field, my heart truly goes out to elders especially with all these high co-pays and people telling them what tests they can and cannot have.

Result number: 92

Message Number 202342

Why I support Evan Bayh for president in 08 & who do you like? View Thread
Posted by marie on 6/27/06 at 20:20

I am promoting Senator Bayh for the 2008 Democratic Candidate. I don't want to argue who is best but I'd like to hear who you like. Please have fun with it. :) Hey stump your candidate!

I'm quoted in this article somewhere.
Bloggers Push Bayh For President

Issues In Focus
Economy

Energy

Healthcare

Trade

Agriculture

War On Terrorism

Evan Bayh Flyer: Print it or Email it






Image hosted by Photobucket.com


Videos & MP3

Karl Rove & National Security

Hold Them Accountable on Iraq

Energy Independence

Bayh On Walter Reid Hospital

Bayh In New Hampshire

Audio: Bayh's Speech In Colorado

Video: Bayh On CSPAN

Bayh Demands Justice For Our Troops

Video: Bayh In NH on WMUR

Video: Bayh On CNN Lou Dobb Tonight

Video: Bayh On The Steel Industry

Video: Bayh On Cost of College

Video: Fiscal Conservative

University of Virginia Commencement Speech

1996 DNC Keynote Speech





Blogers Supporting Bayh

Result number: 93
Searching file 19

Message Number 198973
Re: successful cryo for PF (cont)...to Cyndi View Thread
Posted by Jen R on 5/12/06 at 12:14

Dr. Goldstein,
I was seen at a pain management clinic. It really wasn't what I was expecting though. I was seen three times. The first two times I was given some kind of spinal nerve block under IV sedation. The first time I did notice that my feet were really warm and toasty for about two days but the pain remained and the warm feeling then went away. The second time I had the block I didn't notice any difference at all.
Then on my third visit I was told they couldn't do anything to help me...and that was that. It was a 3 minute office visit (I actually saw the doctor for less than 30 seconds) and I got billed $140! What a country!
Anyway, I don't know what I expected but I sort of thought that I would work with someone who would help me thru the management of oral meds. I sure was wrong.
I had to laugh though...my doctor's name at the pain management clinic was Dr. Cope! Isn't that a hoot?? (I know that a good sense of humor is always a good thing!)
Jen R

Result number: 94

Message Number 197058

Re: DR. Z IS BLOCKING CERTAIN TREADS HE DOESN-T WANT DRS TO SEE View Thread
Posted by Ghost on 4/06/06 at 15:46

Shock Biller and Dr. R (no balls)

Really I am a brain surgeon. When I work in the OR I feel comfortable sitting on Dr. Z.'s rocket.

Here is the mathmatical equation :

Dr. R. plus Shock Biller = Two Losers and Fools

Result number: 95

Message Number 197054

Re: DR. Z IS BLOCKING CERTAIN TREADS HE DOESN-T WANT DRS TO SEE View Thread
Posted by shock biller on 4/06/06 at 15:33

WHY WOULD SOMEONE BILL SONOCUR MACHINE TO HORIZON IF THEY ONLY COVER HIGH ENERGY DONIER MACHINE. I HOPE NOONE IS USING TH E OSABORNE MACHINE AND BILLING 28890 TOO.

Result number: 96

Message Number 197052

Re: DR. Z IS BLOCKING CERTAIN TREADS HE DOESN-T WANT DRS TO SEE View Thread
Posted by Dr. Z on 4/06/06 at 15:29

Tell him I said hello. Very nice gentleman. He is going to ask for your TIN so you better be prepared to give your ESWT company TIN number. Did you know before our contract all payments to ESWT equipment providers had to go to an ASC with a rental arrangment . I hope that you didn't receive any tech payments by mistake if you did the procedures in an office. If you used the Soncur and billed Horizon be prepared to spent some time in Jail.

Result number: 97

Message Number 197051

Re: DR. Z IS BLOCKING CERTAIN TREADS HE DOESN-T WANT DRS TO SEE View Thread
Posted by shock biller on 4/06/06 at 15:07

I THINK YOU ARE THE REAL LOSER GHOST. YOU HAVE NOTHING INTELLIGENT TO SAY BUT CALL PEOPLE LOSERS. YOU CAN'T GET YOUR FACTS STRAIGHT ABOUT HOW AND WHO HORIZON PAYS, AND ON TOP OF THAT, YOU CANT GET PAID BY UHC. WHO IS GOING TO LOSE THEIR DOCTORS 'CAUSE NOONE GETTING PAID. SO WHO DO YOU THINK THE REAL LOSER IS? TRY AND HAVE AN INTELLIGENT CONVERSATION SO MAYBE SOMEONE CAN HELP YOU........

Result number: 98

Message Number 197048

Re: DR. Z IS BLOCKING CERTAIN TREADS HE DOESN-T WANT DRS TO SEE View Thread
Posted by Dr. Z on 4/06/06 at 14:59

This is information that is incorrect. The professional fee billed by the podiatrist and or orthoepedic physician is between $250 and $350 for a single ESWT plantar fascia treatment. The code 29980 is the correct code to use for physicians billing High Energy ESWT and NOT using Excellence Shockwave Therapy Group The days of the $1035 are done beginning Jan 2006.
I can put you in touch with the head of provider relations if you call me and she will concur with what the payment are for professional 28890

Result number: 99

Message Number 197047

Re: DR. Z IS BLOCKING CERTAIN TREADS HE DOESN-T WANT DRS TO SEE View Thread
Posted by shock biller on 4/06/06 at 14:54

no, i work for a shockwave company, i know who pays what, who doesn't pay, and who just turned the eswt world upside down for some eswt providers. i am still trying to figure why certain providers are not getting aid by UHC, maybe i can help, 'cause i dont see any problems at all. Maybe those providers are billing incorrectly.

Result number: 100

Message Number 197043

Re: DR. Z IS BLOCKING CERTAIN TREADS HE DOESN-T WANT DRS TO SEE View Thread
Posted by Ghost on 4/06/06 at 14:32

are "shock biller" and "Dr. R." twin brothers !

Two losers

Result number: 101

Message Number 197038

Re: DR. Z IS BLOCKING CERTAIN TREADS HE DOESN-T WANT DRS TO SEE View Thread
Posted by shock biller on 4/06/06 at 13:44

thats contract only means you are listed in their provider handbook as an eswt provider, it does not mean you are the only one that is going to get paid for the service.

Result number: 102

Message Number 197037

Re: DR. Z IS BLOCKING CERTAIN TREADS HE DOESN-T WANT DRS TO SEE View Thread
Posted by shock biller on 4/06/06 at 13:41

amm for your information, ghost, you dont need that contract to get paid from horizon bcbs for eswt...try billing one without using the contract, u will get paid $1035.00 if its medically necessary.

Result number: 103

Message Number 197017

DR. Z IS BLOCKING CERTAIN TREADS HE DOESN-T WANT DRS TO SEE View Thread
Posted by shock biller on 4/06/06 at 09:09

whY?

Result number: 104

Message Number 197014

Why is Dr. Z blocking the tread "horizon/excellence? View Thread
Posted by shock biller on 4/06/06 at 08:55

Doc, this was an interesting thread, why did you block it? I know i have not commented on it, but it was intersting to read how different shockwave companies do their billing. i am a collector for a shockwave company myself, and would safely say, i know shockwave billing and collections inside -out.

Result number: 105

Message Number 196027

Re: has anyone heard about another eswt provider on the east View Thread
Posted by know them on 3/23/06 at 14:42

They billed Blue Cross using the code for LITHOTRIPSY. They treated feet and billed for crushing kidney stones.
It is obvious that rj has more than a basic interest in Rapid Recovery. I think you work for them don't you rj!! As far as nobody being here to defend them- rj- it appears that you have taken up that task. Your questions and answerss make it obvious that you have a significant involvment with them.

Result number: 106

Message Number 195991

Re: has anyone heard about another eswt provider on the east View Thread
Posted by know them on 3/22/06 at 20:05

They are the former Orthoshockwave who defrauded Blue Cors in the NY area by using the non FDA approve low energy Sonocur for PF. In addition they billed using the lithotripsy code. Blue went after them and a bunch of podiatrist for big $'s and put them under. They were bought by Recovery Systems, who like carrion beetles are trying to exist on the leftovers that the biggest ESWT provider in the US, United Shockwave, leaves in the NY area. They bombard the podiatrists with non-stop faxes and have a dubious billing and payment history. They have been warned by the FDA to cease their false adverstising. In summary- small time operators with a bad history. Now they are trying to sell Laser treatment for hair removal. Maybe they take the hairs off your big toe while they try to treat your PF

Result number: 107

Message Number 195484

Re: Help with stump neuroma View Thread
Posted by john on 3/14/06 at 15:59

You say cryosurgery is covered but you are billing CPT 64640. I read on Blue Cross Kansas that the correct code is 64999 and that it is not covered. Here is the link http://www.bcbsks.com//providers/publications/professional/med_review/experimental/cryogenic.htm

I have also read that insurance companies have noticed an increase in 64640 billing and are auditing the code. If they find that it is incorrectly billed then they request the money back. Do you have a reference that states that 64640 is the correct code for cryosurgery? I am interested in a reference because I do not agree with your interpretation of the code and I would like to see if anyone has committed it to writing.

Thanks

Result number: 108

Message Number 195218

Re: Help with sump neuroma View Thread
Posted by Dr. Goldstein on 3/09/06 at 18:12

David : If it was then why did dr fallat indicate to all he trained that this was for both conditions, the advertising that was done stated for both conditions he was doing PF cases when he trained me and billed for the pf with the 64640 code?

Result number: 109

Message Number 195184

Re: Help with sump neuroma View Thread
Posted by Dr. S . Goldstein on 3/09/06 at 08:16

David : Cryosurgery is not billed under 64450 as that is for a peripheral nerve block. it is billed out currently under 64640 which is a destruction code by chemical or thermal means for destruction of a nerve. We are currently petitioning the AMA CPT-4 division for our own unique code that separates cryo from all other procedures.

I can't believe you would make a statement that i have planted a seed in Tod's mind unless you are also his therapist. As much as you say I speak cryo or have cryo on the brain you must be the only doctor that can treat all the hundreds of patients with evidence based medicine or conservative care and it works 99% of the time.

I am curious as what you do for a patient with heel pain that has has cortisone, PT, custom orthotics, EPF, failed shockwave? What do you do to cure this patient?

What do you do for the neuroma patient that has has cortisone, alcohol, orthotics, be operated on 2-3 times same webspace please let me know what evidence based medicine you perform here?

Result number: 110

Message Number 195183

Re: Help with sump neuroma View Thread
Posted by Dr. S . Goldstein on 3/09/06 at 08:15

David : Cryosurgery is not billed under 64450 as that is for a peripheral nerve block. it is billed out currently under 64640 which is a destruction code by chemical or thermal means for destruction of a nerve. We are currently petitioning the AMA CPT-4 division for our own unique code that separates cryo from all other procedures.

I can't believe you would make a statement that i have planted a seed in Tod's mind unless you are also his therapist. As much as you say I speak cryo or have cryo on the brain you must be the only doctor that can treat all the hundreds of patients with evidence based medicine or conservative care and it works 99% of the time.

I am curious as what you do for a patient with heel pain that has has cortisone, PT, custom orthotics, EPF, failed shockwave? What do you do to cure this patient?

What do you do for the neuroma patient that has has cortisone, alcohol, orthotics, be operated on 2-3 times same webspace please let me know what evidence based medicine you perform here?

Result number: 111

Message Number 195180

Re: Help with sump neuroma View Thread
Posted by Dr. David S. Wander on 3/09/06 at 07:43

Dr. Nordyke,

I'm not sure if it's appropriate to bill 64640 for cryosurgery, so I'll let Dr. Goldstein answer that one. Hopefully, you understood my point regarding 64640 and sclerosing injections. Since 64640 is "destroying" the nerve (for lack of a better term) it theoretically can only be billed once for a particular nerve. When sclerosing injections are performed multiple times and 64640 is billed multiple times, it eventually threw up a red flag with insurance companies. It wasn't anything being done dishonestly by the doctors, it was misinformation by the coding "experts", that are now telling us not to use this code for sclerosing injections, since multiple billing for this procedure is inappropriate. Once again, I'm not sure what is appropriate for cryo.

Result number: 112

Message Number 195161

Re: Help with sump neuroma View Thread
Posted by Dr. David S. Wander on 3/08/06 at 20:36

Dr. Goldstein,

While we are on the subject of billing procedures, I have an interesting question. If I'm not mistaken, cryotherapy/cryosurgery is billed under the code 64450. If I'm also not mistaken, cryosurgery is FDA approved for the sensory treatment of peripheral nerves. If you are treating plantar fasciitis with cryosurgery, and you are billing 64450 there seems to be some discrepancy that I don't understand. Are you billing the diagnosis as plantar fasciitis, or is it now a neuritis? I must believe that you are billing it as a neuritis, since plantar fasciitis could not be billed with the code 64450. So somewhere along the way, the plantar fasciitis has morphed into a neuritis? Has the patient's condition conveiently changed to meet your billing criteria? Just as you didn't want to make any judgements about Todd's doctor, I just was curious regarding this particular point with billing cryosurgery and plantar fasciitis, or is it neuritis?

Result number: 113

Message Number 195160

Re: Help with sump neuroma View Thread
Posted by Dr David S. Wander on 3/08/06 at 20:21

You are beyond unbelievable, or you can't understand English. I haven't figured out which one. You simply don't get it. Although you stated "I am not accusing your doctor of anything", that was a useless statement since you ALREADY planted the seed that Todd's doctor may be performing sclerosing alcohol injections strictly for financial gains. What was the purpose of even mentioning that? Why even bring that point up? What purpose did it serve? It was completely pointless. You repeated what I stated and you don't even realize that fact. When the sclerosing injections were first introduced, doctors were told to use the code 64640. However, the problem was that 64640 is the chemical neurolysis/destruction of a nerve. That means that once a nerve is chemically neurolysed or destroyed, it can't happen again. Therefore, the insurance companies started to realize that there was something wrong when they saw the podiatrists billing for this procedure 3-7 times. As a result, the coding experts decided to tell podiatrists to STOP billing the code 64640 and begin using injection codes or an unlisted procedure code with a written explanation. You also neglected to tell the WHOLE story. The doctors that had to return money did not have to return money because that did anything wrong or performed any wrong procedure or performed any unnecessary procedure. The ONLY reason that they had to return money was because they billed the code 64640 multiple times, and the code can only be billed ONCE. Therefore, they had to return any money they received for billing procedure code 64640 more than ONCE. That's the only reason that had to return any money. It wasn't for any medical violations or ethical violations, it was simply a coding error that many doctors were making that has now been clarified. Doctors now know that the procedure can not be billed as 64640, and if it is, it can only be billed once, despite how many injections are given. Therefore, if you tell a story, tell the WHOLE story.

And of course, you had to end your conversation with the merits of cryosurgery, just like every other conversation you have, even if it has nothing to do with the topic being discussed.

Result number: 114

Message Number 195156

Re: Help with sump neuroma View Thread
Posted by Dr. Goldstein on 3/08/06 at 19:15

I specifically stated "I am not acusing your doctor of anything " unless you mised that part or anyone else of doing anything for monetary gains if you read every word I said. ken malkin stated at a recent NJ seminar that medicare was looking into billing for the 64640 code as it should only be billed once to kill the nerve so why does it need 7 injections and say what you want after gary dockerys article was published a few years back this alcohol went flying off the shelf and that was all that pods were talking about at the seminars. I know of 3 podiatrists in nj that were audited by medicare for excessive use of the code and have paid back large sums of money. Also I cannot tell you how many pods said why should I by a cryo machine because i can give 7 alcohol shots. heard this numerous times. My answer is that alcohol does not treat plantar fasciitis, achilles tendonitis, tarsal tunnel, sural nerve entrapement, plantar fibromas and a host of other ailments cryo does or can. They were using the 64640 code. many many pods all over the country were doing this. I do not need the patient to the OR for neuroma surgery as I can do it in 10 minutes with a small dorsal puncture no sutures post op shoe etc thats why patients are seeking this procedure out because the recovery is much quicker so given a choice more patients are leaning this way whether you think so or not.

Result number: 115

Message Number 195155

Re: Help with sump neuroma View Thread
Posted by Dr. Goldstein on 3/08/06 at 19:14

I specifically stated "I am not acusing your doctor of anything " unless you mised that part or anyone else of doing anything for monetary gains if you read every word I said. ken malkin stated at a recent NJ seminar that medicare was looking into billing for the 64640 code as it should only be billed once to kill the nerve so why does it need 7 injections and say what you want after gary dockerys article was published a few years back this alcohol went flying off the shelf and that was all that pods were talking about at the seminars. I know of 3 podiatrists in nj that were audited by medicare for excessive use of the code and have paid back large sums of money. Also I cannot tell you how many pods said why should I by a cryo machine because i can give 7 alcohol shots. heard this numerous times. My answer is that alcohol does not treat plantar fasciitis, achilles tendonitis, tarsal tunnel, sural nerve entrapement, plantar fibromas and a host of other ailments cryo does or can. They were using the 64640 code. many many pods all over the country were doing this. I do not need the patient to the OR for neuroma surgery as I can do it in 10 minutes with a small dorsal puncture no sutures post op shoe etc thats why patients are seeking this procedure out because the recovery is much quicker so given a choice more patients are leaning this way whether you think so or not.

Result number: 116

Message Number 195132

Re: Help with sump neuroma View Thread
Posted by Dr. David S. Wander on 3/08/06 at 14:48

This post is directed toward Dr. Goldstein. I have no idea what point you were attempting to make. You plant the seed stating that the 5-7 sclerosing injections pay more than surgery, then qualify that statement by saying that you're not making any ethical judgement calls regarding Todd's podiatrist. Then what was your point? Why even bring it up? The only purpose it could possibly serve was to discredit Todd's doctor or any doctor performing this procedure, which I believe was completely out of line. The fact remains that sclerosing alcohol injections are an extremely useful modality in the treatment of painful neuroma's, and the protocol is a minimum of 3 and a maximum of 7 injections, REGARDLESS of the reimbursement. Just because you're on your soapbox performing cryosurgery on everyone doesn't mean we all have financial gain as our motives. I perform this procedure on capitated HMO patients, even when I receive NO additional reimbursement. I treat patients, not insurance companies and I resent ANY inference that I would perform ANY procedure on a patient simply because it's reimbursement is better than another procedure. That may be the way YOU think. The reason insurance companies stopped paying for multiple injections is because the code that was being used was the WRONG code. The code was for a chemical neurolysis of a nerve, which meant that it was a ONE TIME deal, and once the nerve was chemically neurolysed, it was finished, and that's why it paid so well. It is a code that never was supposed to be billed 3-7 times. When the insurance companies looked into it, they realized that the procedure that was being performed did not truly match the code being used. Therefore, all the coding "experts" such as Harry Goldsmith and Ken Malkin began changing their tunes and recommending that the chemical neurolysis of a nerve NOT be used anymore. Therefore, simple injection codes were more appropriate and reimbursements decreased significantly.

Your inference that doctors were/are performing sclerosing injections due to the high reimbursement was completely inappropriate and served no purpose. It is no better than people accusing you of purchasing a cryosurgical unit simply so you can perform your procedure to receive reimbursement without having to spend the time and energy taking the patient to the OR, etc., etc. There are some comments that simply don't need to be stated and serve no purpose. I agree 110% with Dr. Zuckerman on this one.

Result number: 117

Message Number 194238

Re: Good Providers View Thread
Posted by Dr. Z on 2/26/06 at 17:36

Upstate Doc,
The offer to help you is still open as I stated in my first post. I have no interest with providing you or any doctor ESWT services in Upstate New York. I do have alot of experience with how ESWT services are billed, where they are delivered, etc etc. So if you still want adice just e-mail me at footcare at comcast.net and I will try to help you. I am not deperate to help anyone I just like too.

Result number: 118
Searching file 18

Message Number 189778

Re: austin youngswick or hemi implant View Thread
Posted by Dr. Z on 12/16/05 at 17:22

I love you Dr. Wander. We are going to have to change the name of the following surgical procedures listed below. None of these osteotomy procedures cuts the bone through and through. They all only cut one cortex. The Valenti actually cuts two cortex. The dorsum and very close to the plantar. I would never bill this as an osteotomy or would I bill this as a partial ostectomy either. It is usually billed under the as a Silver type procedure.
All of the below procedure only cut one cortex and one two there according to your definition they are wrong because they DON"T cut through and through
1. Akin Osteotomy
2. Reverdin osteotomy
3. Base Wedge Osteotomy

Result number: 119

Message Number 188388

Re: Post ESWT Three Weeks.. need advice View Thread
Posted by Holly on 11/29/05 at 08:17

I live in Orlando. And, yes, I had both feet done for that. But you know how insurance works. That's what the hospital/dr./anesth/Ossatron billed for but what's "allowed" under United Healthcare is about 1/2 that. Even still, I'm hearing about people doing ESWT three or four times and it's done right in a doctor's office. Like I said, I have a hospital, full anesthesiologist, pre-op, etc...???

Result number: 120

Message Number 187681

Are we all up on this??? View Thread
Posted by Ralph on 11/17/05 at 18:01

November 16, 2005

Being a Patient

Young, Assured and Playing Pharmacist to Friends
By AMY HARMON

Nathan Tylutki arrived late in New York, tired but eager to go out dancing. When his friend Katherine K. offered him the Ritalin she had inherited from someone who had stopped taking his prescription, he popped two pills and stayed out all night.

For the two college friends, now 25 and out in the working world, there was nothing remarkable about the transaction. A few weeks later, Katherine gave the tranquilizer Ativan to another friend who complained of feeling short of breath and panicky.

"Clear-cut anxiety disorder," Katherine decreed.

The Ativan came from a former colleague who had traded it to her for the Vicodin that Katherine's boyfriend had been prescribed by a dentist. The boyfriend did not mind, but he preferred that she not give away the Ambien she got from a doctor by exaggerating her sleeping problems. It helps him relax after a stressful day.

"I acquire quite a few medications and then dispense them to my friends as needed. I usually know what I'm talking about," said Katherine, who lives in Manhattan and who, like many other people interviewed for this article, did not want her last name used because of concerns that her behavior could get her in trouble with her employer, law enforcement authorities or at least her parents.

For a sizable group of people in their 20's and 30's, deciding on their own what drugs to take - in particular, stimulants, antidepressants and other psychiatric medications - is becoming the norm. Confident of their abilities and often skeptical of psychiatrists' expertise, they choose to rely on their own research and each other's experience in treating problems like depression, fatigue, anxiety or a lack of concentration. A medical degree, in their view, is useful, but not essential, and certainly not sufficient.

They trade unused prescription drugs, get medications without prescriptions from the Internet and, in some cases, lie to doctors to obtain medications that in their judgment they need.

A spokeswoman for the Drug Enforcement Administration says it is illegal to give prescription medication to another person, although it is questionable whether the offense would be prosecuted.

The behavior, drug abuse prevention experts say, is notably different from the use of drugs like marijuana or cocaine, or even the abuse of prescription painkillers, which is also on the rise. The goal for many young adults is not to get high but to feel better - less depressed, less stressed out, more focused, better rested. It is just that the easiest route to that end often seems to be medication for which they do not have a prescription.

Some seek to regulate every minor mood fluctuation, some want to enhance their performance at school or work, some simply want to find the best drug to treat a genuine mental illness. And patients say that many general practitioners, pressed for time and unfamiliar with the ever-growing inventory of psychiatric drugs, are happy to take their suggestions, so it pays to be informed.

Health officials say they worry that as prescription pills get passed around in small batches, information about risks and dosage are not included. Even careful self-medicators, they say, may not realize the harmful interaction that drugs can have when used together or may react unpredictably to a drug; Mr. Tylutki and Katherine each had a bad experience with a medication taken without a prescription.

But doctors and experts in drug abuse also say they are flummoxed about how to address the increasing casual misuse of prescription medications by young people for purposes other than getting high.

Carol Boyd, the former head of the Addiction Research Center at the University of Michigan, said medical professionals needed to find ways to evaluate these risks.

"Kids get messages about street drugs," Ms. Boyd said. "They know smoking crack is a bad deal. This country needs to have a serious conversation about both the marketing of prescription drugs and where we draw the boundaries between illegal use and misuse."

To some extent, the embrace by young adults of better living through chemistry is driven by familiarity. Unlike previous generations, they have for many years been taking drugs prescribed by doctors for depression, anxiety or attention deficit disorder.

Direct-to-consumer drug advertising, approved by the Food and Drug Administration in 1997, has for most of their adult lives sent the message that pills offer a cure for any ill. Which ones to take, many advertisements suggest, is largely a matter of personal choice.

"If a person is having a problem in life, someone who is 42 might not know where to go - 'Do I need acupuncture, do I need a new haircut, do I need to read Suze Orman?' " said Casey Greenfield, 32, a writer in Los Angeles, referring to the personal-finance guru. "Someone my age will be like, 'Do I need to switch from Paxil to Prozac?' "

For Ms. Greenfield, who could recite the pros and cons of every selective serotonin reuptake inhibitor on the market by the time she graduated from college, years of watching doctors try to find the right drug cocktails for her and for assorted friends has not bolstered faith in their expertise.

"I would never just do what the doctor told me because the person is a doctor," said Ms. Greenfield, who dictates to her doctors what to prescribe for her headaches and sleep problems, and sometimes gives her pills to friends. "I'm sure lots of patients don't know what they're talking about. But lots of doctors don't know what they're talking about either."

Prescriptions to treat attention deficit disorder in adults age 20 to 30 nearly tripled from 2000 to 2004, according to Medco, a prescription management company. Medications for sleeping disorders in the same age group showed a similar increase.

Antidepressants are now prescribed to as many as half of the college students seen at student health centers, according to a recent report in The New England Journal of Medicine, and increasing numbers of students fake the symptoms of depression or attention disorder to get prescriptions that they believe will give them an edge. Another study, published recently in The Journal of American College Health, found that 14 percent of students at a Midwestern liberal arts college reported borrowing or buying prescription stimulants from each other, and that 44 percent knew of someone who had.

"There's this increasingly widespread attitude that 'we are our own best pharmacists,' " said Bessie Oster, the director of Facts on Tap, a drug abuse prevention program for college students that has begun to focus on prescription drugs. "You'll take something, and if it's not quite right, you'll take a little more or a little less, and there's no notion that you need a doctor to do that."

Now, Going Online for Pills

The new crop of amateur pharmacists varies from those who have gotten prescriptions - after doing their own research and finding a doctor who agreed with them - to those who obtain pills through friends or through some online pharmacies that illegally dispense drugs without prescriptions.

"The mother's little helpers of the 1960's and 1970's are all available now on the Internet," said Catherine Wood, a clinical social worker in Evanston, Ill., who treated one young client who became addicted to Xanax after buying it online. "You don't have to go and steal a prescription pad anymore."

In dozens of interviews, via e-mail and in person, young people spoke of a sense of empowerment that comes from knowing what to prescribe for themselves, or at least where to turn to figure it out. They are as careful with themselves, they say, as any doctor would be with a patient.

"It's not like we're passing out Oxycontin, crushing it up and snorting it," said Katherine, who showed a reporter a stockpile that included stimulants, tranquilizers and sleeping pills. "I don't think it's unethical when I have the medication that someone clearly needs to make them feel better to give them a pill or two."

Besides, they say, they have grown up watching their psychiatrists mix and match drugs in a manner that sometimes seems arbitrary, and they feel an obligation to supervise. "I tried Zoloft because my doctor said, 'I've had a lot of success with Zoloft,' no other reason," said Laurie, 26, who says researching medications to treat her depressive disorder has become something of a compulsion. "It's insane. I feel like you have to be informed because you're controlling your brain."

When a new psychiatrist suggested Seraquil, Laurie, who works in film production and who did not want her last name used, refused it because it can lead to weight gain. When the doctor suggested Wellbutrin XL, she replied with a line from the commercial she had seen dozens of times on television: "It has a low risk of sexual side effects. I like that."

But before agreeing to take the drug, Laurie consulted several Internet sites and the latest edition of the Physicians' Desk Reference guide to prescription drugs at the Barnes & Noble bookstore in Union Square.

On a page of her notebook, she copied down the generic and brand names of seven alternatives. Effexor, she noted, helps with anxiety - a plus. But Wellbutrin suppresses appetite - even better.

At the weekly meetings of an "under-30" mood-disorder support group in New York that Laurie attends, the discussion inevitably turns to medication. Group members trade notes on side effects that, they complain, doctors often fail to inform them about. Some say they are increasingly suspicious of how pharmaceutical companies influence the drugs they are prescribed.

"Lamictal is the new rage," said one man who attended the group, "but in part that's because there's a big money interest in it. You have to do research on your own because the research provided to you is not based on an objective source of what may be best."

Recent reports that widely prescribed antidepressants could be responsible for suicidal thoughts or behavior in some adolescents have underscored for Laurie and other young adults how little is known about the risks of some drugs, and why different people respond to them differently.

Moreover, drugs widely billed as nonaddictive, like Paxil or Effexor, can cause withdrawal symptoms, which some patients say they only learned of from their friends or fellow sufferers.

"This view of psychology as a series of problems that can be solved with pills is relatively brand new," said Andrea Tone, a professor of the social history of medicine at McGill University. "It's more elastic, and more subjective, so it lends itself more to taking matters into our own hands."

To that end, it helps to have come of age with the Internet, which offers new possibilities for communication and commerce to those who want to supplement their knowledge or circumvent doctors.

Fluent in Psychopharmacology

People of all ages gather on public Internet forums to trade notes on "head meds," but participants say the conversations are dominated by a younger crowd for whom anonymous exchanges of highly personal information are second nature.

On patient-generated sites like CrazyBoards, fluency in the language of psychopharmacology is taken for granted. Dozens of drugs are referred to in passing by both brand name and generic, and no one is reticent about suggesting medications and dosage levels.

"Do you guys think that bumping up the dosage was a good idea, or should I have asked for a different drug?" someone who called herself Maggie asked earlier this month, saying she had told her doctor she wanted to double her daily intake of the antidepressant fluoxetine to 40 milligrams.

In another recent posting, a participant wrote that his supply of the beta blocker Inderal, acquired in Costa Rica, was running out. He uses the drug for panic attacks, he said, but he has not told his doctor about it. "What do I do/say to get her to prescribe me some?" he asked.

"CraZgirl," who said she was not currently taking any medications, received a resounding "yes" to her posting that asked, "If you wouldn't go on meds for yourself, is it reasonable to do it to keep your marriage intact?"

Still, for some young adults, consulting their peers leads to taking less medicine, not more. When Eric Wisch, 20, reported to an anonymous online group that he was having problems remembering things, several members suggested that he stop taking Risperdal, one of four medications in a cocktail that had been mixed different ways by different doctors.

"I decided to cut back," said Mr. Wisch, a sophomore at the University of Rochester who runs www.thebipolarblog.com, where he posts his thoughts on medications and other subjects. "And I'm doing better." Despite frequent admonitions on all the sites to "check with your Pdoc," an abbreviation for psychiatrist, there are also plenty of tips on how to get medications without a prescription.

"I know I shouldn't order drugs online," one participant wrote in a Sept. 26 posting on the Psycho-babble discussion group. "But I've been suffering with insomnia and my Pdoc isn't keen on sleep aids."

What should he do, the poster wanted to know, after an order he placed with an online pharmacy that promised to provide sleeping pills without a prescription failed to deliver?

Another regular participant, known as "med-empowered," replied that the poster was out of luck, and went on to suggest a private e-mail exchange: "I think I know some sites where you could post your experience and also get info about more reliable sites."

For a hefty markup, dozens of Web sites fill orders for drugs, no prescription required, though to do so is not legal. Instead, customers are asked to fill out a form describing themselves and their symptoms, often with all the right boxes helpfully pre-checked.

Erin, 26, a slender hair stylist, remembers laughing to herself as she listed her weight as 250 pounds to order Adipex, a diet pill, for $113. One recent night, she took an Adipex to stay up cleaning her house, followed by a Xanax when she needed to sleep.

Like many other self-medicators, Erin, who has been on and off antidepressants and sleeping pills since she was in high school, has considered weaning herself from the pills. She wishes she had opted for chamomile tea instead of the Xanax when she wanted to sleep.

"I feel like I have been so programmed to think, 'If I feel like this then I should take this pill,' " she said. "I hate that."

But the problem with the tea, she said, is the same one she faces when she is coloring hair: "It's not predictable. I know how these drugs are going to affect me. I don't know if the chamomile tea will work."

Online pharmacies are not the only way for determined self-prescribers to get their pills. Suffering from mood swings a decade after his illness was diagnosed as bipolar disorder, Rich R., 31, heard in an online discussion group about an antidepressant not available in the United States. A contractor in the Midwest, Rich scanned an old prescription into his computer, rearranged the information and faxed it to pharmacies in Canada to get the drug.

"My initial experience with physicians who are supposed to be experts in the field was disappointing," Rich said. "So I concluded I can do things better than they can."

Even for psychiatrists, patients say, the practice of prescribing psychotropic drugs is often hit and miss. New drugs for depression, anxiety and other problems proliferate. Stimulants like Adderall are frequently prescribed "as needed." Research has found that antidepressants affect different patients differently, so many try several drugs before finding one that helps. And in many cases, getting doctors to prescribe antidepressants, sleeping pills or other psychiatric medications is far from difficult, patients say.

The result is a surplus of half-empty pill bottles that provides a storehouse for those who wish to play pharmacist for their friends.

The rules of the CrazyBoards Web site prohibit participants from openly offering or soliciting pharmaceuticals. But it is standard practice for people who visit the site to complain, tongue-in-cheek, that they simply "don't know what to do" with their leftovers.

The rest takes place by private e-mail. Sometimes, the person requesting the drugs already has a prescription, but because the medications are so expensive, receiving them free from other people has its merits.

A Post-Hurricane Care Package

Dan Todd, marooned in Covington, La., after Hurricane Katrina, said he would be forever grateful to a woman in New Hampshire who organized a donation drive for him among the site's regular participants.

Within two days of posting a message saying that he had run out of his medications, he received several care packages of assorted mood stabilizers and anti-anxiety drugs, including Wellbutrin, Klonopin, Trileptal, Cymbalta and Neurontin.

"I had to drive down to meet the FedEx driver because his truck couldn't get past the trees on part of the main highway," said Mr. Todd, 58. "I had tears in my eyes when I got those packages."

It doesn't always work out so well. When Katherine took a Xanax to ease her anxiety before a gynecologist appointment, she found that she could not keep her eyes open. She had traded a friend for the blue oval pill and she had no idea what the dosage was.

An Adderall given to her by another friend, she said, "did weird things to me." And Mr. Tylutki, who took the Ritalin she offered one weekend last fall, began a downward spiral soon after.

"I completely regretted and felt really guilty about it," Katherine said.

Taking Katherine's pills with him when he returned to Minneapolis, Mr. Tylutki took several a day while pursuing a nursing degree and working full time. Like many other students, he found Ritalin a useful study aid. One night, he read a book, lay down to sleep, wrote the paper in his head, got up, wrote it down, and received an A-minus.

But he also began using cocaine and drinking too much alcohol. A few months ago, Mr. Tylutki took a break from school. He flushed the Ritalin down the toilet and stopped taking all drugs, including the Prozac that he had asked a doctor for when he began feeling down.

"I kind of made it seem like I needed it," Mr. Tylutki said, referring to what he told the doctor. "Now I think I was just lacking sleep."

Result number: 121

Message Number 187483

Re: United Shockwave Therapies, LLC View Thread
Posted by dave b. on 11/15/05 at 15:47

My journey so far: I had ESWT 8 weeks ago. My Achilles tendonosis is getting better due to it! The DPM said I'd pay $1000 to him and $500 to United. Nothing was in writing. I was billed by my DPM and I paid him. I'm waiting for United's bill. DPM said if United bills for more than $500 I should contact him.

Result number: 122

Message Number 187387

Re: POLL for docs/providers: success/failure/complication rate of surgery for PF View Thread
Posted by Teresa D on 11/14/05 at 19:27

I had bilateral plantar fasciotomy in aug'04. I AM STILL HAVING PAIN and have gone to multiple doctors since, hoping and praying that one of them will give me some form of relief. As my luck goes, my most recent Dr. who I felt was really helping me moved to another state... he put me into an "isolation boot"... I made some progress for awhile, but the swelling is back full force. I do have an odd question for someone to answer: did anyone have 4-5 stitches where the incision was made? I thought endoscopic surgery didn't have stitches involved. I am left wondering if the Dr. really did perform an endoscopic procedure like he told me and billed my insurance for, since I had 5 stitches in each foot. There were some other things that I am now left questioning, but nevertheless I AM IN PAIN!

Result number: 123

Message Number 187276

Re: Night splints View Thread
Posted by Dr. David S. Wander on 11/13/05 at 20:03

It depends on the state and depends on the individual plan. There are some states that BCBS does pay depending on the actual plan. You should ask the insurance biller in your doctor's office to check for you. He/she will know the proper codes to bill and should be able to provide you with the correct information.

Result number: 124

Message Number 186960

Re: EPF Surgery Problems View Thread
Posted by Ed Davis DPM on 11/08/05 at 11:20

David:
This was a debated topic 22 years ago and cannot beleive it is still an issue. Theoretically, no nail should exist in an area after a provider billed 11750 which is nail avulsion with "root" or nail matrix but I have seen lots of patients who have a "history" of having done, often by non-podiatrists who need it repeated - something that theroretically should not be happening. There are just too many people who want medicine practiced on a calculator, something that simply cannot be done with the real people who are our patients.
Ed

Result number: 125

Message Number 186801

Re: New Codes View Thread
Posted by vince on 11/05/05 at 17:40

You won't stop being supicious Ralph.

It's very simple Ralph. Medical staff love food. That's why the detail men always bring lunch, snacks, etc. My wife does the same thing. A homemade cake,plate of cookies,an inexpensive box of chocolate or a fruit platter. Gets you the best appointments, extra help with an insurance problem etc. So I simply asked the biller if I could see the 2006 code book and it was no problem.

Just imagine Ralph- you've had nothing but impatient patients, harried doctors and calls to the insurance bandis all day and now a patient shows up with a warm freshly baked cake oozing sweet icing. Get the picture?

Result number: 126

Message Number 185481

Re: Unitedshock wave cases View Thread
Posted by Dr. Z on 10/23/05 at 09:55

Vince,
Here is the article from Medical Economics. It is my understanding that it is both medicare, and commerical insurance that they are talking about.
I understand it that ALL insurance companies are included depending on the state.




Q An equipment vendor approached me with the following proposal: If I use the vendor's equipment and technical services in any procedure, we'll split the billing. I'll bill for the service's professional component, and the vendor will bill for the technical component. If the patient's insurance carrier refuses to pay for the vendor's services, he says he'll just write off the charges. Is there anything wrong with this arrangement?

A Yes. Some states would view such an arrangement as illegal fee splitting. Moreover, if the vendor writes off a fee billed to the carrier without attempting to collect it from the patient, it could be considered insurance fraud, and, depending on the patient, could be deemed Medicare fraud, as well. If you have the volume, you should simply lease the equipment.

Must part

Result number: 127

Message Number 185219

Re: Low energy or high energy for Fasciitis? View Thread
Posted by Dr. Z on 10/19/05 at 23:30

This question and answer came from Healthcare attorneys from the Medical Magazine Medical Economics Here is the truth. This is very serious and should not be taken lightly.This is posted on the New Jersey Podiatric Medical Society Web site. So any doctor in New Jersey doing ESWT read cause if you are doing this well you are all grow up . Do I have to say more.

A good deal or illegal fee splitting

Q An equipment vendor approached me with the following proposal: If I use the vendor's equipment and technical services in any procedure, we'll split the billing. I'll bill for the service's professional component, and the vendor will bill for the technical component. If the patient's insurance carrier refuses to pay for the vendor's services, he says he'll just write off the charges. Is there anything wrong with this arrangement?

A Yes. Some states would view such an arrangement as illegal fee splitting. Moreover, if the vendor writes off a fee billed to the carrier without attempting to collect it from the patient, it could be considered insurance fraud, and, depending on the patient, could be deemed Medicare fraud, as well. If you have the volume, you should simply lease the equipment.

Must part-timers be given

Result number: 128

Message Number 184983

Re: Any one that paid out of pocket in New Jersey for ESWT View Thread
Posted by Dr. Z on 10/16/05 at 21:58

Elvis,
This isn't the classic case that I am looking to help. I really want a case where the patient paid in full for the services and is looking for the insurance company to pay the patient back the money.
In this case we have the problem where there are two fees . One for the patient and one billed to the insurance company.
I really would like to open up Aetna US Healthcare. Aetna has in writing that ESWT is experimental and not medically necessary. This is completely false and misleading.
Showing that the patient benefited and that there is ESWT medical expert willing to go to court ( not really expense) I just can't see how Aetna would win. I just have too much information to back up the claim that ESWT is medical necessary, safe and effective. I can even bring in of the orginal founders of US Healtcare that had ESWT done by Dr. Z and is post two years cured. I can just see the look on the face of the judge when this patient is a witiness.
I did this with IBC and it worked but then another company showed up and started with using non- FDA approved equipment. Another company stated not charging for the tech fee if the insurance company doesnb't pay.
All this ridiculous stuff that destroys the insurance market and causes insurance companies to stop paying for ESWT
So Vince you know NOTHING about how to get insurance coverage if you support this double billing bull.
I have been in podiatry for 25 years and I have never seen this ridiculous tactic. It might work in the MD ESWL market but it won't in the ESWT orthopedic market.
If I sound pissed off I am . Take a look at what markets had ESWT insurance coverage and who was there and take a look at what is now left
The only place where there is good ESWT insurance left is where I am.
Figure it out. Insurance companies aren't stupid !!
and last but not least if Lynn still wants help. I am still willing to advice and help anyone who asks and they don't have to be using my company Excellence Shockwave Therapy.
I just can't believe that we have these conservations. Everyone just use your commone sense. If it sounds too good it is too good.

Result number: 129

Message Number 184333

Re: I finally decided to do ESWT... View Thread
Posted by Ralph on 10/08/05 at 17:46

Susan,
I agree on the point that you mention but would rather it be more of a general statement. I think you are correct when you say doctors don't even go after other doctors that they know are using fraudulent practices in their offices.

They seem to turn a blind eye because they are not going to be the whistle blower guy one day and the pat on the back guy at the convention the next.

Money and colleagues are thick and who among them is willing to put themselves up for audit and possible government examination if they yell fire. They'd rather take a cool pass on a colleague's little office fraud.

Surely know who's doing what, when, where and how, far better than any of their patients.

I had the unfortunate experience of being charged for a toenail removal by a Pod that didn't do the procedure. I came home with 10 toenails yet I was billed for removal of one. Like Dr. Z said it appeared on my insurance statement. Guess what I called the Dr. Office and requested the money be returned to my insurance co. and all I got was a run around an promises from one of his offices to the next.

The same day I called my insurance co and told them to go after the money because they could check me I had all 10 toenails. Here comes the kicker that all the doctors know about and now you will too.

It cost Insurance Companies lots of money to go after fraud and over billings so in smaller cases they just accept the loss. My toenail surgery cost was considered toooo small to spend their time and attorney's fees on. They were just going to let the doc keep the cash.

You can call your insurance company today and ask them the $$$ amount that is necessary before they will go after it and they will tell you.

I was pissed to say the least and handled it myself. I stood outside the doctors office with a sign and talked to eveyone going and coming. It took them less that 1/2 hr to cut me a check for my insurance company after 2 weeks of run around.

So remember when you are told to watch for fraud it's the patients job they mean the big stuff because the small stuff insurance companies let go. Some doctors I think simply consider it extra income for a task well done.

Medicare is the big gun that they watch carefully because they don't want to ruffle those government feathers and have the feds check their books. Medicare pays pretty good for older person's feet and they like a check they can count on.

Result number: 130

Message Number 182055

Re: San Diego Update View Thread
Posted by Dr. Z on 9/05/05 at 23:22

Elvis,
I do use off label protocols and dispensing of medications ie neurotin. As a physician here is what concerns me about off label ESWT use. If there are complications and there was an approved procotol option available the patient could if he wanted to take legal action and win his action. In your csse this wouldn't apply since your doctor has given you all of the ESWT options and alternatives and you are clearly informed about what is going on. I have seen the use of the sonocur used in the low energy protocol for pf where there wasn't any informed consent and was billed to insurance companies as an FDA high energy treatment.

Result number: 131

Message Number 180865

Re: Cost of ESWT View Thread
Posted by Ralph on 8/20/05 at 13:08

John,
A friend of my wife just got the bill for her breast radiation treatment.
Her insurance was billed $30,000 for that treatment. I'm sure there were discounts later. You know how insurance works. No doctor's bills have come in yet.

I don't understand why they bill so high and end up taking less. Why don't they just bill what they are willing to accept in the first place.
It's such a game. That and the price of airline tickets.

Result number: 132

Message Number 180699

Re: Orbie is FDA approved for plantar fasciitis View Thread
Posted by Dr. Zuckerman on 8/18/05 at 11:10

Vince,
Here is my take on this . Medicare will cover this procedure across the board. I personally have excellent relationships with most insurance companies and have in the past been approached by some to contract with due to my fair approach with ESWT.
Yes there are some podiatrists just like there are some orthopedic, internists that have problems with insurance companies. I really don't think that podiatry is worth the trouble with any insurance company due to the small size of our profession and the small amounts billed to insurance companies compared to other professions. Where I live podiatry is very respected and covered by most insurance companies.

Result number: 133

Message Number 180359

Re: Cost of ESWT View Thread
Posted by Lori S. on 8/10/05 at 23:29

The amount billed to my insurance for both feet was over $10,000, just for the treatment, there was the podiatrist and other factors that im sure wanted more....

Result number: 134

Message Number 180272

Re: Sonorex no longer applicable to our practice View Thread
Posted by CBakkemo on 8/09/05 at 18:25

Thanks all for your responses, having recently assumed responsibility at this practice I should have performed a much more thorough review of the modality instead of simply cutting and pasting. As an FYI, claim review shows that upon acquisition the initial treatments were billed under 50590. Denials followed as 50590 didnt match with the dx codes of 726.32 and at the time 728.71 although I see this dx code is no longer active. A second round of billing using the corrected codes 0019T and 0020T were used with reasonable success. As the practice was not then and is not currently a Medicare provider this was not an issue, Medicare patients were not seen. The history seems a bit muddled from what I can gather but again this modality is simply not applicable in our current practice and thus our desire to divest. Finally I found no fraudulent activity only poor coding and, in my own post as well, lack of research. Irresponsible but recoverable. Best regards, C

Result number: 135
Searching file 17

Message Number 179092

Re: chronic plantar fasciitis View Thread
Posted by Norm on 7/26/05 at 05:26

I also went through eswt. My insurance did not pay anything & it was agreed before the procedure that the company that did the eswt would only charge me $500 if the insurance denied it. I believe they billed the ins company $7500 for both feet. My pod tried to bill the ins co $5000 for just standing there watching how it was done. He also agreed to the $500 if ins denied. Can you believe the pod? Wanting $5000.00 to stand there & watch. Anyways the eswt did nothing for my feet.

Result number: 136

Message Number 178909

Re: chronic plantar fasciitis View Thread
Posted by DavidW on 7/23/05 at 07:30

chase, I could not get my insurance to pay either. After looking at several treatment centers, I chose one that promised to deal with my insurance company, and promised to accept whatever payment that the insurance company would pay (and no, I did not get it in writing). The treatment center submitted a $7,500 bill to my insurance, who then pain only $3,600 to the center. The center billed me for the deductible, which was $400. I also paid for the doctor bill, which was around $200. All in all, I think it was a pretty good deal for me. You may want to find and select a treatment center that can offer something similar. I think many of them are desperate for customers.

Anyhow, the ESWT did not help at all. Two doctors have suggested that I go for a 2nd treatment, but I will not. I, like many others, am choosing deep massage treatments, and they are working miracles so far. Something you may want to consider.

Result number: 137

Message Number 178274

Re: Complete list of ESWT research- the rest View Thread
Posted by Ed Davis, DPM on 7/12/05 at 20:45

List of publications from ismst.com website, July, 2005
Author Title Year Publisher
Ackaert KS, Schröder FH Effects of extracorporeal shock wave lithotripsy (ESWL) on renal tissue. 1989 Urological Research, 17: 3-7
Alvarez R. Preliminary results on the safety and efficacy of the OssaTron for treatment of plantar fasciitis. 2002 Foot Ankle Int 2002;23:197-203
Amelio E, Cugola L Acute and chronic tendon pathology in athlete 2000 3rd Congress of the ISMST - Naples, Abstracts:81
Amini A, Hafez M, Zhou S, Garcia E, Coombs R Shockwave Treatment for Chronic Non-union 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 159-164
Ammendolia A, Perticone L, Milano C Chronic shoulder articular pain: treatment by extracorporeal shockwaves 2000 3rd Congress of the ISMST - Naples, Abstracts:19
Ape A, Bosco V, Buselli P, Coco V, Gerardi A, Saggini R A retrospective, multi-centre experience report of shock wave therapy on epicondylitis 2000 3rd Congress of the ISMST - Naples, Abstracts:35-36
Apfel RE Acoustic cavitation. 1981 Methods of experimental physics, vol. 19, P. Edmonds ed., Academic Press New York: 355-411
Arbeitsgruppe "Orthopädische Stosswellenbehandlungen" Standortbestimmung 1995 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Die Stosswelle - Forschung und Klinik, Attempto Verlag, Tübingen: 137-142
Arbeitsgruppe "Technische Entwicklungen" Standortbestimmung 1995 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Die Stosswelle - Forschung und Klinik, Attempto Verlag, Tübingen: 15-20
Assenza, Buselli P, Chiacchio C, Pozzolini M, Scrocca M, Saggini R A retrospective, multi-centre experience report of shock wave therapy on rotator cuff tendonitis with calcific deposit 2000 3rd Congress of the ISMST - Naples, Abstracts:25
Auersperg V, Labek G, Böhler N Correlations Between Length of History and Outcome 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 37-42
Augat P, Claes L, Suger G In vivo effects of shock waves on the healing of fractured bone. 1995 Clin. Biomechan., 10: 374-378
Baloglu I, Aydinok H, Lök V Our results of the ossatherapy for treatment of pseudoathrosis 2000 3rd Congress of the ISMST - Naples, Abstracts:56
Baloglu I, Lök V Shockwave Therapy for Plantar Fasciitis 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 51-52
Bao S, Thrall BD, Miller DL Transfection of a reporter plasmid into cultured cells by sonoporation in vitro. 1997 Ultrasound in Medicine & Biology, 23: 953-959
Baumann J, Baumann J Treatment of neuromuscular dysfunction in children with spastic cerebral palsy by extracorporeal unfocused shock waves. 1997 Siebert W, Buch M (Hrsg), Extracorporal shock waves in orthopaedics, Springer Verlag, Berlin Heidelberg New York: 231-239
Beg M, Melikyan E, Yang X, Bainbridge L Shockwave Treatment for Intractable Tennis Elbow 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 81-90
Begg C, Cho M, Eastwood S Improving the quality of reporting of randomized controlled trials: the CONSORT statement. 1996 JAMA 1996; 276:637-639
Benson K, Hartz AJ A comparison of observational studies and randomized, controlled trials. 2000 N Engl J Med 2000; 342: 1878-1886
Betz U, Heine J, Riedel C, Rompe J D, Schöllner C The value of Cervical Spinal Manipulative Therapy Combined with Low Energy Shockwaves for Chronic Tennis Elbow 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 123-130
Boxberg W, Perlick L, Giebel G Stosswellenbehandlung bei therapieresistenten Weichteilschmerzen. 1996 Chirurg, 67: 1174-1178
Boyer MI, Hastings H Lateral tennis elbow: Is there any science out there? 1999 J Shoulder Elbow Surg 1999; 8:481-491
Braun W, Claes L, Rüter A, Paschke D Untersuchung zur Wirksamkeit von Stosswellen auf die Festigkeit des Verbundes von Knochen und Polymethylmetacrylat. 1991 Experimentelle Orthopädie, 130: 236
Braun W, Claes L, Rüter A, Paschke D Effects of extracorporeal shock waves on the stability of the interface between bone and polymethylmethacrylate: an in vitro study on human femoral segments. 1992 Clin. Biomechan., 7: 47-54
Braun W, Rüter A Frakturheilung: Morphologische und physiologische Gesichtspunkte. 1996 Unfallchirurg, 99: 59-67
Brendel W, Delius M, Goetz A Effect of shock waves on the microvasculature. 1987 Prog. Appl. Microcirculation, 12: 41-50
Brocai DRC, Lukoschek M, Hartmann M, Loew M Biometrische Planung klinisch-orthopadischer Studien. Der optimale Stichprobenumfang. 1998 Orthopäde 1998; 27:301-304
Brunner W, Thüringer R, Ascher G, Maluche C, Kellner F, Neuking A, Solleder A, Schmidt-Hoensdorf F, Vetter K High energy shock waves for pain management in orthopedics - a two year foolow-up in 899 cases 2000 3rd Congress of the ISMST - Naples, Abstracts:75
Brunner W, Thüringer R, Ascher G, Neuking A, Flesch A, Solleder A, Schmidt-Höhnsdorff F, Bärtel B Die extrakorporelle Stosswellentherapie in der Orthopädie - Drei-Monats-Ergebnisse in 443 Fällen. 1997 Orthopädische Praxis, 7: 461-464
Brümmer F, Brenner J, Bräuner T, Hülser D Effect of shock waves on suspended and immobilized L1210 cells. 1989 Ultrasound in Medicine & Biology, 15: 229-239
Brümmer F, Bräuner T, Hülser D Biological effects of shock waves. 1990 World Journal of Urology, 8: 224-232
Brümmer F, Suhr D, Hülser D Sensitivity of normal and malignant cells to shock waves. 1992 Stone Disease, 4: 243-248
Bräuner T, Brümmer F, Hülser DF Histopathology of shock wave treated tumor cells suspensions and multicell tumor spheroids. 1989 Ultrasound in Medicine & Biology, 15: 451-460
Buch M Shock wave therapy of heel spur. 1997 Orthopaedic Product News, July/Aug./Sep.: 28-30
Buch M Prospektiver Vergleich der hochenergetischen Stoßwellentherapie sowie des Needling bei der Tendinosis calcarea der Schulter 2001 Siebert W, Buch M (Hrsg), Extrakorporale Stoßwellentherapie in der Orthopädie - Grundlagen und Anwendung, Ecomed Verlagsgesellschaft, Germany: 127-136
Buch M, Fleming L, Theodore G, Amendola A, Bachmann C, Zingas C. Resultate einer prospektiven placebokontrollierten randomisierten doppelblinden Multicenterstudie zur Evaluation der Effektivität und Sicherheit der Stoßwellentherapie bei plantarer Fasciitis. 2001 Vortrag, Symposium Muskuloskeletale Stoßwellentherapie, Mainz
Buch M, Knorr U, Fleming L, Theodore G, Amendola A, Bachmann C et al Extracorporeal shock wave therapy in plantar fasciitis: a review. 2002 Orthopaede 2002;31:637-644
Buch M, Knorr U, Siebert W E Chronic plantar fasciitis treated by ESWT 2000 Minimally Invasive Therapy & Allied Technologies, Isis Medical Media, Volume 9, Number 3/4 August 2000: 310 (Abstract 7)
Buch M, Schlangmann B, Träger D, Siebert W Prospektiver Vergleich der niedrig- und hochenergetischen Stosswellentherapie und Needling bei der Behandlung der Tendinosis calcarea der Schulter. 1997 45. Jahrestagung der Vereinigung Süddeutscher Orthopäden, Abstractband: 101-102
Buch M, Siebert W Shockwave Treatment for Heel Pain Syndrome - a Prospective Investigation 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 73-77
Burger C, Tsironis K, Helling HJ, Prokop A, Rehm KE Die extrakorporale Stosswellentherapie bei Ansatztendopathien der Schulter, des Ellenbogens und der Ferse - vorläufige Ergebnisse einer prospektiven Kölner Studie. 1996 45. Jahrestagung der Deutschen Orthopädenvereinigung e.V. User Meeting Ossatron, Wiesbaden
Buselli P, Saggini R ESWT in ossificans myositis 2000 3rd Congress of the ISMST - Naples, Abstracts:83
Bürger R, Witzsch U, Haist J, Grebe P, Hohenfellner R Die extrakorporale Stosswellentherapie (ESWT) - eine neue Möglichkeit der Behandlung von Pseudarthrosen. 1993 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Stosswellenlithotripsie - Aspekte und Prognosen, Attempto Verlag, Tübingen: 127-130
Bürger R, Witzsch U, Haist J, Karnofsky V Extrakorporale Stosswellenbehandlung bei Pseudarthrose und aseptischer Knochennekrose. 1991 Urologe A, 30: 48
Bürger R, Witzsch U, Haist J, Karnofsky V, Hohenfellner R Extracorporeal shock wave therapy of pseudo-arthrosis and aseptic osteonecrosis. 1991 Endourology, 5, Suppl. 1: 48
Bürger R, Witzsch U, Haist J, Karnovsky V, Ahlers J, Hohenfellner R Extracorporeal shock wave therapy of pseudo-arthrosis. 1992 Urology, 147: 48 ff
Bödekker I, Haake M Die extrakorporale Stosswellentherapie zur Behandlung der Epicondylitis humeri radialis. Ein aktueller Überblick. 2000 Orthopäde 2000; 29:463-469
Bödekker R, Schafer H, Haake M Extracorporeal shock wave therapy in the treatment of plantar fasciitis – a biometrical review. 2001 Clin Rheumatol 2001; 20:324-330
Chaussy C, Eisenberger F, Wanner K, Forssmann F, Hepp W, Schmiedt E, Brendel W The use of shock waves for the destruction of renal calculi without direct contact. 1976 Urol Res 1976; 4:181-188
Chen H, Chen L, Huang T Treatment of painfull heel syndrome with shock waves 2001 Clinical Orthopaedics and Related Research, 387: 41-46
Chen H, Chen L, Huang T Treatment of painful heel syndrome with shock waves 2001 Clin Orthop 2001; 387: 41-46
Child SZ, Hartman C, Schery LA, Carstensen EL Lung damage from exposure to pulsed ultrasound. 1990 Ultrasound in Medicine & Biology, 16: 817-825
Church C A theoretical study of cavitation generated by an extracorporeal shock wave lithotripter. 1989 Acoustic Society of America, 86: 215-227
Coleman AJ, Saunders JE A review of the physical properties and biological effects of the high amplitude acoustic fields usedr in extracorporeal lithotripsy. 1993 Ultrasonics, 31: 75-89
Coleman AJ, Saunders JE A survey of the acoustic output of commercial extracorporeal shock wave lithotripters. 1989 Ultrasound in Medicine & Biology, 15: 213-227
Coleman AJ, Saunders JE, Crum LA, Dyson M Acoustic cavitation generated by an extracorporeal shock wave lithotripter. 1987 Ultrasound in Medicine & Biology, 13: 69 ff
Concato J, Shah N, Jorwitz RI Randomized, controlled trials, observational studies, and the hierarchy of research. 2000 N Engl J Med 2000; 342: 1887-189
Corrado B, Russo S, Gigliotti S, De Durante C, Canero R Shockwave Treatment for Non-unions of the Carpal Scaphoid 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 187-194
Cosentino R, de Stefano R, Frati E, Manca S, Tofi C, Falsetti P, Linari S, Morfini M, Rossi-Ferrini P, Marcolongo R Safety and efficacy of extracorporeal shock wave therapy in the treatment of painful non articular rheumatism of patients with hemophilia 2000 3rd Congress of the ISMST - Naples, Abstracts:86
Cozzolino F, Corrado B, Izzo M, Borrelli M, Russo S, Gigliotti S, de Durante C Axial external fixation plus high energy shock waves in the treatment of unstable leg non union 2000 3rd Congress of the ISMST - Naples, Abstracts:61
Crawford F, Atkins D, Edward J Interventions for treating plantar heel pain (Cochrane Review) 2000 Cochrane Library, Issue 3. Oxford: Update Software, 2000
Crowther M. A prospective randomised study comparing shockwave therapy and steroid injection in the treatment of 'tennis elbow' 2000 3rd Congress of the ISMST - Naples, Abstracts:34
Crum L Tensile strength of water. 1979 Nature, 278: 148-149
Crum L Acoustic cavitation. 1982 Proceedings of the 1982 IEEE ultrasonics Symposium, IEEE, New York: 1-11
Cugola L, Amelio E Long bone non-union: treatment by extracorporeal shock wave (ESW) 2000 3rd Congress of the ISMST - Naples, Abstracts:59Dahm K Stosswellentherapie bei schmerzhaftem Fersensporn: Nachuntersuchungen bei 362 Patienten. 1997 2. Radevormwalder ESWT-Symosium, Radevormwald: 8-9
Dahmen GP, Franke R, Gonchars V, Poppe K, Lentrodt S, Lichtenberger S, Jost S, Montigel J, Nam VC, Dahmen G Die Behandlung knochennaher Weichteilschmerzen mit extrakorporaler Stosswellentherapie (ESWT) - Indikation, Technik und bisherige Ergebnisse. 1995 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Die Stosswelle - Forschung und Klinik, Attempto Verlag, Tübingen: 175-186
Dahmen GP, Meiss L, Nam VC, Skruodies B Extrakorporale Stoßwellentherapie (ESWT) im knochennahen Weichteilbereich an der Schulter 1992 Extracta Orthopaedica 1992; 15:25-28
Dahmen GP, Nam VC, Meiss L Extrakorporale Stosswellentherapie zur Behandlung von knochennahen Weichteilschmerzen: Indikation, Technik und vorläufige Ergebnisse. 1993 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Stosswellenlithotripsie - Aspekte und Prognosen, Attempto Verlag, Tübingen: 143-148
Davis PF, Severud E, Baxter DE Painful heel syndrome: results of nonoperative treatment. 1994 Foot Ankle Int 1994;15:531-5
de Durante C, Russo S, Gigliotti S, Corrado B The Treatment of Shoulder Periarticular Calcification 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 143-144
de Durante C, Russo S, Gigliotti S, Pecoraro C The treatment of shoulder periarticular calcifications by shock waves 2000 3rd Congress of the ISMST - Naples, Abstracts:23
de Maio M, Paine R, Mangine RE, Drez D Plantar fasciitis. 1993 Orthopedics 1993;16: 1153-63
de Oya R, Sanchez Benitez Soto J, Garcia Munilla M Extracorporeal shock waves in the treatment of tendinitis of shoulder 2000 3rd Congress of the ISMST - Naples, Abstracts:13
de Pretto M, Dalla Valle I, Ferrari G, Pacetti A Follow-up and evaluation of heterotopic ossifications treated with shockwave therapy 2000 3rd Congress of the ISMST - Naples, Abstracts:85
de Pretto M, Guerra L, Pozzolini M, Zucchetti R, Saggini R A retrospective multi-centre experience report of shock wave therapy on achilles tendonitis 2000 3rd Congress of the ISMST - Naples, Abstracts:45-46
Delius M Minimal static excess pressure minimizes the effect of extracorporeal shock waves on cells and reduces it on gallstones. 1997 Ultrasound in Medicine & Biology, 23: 611-617
Delius M Experimentelle Stosswellenlithotripsie - aktuelle Entwicklungen. 1995 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Die Stosswelle - Forschung und Klinik, Attempto Verlag, Tübingen: 3-9
Delius M Biologische Wirkung von Stosswellen - mehr als "nur" Steinzertrümmerung? 1995 Zentralblatt Chirurgie, 120: 259-273
Delius M Medical applications and bioeffects of extracorporal shock waves. 1994 Shock waves, 4: 55-72
Delius M Bioeffects of shock waves: in vivo and in vitro actions 2000 3rd Congress of the ISMST - Naples, Abstracts:9
Delius M, Denk R, Berding C, Liebich H, Jordan M, Brendel W Biological effects of shock waves: cavitation by shock waves in piglet liver. 1990 Ultrasound in Medicine & Biology, 16: 467-472
Delius M, Draenert K Einfluß hochenergetischer Stosswellen auf Knochen, Wirkung von Stosswellen auf Knochen. 1997 Siebert W, Buch M (Hrsg), Stosswellenanwendung am Knochen - Klinische und experimentelle Erfahrungen, Dr. Kovac, Hamburg: 10-11
Delius M, Draenert K, Al Diek Y, Draenert Y Biological effect of shock waves: in vivo effect of high energy pulses on rabbit bone. 1995 Ultrasound in Medicine & Biology, 21: 1219-1225
Delius M, Draenert K, Draenert Y, Börner M Effects of extracorporeal shock waves on bone: a review of shock wave expiriments and the mechanism of shock wave action. 1997 Siebert W, Buch M (Hrsg), Extracorporeal shock waves in orthopaedics, Springer Verlag, Berlin Heidelberg New York: 91-107
Delius M, Enders G, Heine G, Stark J, Remberger K, Brendel W Biological effects of shock waves: lung hemorrhage by shock waves in dogs - pressure dependence. 1987 Ultrasound in Medicine & Biology, 13: 61-67
Delius M, Enders G, Xuan Z, Liebich H, Brendel B Biological effects of shock waves: kidney damage by shock waves in dogs - dose dependence. 1988 Ultrasound in Medicine & Biology, 14: 117-122
Delius M, Hoffmann E, Steinbeck G, Conzen P Biological effects of shock waves: induction of arrhythmia in piglet hearts. 1994 Ultrasound in Medicine & Biology, 20: 279-285
Delius M, Jordan M, Eizenhoefer H, Marlinghaus E, Heine G, Liebich H, Brendel W Biological effects of shock waves: kidney hemorrhage by shock waves in dogs - administration rate dependence. 1988 Ultrasound in Medicine & Biology, 14: 689-694
Delius M, Jordan M, Liebich H, Brendel W Biological effects of shock waves: effect of shock waves on the liver and gallbladder wall of dogs - administration rate dependence. 1990 Ultrasound in Medicine & Biology, 16: 459-466
Delius M, Weiss N, Gambihler S, Goetz A, Brendel W Tumor therapy with shock waves requires modified lithotripter shock waves 1989 Naturwissenschaften, 76: 573-574
Delius M, Überle F, Eisenmenger W Extracorporeal shock waves act by shock wave gas bubble interaction. 1998 Ultrasound in Medicine & Biology, 24: 1055-1059
Dellian M, Walenta S, Gamarra F, Kuhnle G, Mueller-Klieser W, Goetz A Ischemia and loss of ATP in tumors following treatment with focused high energy shock waves. 1993 British Journal of Cancer, 68: 26-31
di Silverio F, Galluci M, Gambardella P, Alp G, Benedetti R, La Mancusa R, Pulcinelli FM, Romiti R, Gazzangia PP Blood cellolar and biochemical changes after extracorporeal shock wave in lithotripsy. 1990 Urological Research, 18: 49 ff
Dieppe P, Chard J, Tallon D, Egger M Funding clinical research. 1999 Lancet 1999; 353:1626-1629
Diesch R, Haupt G Anwendung der hochenergetischen extrakorporalen Stosswellentherapie bei Pseudarthrosen. 1997 Siebert W, Buch M (Hrsg), Stosswellenanwendung am Knochen - Klinische und experimentelle Erfahrungen, Dr. Kovac, Hamburg: 63-64
Diesch R, Haupt G Use of extracorporeal shock waves in the treatment of pseudarthrosis. 1991 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), High energey shock waves in medicine, Thieme Verlag, Stuttgart: 136-139
Diesch R, Haupt G Extracorporeal shock wave treatment of pseudarthrosis, tendinosis calcarea of the shoulder and calcaneal spur. 1997 Siebert W, Buch M (Hrsg), Extracorporeal shock waves in orthopaedics, Springer Verlag, Berlin Heidelberg New York: 131-135
Diesch R, Straub T, Penninger E, Frolich T, Scholl J Conventional Versus Ballistic Shockwave Treatment for Calcaneal Spur 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 71-72
Duarte LR The stimulation of bone growth by ultrasound. 1983 Archives of Orthopaedic and Trauma Surgery, 101: 153 ff
Dyson M, Brookes M Stimulation of bone repair by ultrasound. 1983 Ultrasound in Medicine & Biology, Suppl 2: 61 ff
Eichenblat M Experience with two different types of shockwave therapy for chronic calcifying tendinitis of the shoulder and chronic heel syndrome 2000 3rd Congress of the ISMST - Naples, Abstracts:71
Eisenmenger W Experimentelle Bestimmung der Stossfrontdicke aus dem akustischen Frequenzspektrum elektromagnetisch erzeugter Stosswellen in Flüssigkeiten bei einem Stossdruckbereich von 10 atm bis 10 atm. 1964 Acustica, 14: 188-204
Ekkernkamp A Extrakorporale Stosswellen. 1998 Deutsches Ärzteblatt, 95: B-1403
Ekkernkamp A Die Wirkung extrakorporaler Stosswellen auf die Frakturheilung. 1992 Habilitationsschrift, Ruhr-Universität, Bochum
Ekkernkamp A, Bosse A, Haupt G, Pommer A Der Einfluß der extrakorporalen Stosswellen auf die standardisierte Tibiafraktur am Schaf. 1992 Ittel TH, Sieberth HG, Matthiaß HH (Hrsg), Aktuelle Aspekte der Osteologie, Springer Verlag, Berlin Heidelberg New York: 307-310
Ekkernkamp A, Haupt G, Knopf HJ, Püllenberg P, Muhr, Senge T Effects of extracorporeal shock waves on standardized fractures in sheeps. 1991 Urology, 145: 257 ff
Feigl T, Schneider T, Riedlinger R, Löhr M, Hahn EG, Ell C Beschallung von humanen Pankreaskarzinomzellen mit hochenergetischem gepulsten Ultraschall. 1992 Med. Tech., 3: 139-143
Ferrari G, lo Prete F, de Pretto M, Pacetti A Use of imaging for heterotopic ossifications evaluation 2000 3rd Congress of the ISMST - Naples, Abstracts:84
Folberth W, Krause H, Reuner T Stosswellenmesstechnik in der Lithotripsie: Historie und Ausblick. 1995 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Die Stosswelle - Forschung und Klinik, Attempto Verlag, Tübingen: 45-50
Forriol F, Solchaga L, Moreno JL, Canadell J The effects os shock waves on mature and healing cortical bone. 1994 International Orthopaedics, 18: 325-329
Fritze J Extrakorporale Stoßwellentherapie in orthopädischer Indikation: Eine ausgewählte Übersicht. 1998 Versicherungsmedizin 1998; 50: 180-183
Fukada E, Yasuda I On the piezoelectric effect of bone. 1957 Phys. Soc. Japan, 12: 1158-1162
Fuson RL, Sherman M, Van Fleet J, Wendt, T The conduct of orthopaedic clinical trials. 1997 J Bone Joint Surg 1997; 79-A: 1089-1098



Feigl T, Schneider T, Riedlinger R, Löhr M, Hahn EG, Ell C Beschallung von humanen Pankreaskarzinomzellen mit hochenergetischem gepulsten Ultraschall. 1992 Med. Tech., 3: 139-143
Ferrari G, lo Prete F, de Pretto M, Pacetti A Use of imaging for heterotopic ossifications evaluation 2000 3rd Congress of the ISMST - Naples, Abstracts:84
Folberth W, Krause H, Reuner T Stosswellenmesstechnik in der Lithotripsie: Historie und Ausblick. 1995 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Die Stosswelle - Forschung und Klinik, Attempto Verlag, Tübingen: 45-50
Forriol F, Solchaga L, Moreno JL, Canadell J The effects os shock waves on mature and healing cortical bone. 1994 International Orthopaedics, 18: 325-329
Fritze J Extrakorporale Stoßwellentherapie in orthopädischer Indikation: Eine ausgewählte Übersicht. 1998 Versicherungsmedizin 1998; 50: 180-183
Fukada E, Yasuda I On the piezoelectric effect of bone. 1957 Phys. Soc. Japan, 12: 1158-1162
Fuson RL, Sherman M, Van Fleet J, Wendt, T The conduct of orthopaedic clinical trials. 1997 J Bone Joint Surg 1997; 79-A: 1089-1098


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Galasso O, de Durante C, Russo S, Gigliotti S, Corrado B Chronic achilloynia. Treatment with extracorporeal shock waves 2000 3rd Congress of the ISMST - Naples, Abstracts:43
Gambihler S, Delius M In vitro interaction of lithotripter shock waves and cytotoxic drugs. 1992 British Journal of Cancer, 66: 69-73
Gambihler S, Delius M, Ellwart JW Permeabilization of the plasma membrane of L1210 mouse leukemia cells using lithotripter shock waves. 1994 Membr. Biol., 141: 267-275
Gambihler S, Delius M, Ellwart JW Transient increase in membrane permeability of L1210 cells upon exposure to lithotripter shock waves in vitro. 1992 Naturwissenschaften, 79: 328-329
Gebhart C, Widhalm R The Biological Effects of Shockwave Treatment 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 11-12
Gerdesmeyer L ESWT bei Tendinosis calcarea – Ergebnisse der prospektiven placebokontrollierten Multicenterstudie der DGOOC. 2001 Vortrag, Arbeitskreis Stoßwellentherapie, Berlin, 2001
Gerdesmeyer L, Bachfischer K, Hauschild M Overview of Calcifying Tendonitis of the Shoulder Treated with Shockwave Treatment 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 151-156
Gerdesmeyer L, Hasse A, Engel A, Bachfischer K, Rechl H Der Einfluß extrakorporaler Stoßwellen auf die Osteoinduktion nach Radiatio 2001 Siebert W, Buch M (Hrsg), Extrakorporale Stoßwellentherapie in der Orthopädie - Grundlagen und Anwendung, Ecomed Verlagsgesellschaft, Germany: 13-22
Gerdesmeyer L, Hauschild M, Bachfischer K The change of clinical outcome of tendinitis calcarea after ESWT in course of time 2000 3rd Congress of the ISMST - Naples, Abstracts:28
Gerdesmeyer L, Russlies M, Peters P, Gradinger R Die hochenergetische ESWT zur Behandlung der Tendinosis calcarea. 1997 46. Jahrestagung Norddeutsche Orthopädenvereinigung, Kurzreferate: 14
Galasso O, de Durante C, Russo S, Gigliotti S, Corrado B Chronic achilloynia. Treatment with extracorporeal shock waves 2000 3rd Congress of the ISMST - Naples, Abstracts:43
Gambihler S, Delius M In vitro interaction of lithotripter shock waves and cytotoxic drugs. 1992 British Journal of Cancer, 66: 69-73
Gambihler S, Delius M, Ellwart JW Permeabilization of the plasma membrane of L1210 mouse leukemia cells using lithotripter shock waves. 1994 Membr. Biol., 141: 267-275
Gambihler S, Delius M, Ellwart JW Transient increase in membrane permeability of L1210 cells upon exposure to lithotripter shock waves in vitro. 1992 Naturwissenschaften, 79: 328-329
Gebhart C, Widhalm R The Biological Effects of Shockwave Treatment 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 11-12
Gerdesmeyer L ESWT bei Tendinosis calcarea – Ergebnisse der prospektiven placebokontrollierten Multicenterstudie der DGOOC. 2001 Vortrag, Arbeitskreis Stoßwellentherapie, Berlin, 2001
Gerdesmeyer L, Bachfischer K, Hauschild M Overview of Calcifying Tendonitis of the Shoulder Treated with Shockwave Treatment 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 151-156
Gerdesmeyer L, Hasse A, Engel A, Bachfischer K, Rechl H Der Einfluß extrakorporaler Stoßwellen auf die Osteoinduktion nach Radiatio 2001 Siebert W, Buch M (Hrsg), Extrakorporale Stoßwellentherapie in der Orthopädie - Grundlagen und Anwendung, Ecomed Verlagsgesellschaft, Germany: 13-22
Gerdesmeyer L, Hauschild M, Bachfischer K The change of clinical outcome of tendinitis calcarea after ESWT in course of time 2000 3rd Congress of the ISMST - Naples, Abstracts:28
Gerdesmeyer L, Russlies M, Peters P, Gradinger R Die hochenergetische ESWT zur Behandlung der Tendinosis calcarea. 1997 46. Jahrestagung Norddeutsche Orthopädenvereinigung, Kurzreferate: 14
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Haake M, Böddeker IR, Decker T, Buch M, Vogel M, Labek G, Maier M, Loew M, Maier-Boerries O, Fischer J, Betthäuser A, Rehack HC, Kanovsky W, Müller I, Gerdesmeyer L, Rompe JD Efficacy of Extracorporal Shockwave Therapy (ESWT) in patients with lateral epicondylitis - A placebo controlled multicenter trial. 2001 4th International Congress of the ISMST, Berlin, 2001
Haake M, Böddeker IR, Decker T, Buch M, Vogel M, Labek G, Maier M, Loew M, Maier-Boerries OM, Fischer J, Betthäuser A, Rehack HC, Kanovsky W, Müller I, Gerdesmeyer L, Rompe JD Side effects of Extracorporeal Shock Wave Therapy (ESWT) in the treatment of tennis elbow. 2002 Arch Orthop Traum Surg 2002
Haake M, Deike B, Thon A, Schmitt J Exact focusing of extracorporeal Shock Wave Therapy for calcifying tendinopathy. 2002 Clin Orthop 2002
Haake M, Deike B, Thon A, Schmitt J. Importance of accurately focussing of extracorporeal shock waves (ESWT) in the treatment of calcifying tendinitis - A prospective randomised study. 2001 Biomed Tech 2001; 45: 69-74
Haake M, Jensen K, Prinz H, Willenberg T Design einer Multizenterstudie zum Wirksamkeitsnachweis der Extrakorporalen Stosswellentherapie (ESTW) bei Epicondylitis humeri radialis. 2000 Z Orthop Ihre Grenzgeb 2000; 138:99-103
Haake M, Rautmann M, Griss P Therapieergebnisse und Kostenanalyse der Extrakorporalen Stoßwellentherapie bei Tendinitis calcarea und Supraspinatussehnensyndrom. 1998 Orthop Praxis 1998;34: 110-113
Haake M, Rautmann M, Wirth T Assessment of treatment costs of Extracorporeal Shock Wave Therapy (ESWT) - Comparison of ESWT and surgical treatment in shoulder diseases 2001 Int J Tech Ass Health Care 2001; 17: 612-617
Haake M, Rautmann M, Wirth T Extracorporeal Shock Wave Therapy versus surgical treatment in calcifying ttttrendinitis and non calcifying tendinitis of the supraspinatus muscle. 2001 Eur J Orthop Surg Traumatol 2001; 11: 21-24
Haake M, Sattler A, Gross MW, Schmitt J, Hildebrandt R, Müller HH Vergleich der Extrakorporalen Stoßwellentherapie mit der Röntgenreizbestrahlung beim Supraspinatussehnensyndrom – ein prospektiver randomisierter einfachblinder Parallelgruppenvergleich 2001 Z Orthop Ihre Grenzgeb 2001; 139: 397-402
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Haist J Einsatzmöglichkeiten der analgetisch wirksamen extrakorporalen Stosswellentherapie an der Schulter. 1995 Orthopädische Praxis, 9: 591-593
Haist J Shockwave Treatment for Radial and Ulnar Epicondylitis 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 115-113
Haist J Shockwave Therapy for Pseudarthroses 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 195-196
Haist J Shockwave Treatment of Dupuytren's Contracture and Ledderhose's Contraction 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 253-254
Haist J, Reichel W, Bürger R, Witzsch U Einsatz der extrakorporalen Stosswelle bei der osteosynthetisch versorgten Pseudarthrose - eine experimentelle Studie. 1993 Orthopädische Praxis, 5: 345-346
Haist J, Reichel W, Witzsch U, Bürger R Die extrakorporale Stosswellenbehandlung der gestörten Frakturheilung - eine Alternative zu operativen Verfahren ? 1993 Orthopädische Praxis, 29: 842-844
Haist J, Steeger von Keitz D Die Stosswellentherapie (ESWT) der Epicondylopathia radialis et ulnaris. Ein neues Behandlungskonzept knochennaher Weichteilschmerzen. 1994 Orthopädie Mitteilungen, 173
Haist J, Steeger von Keitz D Stosswellentherapie knochennaher Weichteilschmerzen - ein neues Behandlungskonzept. 1995 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Die Stosswelle - Forschung und Klinik, Attempto Verlag, Tübingen: 162-165
Haist J, Steeger von Keitz D, Mohr G, Schulze G, Weber F The orthopaedic shock wave therapy in the treatment of chronic insertion tendopathy and tendinosis calcarea. 1997 Siebert W, Buch M (Hrsg), Extracorporeal shock waves in orthopaedics, Springer Verlag, Berlin Heidelberg New York: 159-163
Haist J, Steeger von Keitz D, Witzsch U, Bürger R, Haist U The extracorporeal shockwave therapy in the treatment of disturbed bone union. 1992 7th International Conference on Biomedical Engineering, December 2.- 4.1992, Singapore: 222-224
Haist J, Steeger von Keitzr D Shock wave therapy in the treatment of near to bone soft tissue pain in sportsmen. 1996 International Journal of Sports Medicine, 17: 79-81
Hammer DS, Rupp S, Ensslin S, Kohn D, Seil R Extracorporal shock wave therapy in patients with tennis elbow and painful heel. 2000 Arch Orthop Trauma Surg 2000; 120:304-7
Hammer DS, Rupp S, Kreutz A, Pape D, Kohn D, Seil R Extracorporeal shockwave therapy (ESWT) in patients with chronic proximal plantar fasciitis. 2002 Foot Ankle Int 2002;23:309-13
Hasegawa S, Kato K, Takashi M, Zhu Y, Obata K, Miyake K S100a0 protein as a marker for tissue damage related to extracorporeal shock wave lithotripsy. 1993 Eur. Urology, 24: 393-396
Haupt G Stosswellen in der Orthopädie. 1997 Urologe A, 36, Nr.3: 233-238
Haupt G Use of extracorporeal shock waves in the treatment of pseudarthrosis, tendopathy and other orthopaedic diseases. 1997 Urology, 158: 4-11
Haupt G, Diesch R, Straub T, Penninger E, Fröhlich T, Scholl J, Löhrer H, Senge T Ballistic Shockwave Treatment 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 271-272
Haupt G, Ekkernkamp A, Püllenberg A, Senge T Einfluß extrakorporal erzeugter Stosswellen auf standardisierte Tibiafrakturen im Schafmodell. 1992 Urologe A, 31: A 43ff
Haupt G, Haupt A, Ekkernkamp A, Gerety B, Chvapil M Influence of shock waves on fracture healing. 1992 Urology, 39: 529-532
Haist J, Steeger von Keitz D, Witzsch U, Bürger R, Haist U The extracorporeal shockwave therapy in the treatment of disturbed bone union. 1992 7th International Conference on Biomedical Engineering, December 2.- 4.1992, Singapore: 222-224
Haist J, Steeger von Keitzr D Shock wave therapy in the treatment of near to bone soft tissue pain in sportsmen. 1996 International Journal of Sports Medicine, 17: 79-81
Hammer DS, Rupp S, Ensslin S, Kohn D, Seil R Extracorporal shock wave therapy in patients with tennis elbow and painful heel. 2000 Arch Orthop Trauma Surg 2000; 120:304-7
Hammer DS, Rupp S, Kreutz A, Pape D, Kohn D, Seil R Extracorporeal shockwave therapy (ESWT) in patients with chronic proximal plantar fasciitis. 2002 Foot Ankle Int 2002;23:309-13
Hasegawa S, Kato K, Takashi M, Zhu Y, Obata K, Miyake K S100a0 protein as a marker for tissue damage related to extracorporeal shock wave lithotripsy. 1993 Eur. Urology, 24: 393-396
Haupt G Stosswellen in der Orthopädie. 1997 Urologe A, 36, Nr.3: 233-238
Haupt G Use of extracorporeal shock waves in the treatment of pseudarthrosis, tendopathy and other orthopaedic diseases. 1997 Urology, 158: 4-11
Haupt G, Diesch R, Straub T, Penninger E, Fröhlich T, Scholl J, Löhrer H, Senge T Ballistic Shockwave Treatment 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 271-272
Haupt G, Ekkernkamp A, Püllenberg A, Senge T Einfluß extrakorporal erzeugter Stosswellen auf standardisierte Tibiafrakturen im Schafmodell. 1992 Urologe A, 31: A 43ff
Haupt G, Haupt A, Ekkernkamp A, Gerety B, Chvapil M Influence of shock waves on fracture healing. 1992 Urology, 39: 529-532
Haupt G, Haupt A, Gerety B, Chvapil M Enhancement of fracture healing with extracorporeal shock waves. 1990 AUA Annual Meeting, New Orleans 1990
Haupt G, Haupt A, Senge T Die Behandlung von Knochen mit extrakorporalen Stosswellen - Entwicklung einer neuen Therapie. 1993 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Stosswellenlithotripsie - Aspekte und Prognosen, Attempto Verlag, Tübingen: 120-126
Haupt G, Katzmeier P Anwendung der hochenergetischen Stosswellen-therapie bei Pseudarthrosen, Tendinosis calcarea der Schulter und Ansatztendinosen (Fersensporn, Epiconylitis). 1995 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Die Stosswelle - Forschung und Klinik, Attempto Verlag, Tübingen: 143-146
Hearnden A, Flannary MC A prospective, blinded randomised control trial assessing the use of different energy extracorporeal shock wave therapy for calcifying tendonitis 2000 3rd Congress of the ISMST - Naples, Abstracts:16
Heckman JD, Ryaby JP, McCabe J, Frey JJ, Kilcoyne RF Accleration of tibial fracture-healing by non-invasive low-intensity pulsed ultrasound. 1994 Bone Joint Surgery (Am), 76: 26-34
Heidersdorf S, Lauber S, Lauber H, Hötzinger H, Ludwig J, Dreisliker U Rädel R Osteochondritis Dissecans 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 255-264
Heinrichs W, Witzsch U, Bürger R Extrakorporale Stosswellentherapie (ESWT) von Pseudarthrosen. 1993 Anaesthesist, 42: 361-364
Helbig K, Herbert C, Schostok T, Brown M, Thiele R Correlations between the duration of pain and the success of shock wave therapy 2001 Clinical Orthopaedics and Related Research, 387: 68-71
Helbig K, Schostok T, Brown M, Herbert C, Thiele R Correlations Between Duration of Pain and Success 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 43-48
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Herbert C, Thiele R, Hartmann T, Helbig K Musculoskeletal shock wave therapy for the treatment of tendinosis calcarea, follow-up of 1483 patients between 1995 and 1998 (4 years) 2000 Minimally Invasive Therapy & Allied Technologies, Isis Medical Media, Volume 9, Number 3/4 August 2000: 322 (Abstract 28)
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Hötzinger H, Rädel R, Lauber S, Lauber H, Platzek P, Ludwig J MRI-Guided Shockwaves for Multiple Stress Fractures of the Tibia 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 165-168
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Johannes EJ, Sukul Kaulesar DMKS, Mature E, Schutte HE High energy shock waves for the treatment of nonunions - experiments in dog. 1994 Surg. Research, 57: 246-252
Jurgowski W, Loew M, Cotta H, Staehler G Extracorporeal shock wave treatment of calcareous tendinitis of the shoulder. 1993 Endourology, 7, Suppl. 1: 193
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Karpman R, Magee F, Gruen T, Mobley M The Lithotriptor and its potential use in the revision of total hip arthroplasty 2001 Clinical Orthopaedics and Related Research, 387: 4-7
Kawahara K, Koba M The effect of extracorporeal shock wave therapy (ESWT) for carpal tunnel syndrome (CTS) in chronic hemodialysis patients 2000 3rd Congress of the ISMST - Naples, Abstracts:93
Ko J, Chen H, Chen L Treatment of lateral epicondylitis of the elbow with shock waves 2001 Clinical Orthopaedics and Related Research, 387: 60-67
Koeweiden E, Chin A Paw E Promising results of ESWT for tennis elbow 2000 3rd Congress of the ISMST - Naples, Abstracts:33
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Krischek O, Rompe JD, Herbsthofer B, Nafe B Symptomatische niedrig-energetische Stosswellentherapie bei Fersenschmerzen und radiologisch nachweisbarem plantarem Fersensporn. 1998 Orthopädie, 136: 169-174
Krischek O, Rompe JD, Hopf C, Stratmann M, Vogel J, Nafe B Ist die extrakorporelle Stosswellentherapie bei Epicondylitis humeri ulnaris indiziert? Kurzfristige Ergebnisse einer vergleichenden, prospektiven Studie. 1997 Orthopädische Praxis, 7: 465-469
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Kuderna H, Schaden W, Sailler A, Fischer A, Kölpl C, Hagmüller V Comparison of 30 tibial non-unions: costs of surgical treatment versus costs of extracorporeal shockwave therapy 2000 3rd Congress of the ISMST - Naples, Abstracts:65-66
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Kusnierczak D, Brocai DRC, Vettel U, Loew M The influence of extrycorporeal shock wave application (ESWA) on the biological behaviour of bone cells in vitro 2000 3rd Congress of the ISMST - Naples, Abstracts:100
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Larini P, Marcato C, Ugolotti U, Meneghetti S, Paroli C, Mazzucchi A, Cavatorta S Extracorporeal shock wave therapy in paraosteoarthropathy (POA). Preliminary results 2000 3rd Congress of the ISMST - Naples, Abstracts:76
Lauber S, Lauber HJ, Ludwig J, Hötzinger H, Rädel R, Dreisilker U MRI controlled results of extracorporeal shockwave therapy in adult osteonecrosis of the femoral head 2000 3rd Congress of the ISMST - Naples, Abstracts:91
Lauber S, Ludwig J, Hötzinger H, Dreisilker U, Rädel R, Platzek P MRI after Shockwave Treatment for Osteonecrosis of the Femoral Head 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 241-247
Lauber S, Ludwig J, Lauber H, Hötzinger B, Dreisilker U, Rädel R Die ESWT-Behandlung der Hüftkopfnekrose und der Osteochondrosis dissecans 2001 Siebert W, Buch M (Hrsg), Extrakorporale Stoßwellentherapie in der Orthopädie - Grundlagen und Anwendung, Ecomed Verlagsgesellschaft, Germany: 161-192
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Lehmkühler K, Köhnke W, Wrede A Focus Positioning 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 33-34
Levitt R, Alvarez R, Ogden JA The FDA Studies of Musculoskeletal Shockwave Therapy for Lateral Epicondylitis and Heel Pain Syndrome 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 107-110
Levitt R, Ogden JA, Selesnick H FDA study for chronic lateral epicondylitis 2000 3rd Congress of the ISMST - Naples, Abstracts:39
Loew M Stosswellenbehandlung bei Erkrankungen an Schulter und Ellenbogen - Mythen und Wirklichkeit. 1997 Mitteilungsblatt DVSE Juni 1997: 5-7
Loew M Die Wirkung extrakorporal erzeugter hoch-energetischer Stosswellen auf den klinischen, röntgenologischen und histologischen Verlauf der Tendinosis calcarea der Schulter - eine klinische und experimentelle Studie. 1994 Habilitationsschrift, Ruprecht-Karls-Universität Heidelberg
Loew M, Daecke W, Kusnierczak D, Rahmanzadeh M, Ewerbeck V Extracorporal shock wave application – an effective treatment for patients with chronic and therapy-resistant calcifying tendinitis? 1999 Bone Joint Surg 1999 ; 81-B:863-867
Loew M, Jurgowski W Erste Erfahrungen mit der extrakorporalen Stosswellen-Lithotripsie in der Behandlung der Tendinosis calcarea der Schulter. 1993 Orthopädie, 131: 470-473
Loew M, Jurgowski W Erste Erfahrungen mit der Extrakorporalen Stosswellen-Lithotripsie (ESWL) in der Behandlung der Tendinosis calcarea der Schulter. 1993 Orthop Ihre Grenzgeb 1993; 131:470-473
Loew M, Jurgowski W, Mau HC, Perlick L, Kuszniercak D Die Wirkung extrakorporal erzeugter hochenergetischer Stosswellen auf den klinischen, röntgenologischen und histologischen Verlauf der Tendinosis calcarea der Schulter - eine prospektive Studie. 1995 Chaussy C, Eisenberger F, Jocham D, Wilbert D (Hrsg), Die Stosswelle - Forschung und Klinik, Attempto Verlag, Tübingen: 153-156
Loew M, Jurgowski W, Mau HC, Thomsen M Treatment of calcifying tendinitis of rotator cuff by extracorporeal shock waves: a preliminary report. 1995 Shoulder Elbow Surg 1995; 4:101-106
Loew M, Jurgowski W, Thomsen M Die Wirkung extrakorporaler Stosswellen auf die Tendinosis calcarea der Schulter. 1995 Urologe A, 34: 49-53
Loew M, Jurgowski W, Thomsen M, Cotta H Extracorporale Stosswellenbehandlung bei chronischer Tendinitis calcarea der Schulter 1994 Orthopädie Mitteilungen
Loew M, Nitschmann R Shock wave application in heel spur syndrome. 1995 3. Münchener Symposium für Fußchirurgie, München


Loew M, Rompe JD Stosswellenbehandlung bei orthopädischen Erkrankungen. 1998 Grifka J (Hrsg), Bücherei des Orthopäden, Band 71, Enke, Stuttgart
Lohse-Busch H, Kraemer M, Reime U The use of extracorporeal shock wave fronts for treatment of muscle dysfunction of various etiologies: an overview of first results. 1997 Siebert W, Buch M (Hrsg), Extracorporeal shock waves in orthopaedics, Springer Verlag, Berlin Heidelberg New York: 215-230
Lohse-Busch H, Kraemer M, Reime U Pilotuntersuchung zur Wirkung von niederenergetischen, extrakorporalen Stosswellen auf Muskelfunktionsstörungen bei spastischen Bewegungsstörungen von Kindern. 1997 Schmerz, 11, Nr. 2: 108-112
Ludwig J, Hötzinger H, Lauber S, Trenkel I Pre- and post shockwave therapy (SWT) MRI evaluation of artificial calcifications of the supraspinate tendon in pig shoulders 2000 3rd Congress of the ISMST - Naples, Abstracts:94
Ludwig J, Lauber S, Lauber H, Dreisilker U, Rädel R, Hötzinger H High-energy shock wave treatment of femoral head necrosis in adults 2001 Clinical Orthopaedics and Related Research, 387: 119-126
Lüssenhop S, Hahn M, Seemann S, Meiss L Einfluß der Stosswelle auf Epiphysenfugen. 1997 Siebert W, Buch M (Hrsg), Stosswellenanwendung am Knochen - Klinische und experimentelle Erfahrungen, Dr. Kovac, Hamburg: 12-13
Lüssenhop S, Seemann D, Hahn M, Meiss L The influence of shock waves on epiphysal growth plates: first results of an in-vivo study with rabbits. 1997 Siebert W, Buch M (Hrsg), Extracorporeal shock waves in orthopaedics, Springer Verlag, Berlin Heidelberg New York: 109-118
Lök V, Baloglu I, Aydinok H Experience of Shockwaves for Non-unions in Izmir 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 185-186


Maier M Gibt es magnetresonanztomographische Veränderungen nach Stosswellenbehandlung bei Tendinitis calcarea ? 1997 Orthopädie, 2: 20-21
Maier M, Dürr HR, Kohler S, Staupendahl D, Pfahler M, Refior HJ, Meier M Analgetische Wirkung niederenergetischer extrakorporaler Stosswellen bei Tendinosis calcarea, Epikondylitis humeri radialis und Plantarfasziitis. 2000 Orthop Ihre Grenzgeb 2000; 138:34-8
Maier M, Dürr HR, Staupendahl D, Refior HJ Einfluß des Koppelmediums auf den Applikationsschmerz bei der ESWT des Stütz- und Bewegungsapparates 2001 Siebert W, Buch M (Hrsg), Extrakorporale Stoßwellentherapie in der Orthopädie - Grundlagen und Anwendung, Ecomed Verlagsgesellschaft, Germany: 227-234
Maier M, Schnarkowski P, Pfahler M, Refior H Kernspintomographische Veränderungen der Schulterregion nach Stosswellentherapie bei Tendinosis calcarea. 1997 45. Jahrestagung der Vereinigung Süddeutscher Orthopäden, Abstractband: 101
Maier M, Stabler A, Lienemann A, Kohler S, Feitenhansl A, Dürr HR, Pfahler M, Refior HJ Shockwave application in calcifying tendinitis of the shoulder - prediction of outcome by imaging. 2000 Arch Orthop Trauma Surg 2000; 120:493-8
Maier M, Steinborn M, Staebler A, Koehler S, Pfahler M, Dürr HR, Refior HJ Extracorporeal shock wave application for chronic plantar fasciitis – prediction of outcome by imaging? 2000 Rheumatol 2000; 27:2455-246
Marchetti I, Carnevali R, Russo N Our experience with ESW: first review of the cases 2000 3rd Congress of the ISMST - Naples, Abstracts:73
May TC, Krause WR, Preslar AJ, Smith MJV, Beaudoin AJ Use of high energy shock waves for bone cement removal. 1990 Arthroplasty, 01: 19-27
McCullough DL, Yeaman LD, Bo WJ, Assimos DG, Kroovant RL, Griffin AS, Furr EG Effects of shock waves on the rat ovary. 1989 Urology, 141: 666-669
Melegati G, Tornese D, Bandi M, Cappadonia C L'utilizzo della terapia con onde d'urto extracorporee nella sindrome da conflitto acromion-omerale: studio prospettico controllato 2000 3rd Congress of the ISMST - Naples, Abstracts:17-18
Neuland HG The treatment of complaints caused py playing golf using ESWT 2000 3rd Congress of the ISMST - Naples, Abstracts:78
Niethard FU Wissenschaftlichkeit und Wirtschaftlichkeit in Orthopädie und Physiotherapie - Editorial. 1997 Orthopädie, 135:1-2
Niethard FU Qualitätssicherung - Editorial 1997 Orthopädie, 135: 93-94
Nigrisoli M, Bosco V Non-unions-treatment and results 2000 3rd Congress of the ISMST - Naples, Abstracts:57
Nigrisoli M, Bosco V, Sisca G Shockwave Treatment for Knee and Achilles Tendinopathies 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 249-251
O'Brien WD, Zachary JF Rabbit and pig lung damage comparison from exposure to continuous wave 30 kHz ultrasound. 1996 Ultrasound in Medicine & Biology, 22: 345-354
Ogden JA, Alvarez R, Levitt R, Cross GL Chronic heel pain: results of FDA shockwave study 2000 3rd Congress of the ISMST - Naples, Abstracts:51
Ogden JA, Alvarez R, Levitt R, Cross GL, Marlow M Shock wave therapy for chronic proximal plantar fasciitis 2001 Clinical Orthopaedics and Related Research, 387: 47-59
Ogden JA, Alvarez R, Levitt R, Marlow M Shock Wave Therapy (Orthotripsy®) in Musculoskeletal Disorders 2001 Clinical Orthopaedics and Related Research, 387: 22-40
Ogden JA, Tóth-Kischkat A, Schultheiss R Principles of Shock Wave Therapy 2001 Clinical Orthopaedics and Related Research, 387: 8-17
Oosterhof G, Cornel EB, Smits GA, Debruyne F, Schalken J The influence of high energy shock waves on the development of metastases. 1996 Ultrasound in Medicine & Biology, 22: 339-344
Oosterhof G, Smits G, de Ruyter A, Schalken J, Debruyne F Effects of high energy shock waves combined with biological response modifiers in different human kidney cancer xenografts. 1991 Ultrasound in Medicine & Biology, 17: 391-399


Peers K, Onkelinx L, Brys P, Lysens R ESWT for calcific tendinopathy of the rotator cuff: one year foolow-up and outcome comparison with surgery 2000 3rd Congress of the ISMST - Naples, Abstracts:15
Peers K, van den Eeede E, Brys P, Bellemans J, Lysens R Cross sectional functional outcome comparison of ESWT versus surgery for chronic patellar tendinopathy 2000 3rd Congress of the ISMST - Naples, Abstracts:42
Perlick L, Boxberg W, Giebel G Hochenergetische Stosswellenbehandlung des schmerzhaften Fersensporns. 1998 Unfallchirurg 1998; 101:914-918
Perlick L, Gassel F, Zander D, Schmitt O, Wallny T. Vergleich der Ergebnisse der mittelenergetischen ESWT und der operativen Therapie in der Technik nach Mittelmeier bei der therapieresistenten Epicondylitis humeri radialis 1999 Orthop Ihre Grenzgeb 1999; 137: 316-321
Perlick L, Wallny T Die ESWT der Tendinosis calcarea. Untersuchungen zur Desintegrationswirkung von Stoßwellen auf ein standardisiertes Kalkdepot im Tiermodell 2001 Siebert W, Buch M (Hrsg), Extrakorporale Stoßwellentherapie in der Orthopädie - Grundlagen und Anwendung, Ecomed Verlagsgesellschaft, Germany: 149-160
Perren SM Aktivierung der Knochenbildung durch Stosswellentherapie in der Frakturbehandlung. 1993 AO Forschungsinstitut, Davos
Philipp A, Delius M, Scheffzyk C, Vogel A, Lauterborn W Interaction of lithotripter-generated shock waves with air bubbles. 1993 Acoustic Society of America, 93: 2496-2509
Pigozzi F, Giombini A, Parisis A, Casciello G, Di Salvo V, Santori N, Mariani PP The application of shock wave therapy in the treatment of resistant chronic painful shoulder. 2000 Sports Med Phys Fitness 2000; 40:356-361
Polak HJ Ergebnis der Literaturrecherche der MDK-Gemeinschaft zur ESWT mit orthopädischen Indikationen. 1997 Siebert W, Buch M (Hrsg), Stosswellenanwendung am Knochen - Klinische und experimentelle Erfahrungen, Dr. Kovac, Hamburg: 66-68
Prat F, Sibille A, Luccioni C, Pansu D, Chapelon J, Beaumatin J, Ponchon T, Cathignol D Increased chemocytotoxicity to colon cancer cells by shock wave induced cavitation. 1994 Gastroenterology, 106: 937-944


Randazzo RF, Chaussy C, Fuchs GJ, Lovrekovich H, de Kernion JB The in vitro and in vivo effects of extracorporeal shock waves on malignant cells. 1988 Urological Research, 16: 419-426
Richter D, Ekkernkamp A Klinischer Einsatz der Stosswellentherapie in der Unfallchirurgie. 1997 Siebert W, Buch M (Hrsg), Stosswellenanwendung am Knochen - Klinische und experimentelle Erfahrungen, Dr. Kovac, Hamburg: 12-13
Richter D, Ekkernkamp A, Muhr G Die extrakorporale Stosswellentherapie - ein alternatives Konzept zur Behandlung der Epicondylitis humeri radialis ? 1995 Orthopäde, 24: 303-306
Rodríguez de Oya R, Sánchez Benitez de Soto J, Garcia Munilla M Shockwave Treatment for Chronic Non-unions 2000 Coombs R, Schaden W, Zhou S (eds), Musculoskeletal Shockwave Therapy, Greenwich Medical Media Ltd, London: 169-172
Roles NC, Maudsley RH Radial tunnel syndrome: resistant tennis elbow as a nerve entrapment. 1972 Bone Joint Surg [Br] 1972;54:499-508
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Rompe JD Extrakorporale Stosswellentherapie - Grundlagen, Indikation, Anwendung. 1997 Chapman & Hall GmbH, London Glasgow Weinheim New York Tokio Melbourne Madras
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Rompe JD, Bohl J, Riehle HM, Schwitalle M, Krischek O Überprüfung der Läsionsgefahr des Nervus ischiadicus des Kaninchens durch die Applikation niedrig- und mittelenergetischer extrakorporaler Stosswellen. 1998 Zeitschrift für Orthopädie, 136: 407-411
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Result number: 138

Message Number 177258

Re: cost/comparison? View Thread
Posted by S. B. on 6/23/05 at 16:08

We have Cigna, and they told us the same thing. However, it wasn't covered. Even though the doctor said it was medically necessary, they decided it was not. The doctor and Healthtronics told us ahead of time it would not be covered by Cigna, and that Cigna is one of the most difficult to deal with about it. They all cut us deals for out of pocket and we paid up front. Cigna was billed and covered nothing.

Result number: 139

Message Number 172967

Re: would 1 doctor answer this question please? View Thread
Posted by milley on 4/11/05 at 12:00

How much would you say an average office visit should cost, he has billed 350.00 for each office visit and submitted it as surgery?

Result number: 140
Searching file 16

Message Number 169802

Dr Z - Anti-Kickback Statutes View Thread
Posted by elvis on 2/24/05 at 13:06

I did some looking last night. It appears that there are federal anti-kickback statutes regulating the health care industry especially relating to services provided under a federal health program. It's complicated and I don't have time right now to look into this. However, a couple of comments. I don't see the equipment manufacturer's discount to me as a kickback to anyone at least under the normal meaning of the word'kickback.' Of course there are "safe harbor" rules that allow 'kickbacks' in certain cases. For every rule a lawyer makes there's got to be exceptions! LOL Anyway here's some info on the federal law which I think only applies if the services are billed to a federal health care program.

http://oig.hhs.gov/fraud/docs/safeharborregulations/safefs.htm

That's one reason maybe that United Shock Wave doesn't do Medicare patients. The other is that there is a prohibition against having an ownership interest by a doctor in an entity
that provides service and bills under Medicare - reason #2 for United not treating Medicare patients.

Here's another exception (i think) where hospitals are allowed to grant discounts or even waive payments to underinsured and uninsured patients without violation of the anti-kickback statute. They distinguish between discounts/waiver of payment versus bad debts.

http://www.lw.com/resource/Publications/ClientAlerts/clientAlert.asp?pid=946

The scenario that I was quoted ($800 doctor fee and the equipment company would pursue reimbursement from my insurance carrier) resulting in me paying only $800 for a Dornier ESWT procedure is very similar to the above exception. I can't see that it is a kickback. To the contrary, the equipment company is undertaking all of the risk for getting reimbursement from my insurance company (Blue Cross PPO). As you aptly pointed out in an ealrier post what this system ends up with are some patients in effect getting free equipment use while others pay for equipment use. The equioment comapny get reimbursed for some of their claims and not for others. This makes it difficult to figure out what is a "fair" price or normal and custumary charge. But that is the fight that all procedures go through between the provider and the insurance company. by United taking on the fight with the insurance companies I bleieve that ultimatelty it will end up that ESWT will be a covered procedure. The little I know about competition and anti-trust law I would expect that the feds would stay out of this dispute because right now it is pro-c0onsumer and the prices are erroding. You are 100% correct though in assuming that if a monopoly is formed then the price will indeed go up. Then the feds will step in and do something. In the meantime I think we're stuck with what's going on. It's good for me the consumer and bad for all providers but not equally. Some providers will suffer much more than others.

I will check with a friend to see if I can find out more.

Result number: 141

Message Number 169748

Re: Skill of Attending Doctor in ESWT View Thread
Posted by elvis on 2/23/05 at 20:52

Dr. Z.......I'm a patent attorney so this is way out of my area of expertise. I believe this is a situation they call subrogation. I assign my rights to the equipment company for being reimbursed from the insurance company. The equipment company then fights it out with the insurance company. As a consumer this is a great deal for me. As long as I am aware of this then I see no problem. The same thing happens with my PPO insurance company. The insurance company contracts with the health care providers to provide services to me at a set cost per service as a PPO provider. I go to the "in plan" provider and pay a co-pay. The provider then submits a bill to the insurance company and they pay whatever amount that was bargained for which is usually less than the billed amount. My understanding in the health filed is that when a doctor sends a patient for an MRI then there is some kind of "finders fee" or "kickback." I don't know if that's illegal but if there is a negative impact to the patient (either inflated cost or qualtiy of service) then I would think there's an ethical problem. Lawyers have ethical rules regarding fee splitting or finder's fees. I've been a corporate patent lawyer for 20+ years and only recently been employed by a law firm but our firm does not do any fee splitting that I am aware of.

As to your other concern......if in fact that this subrogation (or whatever you call it....a kickback) arrangement is the reason for the insurance industry not paying for ESWT then I agree wholeheartedly that something should be done about it. I would like to think that as the benefits of ESWT are confirmed and documented that the insurance industry would acquiesce and start paying for this treatment which as I stated in another post would probably decrease the health care costs for this chronic condition. It makes no sense to me that my insurance will cover surgery but not ESWT. I also must admit that it's really not that apparent to me that assigning my rights to the equipment company would be a reason for the insurance industry to deny coverage. I can see however your arguments that requiring ESWT being done in a surgical center under anesthesia (OssaTron protocol) when in fact it is unnecessary would cause the insurance companies to fight against paying for this procedure.

As an aside in 1996 I was the victim of real name fraud (before it became popular) by my ex-insurance agent. When the insurance company found out that my insurance agent obsconded with an $1,100 premium check for supplemental disability insurance I assigned (subrogation agreement) all of my legal rights against the insurance agent over to the insurance compnay so that they insurance compnay could nail him whihc they did. So subgrogation isn't all bad.

I would be interested in hearing your view as to why the equipment company's stepping into my shoes in getting reimursed is a reason for the insurance companies not covering ESWT.

Result number: 142

Message Number 169311

Re: fed up with feet View Thread
Posted by Fed Up Also on 2/18/05 at 08:26

I feel your pain (boy do I feel your pain!). I get the feeling that the podiatrist that are just sucking the insurance companies for every dime they can.

Same situation, let us try this, well how about this and that. Night splints, physical therapy, shots, stretching exercises, rest, cam walker, orthodics, heel lifts, heat, ice, etc., etc., etc. Thousands in co-pays, $500 for orthodics not covered by insurance (because I not diabetic), around $15,000 billed to insurnace company ($200 per physical therapy visit X 15, $150 per office vist X 2 times monthly, $180 for night splint, $150 per shot, $400 for cam walker, seen by sport medicine Dr, sent to Foot & Ankle specialist (by the way "different diagnosis" from the other 2 Dr.), blah, blah, blah).

How about this, office vist, $30 co-pay, $120 billed to insurance, Dr. never looked at foot, asked how it felt, when I said "no change", reply, "OK, see you in 2 weeks"............Less then 5 minutes........ $150 in fees.........could have been accomplished over telephone for $0.25.

WHAT GIVES.....................

Result number: 143

Message Number 166006

Re: RE: united shockwave billing policy View Thread
Posted by Virginia C. on 12/22/04 at 18:36

I would not say that information provided is "False", unless you consider not telling the whole truth as "False". Call United Shockwave. Ask them what their fees are. Ask them if they will put it in writing. See if you can get a full disclosure of what your insurance company will be billed and the specific dollar amount you as a patient will be held responsible for. Just this week, someone did this and was told that the $400.00 billed to United by the hospital for the usage of the room was United's fee, in other words, that was the only fee United had to pay. Well, not false, but not the information this patient was seeking. Why does a patient not have the right to know the "true cost" of a procedure, since we are speaking of "true costs"?

Most people pay for their insurance and they pay a great deal for it. Nothing is free. The policies may be provided as part of their wage, but the laborer is still paying for that policy. Many have a "disability policy" included in their benefits. If they have to be off work, part of the loss of income is reimbursed. Why should an insurance company be concerned about the loss of a person's income and take that into consideration as part of the true cost of a surgery? It is elective as to whether they can afford a loss of income and some do not experience a loss of income after a surgery.

Now I think we have to admit that the studies on the effectiveness of ESWT have been inconclusive at best. It's efficacy has not been proven. It is at this stage still considered experimental or investigational. Anyone who wants to be a guinea pig, go for it. But in these recent days when FDA approved medications are being recalled right and left due to flawed and skewed studies put out by the manufacturer, I personally would think about it long and hard before I would submit to a procedure that no one seems to know why or how it works or if it works. I know this is an exaggerated comparison, but they said the same thing about lobotomies 40 years ago (let's just go in there and ram around a little bit, maybe it will get better).

Virginia C.

Result number: 144

Message Number 165539

Re: RE: united shockwave billing policy View Thread
Posted by Virginia C. on 12/12/04 at 18:09

The EOB (Explanation of Benefits) states what bill was submitted to the insurance company and what they covered. This insurance company was at first covering ESWT. Very shortly after our patient brought in her EOB showing that the insurance covered 80% of the $6000. billed, they quit covering it for this reason: not shown to be medically more effective than conservative treatment. The patient herself was not billed, but did not realize the cost of the treatment and very plainly stated to us that "that is a ridiculous amount." The name of this insurance company is Coresource (of Jackson, MN). ESWT was not successful for this patient. She ended up having a bilateral plantar fascial release. Not a happy camper.
The insurance companies are now aware of how United Shockwave bills and it has blown them away. Why on earth should they cover it when private pay is so much less. But...Medicare patients cannot obtain ESWT even if they are willing to pay privately.
Anecdotal.. another patient called today, heel spurs bothering her. Had ESWT in March, said she felt good for 6 weeks with it, but now is back to having pain.
Seriously, from my unbiased experience (I am not an investor), ESWT is not more effective than conservative therapy.

Virginia

Result number: 145

Message Number 165188

Re: RE: united shockwave billing policy View Thread
Posted by Ed Davis, DPM on 12/04/04 at 15:51

Virginia:
Having been sent an EOB is not the same as being billed. The United policy went into effect Feb 1, 2004. Let me know if you need a copy of the letter which I supplied to Dr. Z but the letter is very clear about the billing policies.
Ed

Result number: 146

Message Number 165149

Re: RE: united shockwave billing policy View Thread
Posted by Virginia C. on 12/03/04 at 17:14

I do not know of any of our patients that were informed, other by than by myself, that United Shockwave would bill their insurance between $6000 and $8000 for Ossatron, as a "free-standing clinic". We were instructed, by United Shockwave, NOT to discuss United's fees with our patients. In fact, we ourselves did not know until a patient brought in an EOB from her insurance company. This company is no longer covering the procedure. BCBS of Illinois has dropped coverage as of Sept. 1, 2004.
So, a contracted co-pay of 20% would run $1200-1600, or absolutely free if United is not contracted with the insurance company. Here was where the confusion comes. First, they would do it for $500. Our patients were incorrectly informed that that was the top amount United would bill them for. The contracted insurance information was not made clear. So someone who thought they would be billed for no more than $500, suddenly is being dunned by United for $800, nothing in writing. Currently, the deal is for free, if there is no coverage or contract. However, absolutely NO Medicare, and that is getting the Medicare patients angry. Seems quite unfair to me, a whole class of citizens disallowed from the new miracle cure.
Not being able to get a firm yes/no answer from the insurance company as to coverage (many still do not recognize the 0020T code)leaves the end results of payment up in the air: You either owe nothing or could be approximately $2000, for something that may or may not work for you.
I do have plantar fasciitis. I am thin and have a sit down job. I wear Birkenstocks which work well for me.
On a side note....I have noticed a high percentage of patients who opt for the standard orthotics that cover the foot up to the ball of the foot and do not support the toes, develop neuromas right where the orthotic cuts across the foot. HMMM.....

Virginia

Result number: 147

Message Number 165148

Re: Annie View Thread
Posted by john on 12/03/04 at 17:10

Robert, ask Healthtronics to help you with the billing. Tell them about the problem, ask them what is the typical podiatrist fee, insist that they answer your questions. If Healthtronics does not help, write a letter to their new president and ask him for help. You can find the names and addresses of the executives at www.healthtronics.com

You should also contact your State's insurance commissioner and explain the situation. Ask the podiatrist to provide a letter stating that you are the only United patient that is having trouble and include a description of their experience with United for other patients. Make sure that the podiatrist gives you a letter of medical necessity that states that ESWT was needed.

I would not pay anything until you get United to explain how they can pay for the equipment but not pay for the doctor to operate it. Make sure that you have the correct code. It is hard to believe that ESWT is an unlisted code, maybe the podiatrist billed the wrong code. Ask the podiatrist what code they billed and ask to see the billing sheet. Make sure it is correct. The code may also be on your explanation of benefits (EOB) from United.

If everything fails with United, fight the podiatrist. Your decision to have ESWT performed was based on the podiatrist stating that United would pay for ESWT. The podiatrist needs to stand by his statements and discount his fees to reasonable and customary. Furthermore, $4,000 is too much to pay the podiatrist for his services. There is no justification for that fee!

Finally, while this is going on, you might consider seeing another podiatrist and having that podiatrist perform ESWT. Make sure that the new podiatrist gets written authorization from United for the second treatment so you will not have the same problem.

Good Luck!

Result number: 148

Message Number 165006

Re: ESWT worked for me View Thread
Posted by Dr. Z on 12/01/04 at 00:01

Ed,
I will keep an open mind. Can you help me out with an example of the United Model that provided your scenario. I do know exactly how some insurance coverage happened with the Blues in my area. Patients came to see me and the same group of providers we had. The patients paid a fair fee and then submitted to their insurance company a paid bill. We helped along with the patient ( very important since they were subscribers) get their billed paid. The key was that the service was rendered and the patient had paid, in addition to paying insurance premiums. The demand increased to the point that the medical directors started to call us about ESWT and a relationship started. So here is what I leared. First you need a demand. Seoond you need support from the patient. Third insurance companies come on board because of the demand from the subscriber.

I just don't see this with the No Thrills model. There is no paid bill. The insurance has no relationship with the equipment vendor. So therefore the insurance Co. has no pressure to satisfy anyone but themselves.
All I see is an equipment vendor placing presure on an insurance company that sees no reason to agree to anything.
How is the insurance company to believe that the fees are fair and reasonable. I will tell you how. When alot of patients start paying a fee and submitting it to their insurance company and are praising ESWT it makes the point of what is fair. The market just set the fee. Healthronis is another issue which I agee wit you.
It is my opinion that one of the reasons that there is a no thrills program is to get the doctor to do these procedures. For some reason there is a fear that if you must explain to the patient that there is a fee and your insurance company won't pay the doctor becomes fearful. When you have to explain and charge a fee you have to understand, study, and believe in your treatment. It is amazing to me how many doctors just won't do ESWT unless insurance covers the procedure. Sad but true. I say if you don't understand the procedure take the time to learn the procedure. If you don't believe in a procedure don't do it. If you charge a fair fee, understand the procedure and believe in its benefits patients will pay.
ESWT is an effective procedure that will stay whether insurance is present or not. The real question will be which companies will be around when insurance ends due to the no thrill model. Its tough to try and point out something that you know is true because you have experienced this. My feeling is that the no thrill model will stay and only be talked about as the cause why this is little to know insurance coverag AFTER it happens I hope I am wrong. I wish that there was more foresight in our profession and less short term thinking.

Result number: 149

Message Number 164837

Re: Price of foot surgery View Thread
Posted by Pat on 11/29/04 at 07:14

It really depends on your insurance, what exactly the doctor has to do, where it's done etc. I just had EPF with spur removal at a hospital surgical center. I have to pay 10% of the allowance (basically the amount that the insurance company is billed) and the total bill between the hospital and the doctor and the crutches and all that came out to about $350 so it looks like it was $3,500.

Result number: 150

Message Number 164757

Re: John, cost of Ossatron View Thread
Posted by J. P. (Sunny) Jacob on 11/26/04 at 18:15

ESWT fees charged by certain professionals to the extent of 'kickbacks and fee splitting', including not so ethical billing to the insurance companies, etc., is unfamiliar territory to me.
In Canada, such actions by medical professionals, although very rare, can lead to cancellation of the license to practice by the College of Physicians and Surgeons. In our clinic, the Medical Director can lose his license too in case of the clinic's improper billing practice.
Dr. Z. is right. Knowingly participating in such activities by physicians and patients may jeopardize the progress made to date with some insurance companies in U.S.A.
As a service to the patients visiting this site, may I propose that someone take the leadership and prepare a series of questions that potential patients could ask providers and clinics. This may include fee structure, i.e. technical and professional component of fees, any 'hidden' or additional costs that the patient may/will incur, disclosure of any facility fees billed to patients, amount billed to insurance company and post treatment advice.

Result number: 151

Message Number 164698

Re: John, cost of Ossatron View Thread
Posted by vince on 11/25/04 at 08:32

There is no comapny called "Ossatron" There are companies that use the "Ossatron" for ESWT and they bill for the use of the equipment.

If you claim that there is no insurance how would the technical fee be paid? The amount billed for the technical fee is very high.

Result number: 152

Message Number 164521

Re: Debating Surgery or ESWT for PF View Thread
Posted by Lynn F. on 11/21/04 at 22:30

My insurance did not cover ESWT. My dr's fee was $500. He owns the Dornier equipment and supervised the procedure. My follow-up visits are being billed to my insurance co. and I make a $25 co-payment each time I go. I never asked if the $500 fee included post treatment visits.. but clearly it does not.

Result number: 153

Message Number 162631

Re: Can someone explain? View Thread
Posted by Ed Davis, DPM on 10/31/04 at 14:04

Dr. Z;
Sorry to say that we have such varied experiences with colleagues. Needless to say, you and I are both straight shooters. The people I have dealt with in the low energy arena have billed honestly and dealt with patients in a straightforward fashion. I think that readers, by reading this site, can educate themselves to see what consititutes proper, ethical billing practices and what does not. As for third parties, they need to spend more time listening to providers such as you and I and get their heads "out of the clouds" as the "wall" they place between themselves and providers (and often their patients) serves to benefit no one.
Ed

Result number: 154

Message Number 162612

Re: Can someone explain? View Thread
Posted by Dr. Z on 10/31/04 at 08:41

It wasn't billed correctly routinely. You are the only one I know that bills correctly.
Horizon Blue Shield never paid for low energy it was in their written policy but still companies, doctors, billed using 0020T times three due to no global period. They will pain in alot of cases three full times.

Result number: 155

Message Number 162591

Re: Can someone explain? View Thread
Posted by Ed Davis, DPM on 10/31/04 at 00:23

Dr. Z:
Paying three times is proper if the procedure (low energy) is billed properly, that is 0020T-58. The "-58" modifier means a staged procedure.
Each one of the 3 is about 1/3 of the cost of one high energy treatment.
Many procedures are staged and that is why the 58 modifier exists, to properly identify such procedures. Now if someone was billing the whole amount 3 times, that would be improper but am NOT familiar with anyone doing so. It is always possible to find a scoundrel but one should not generalize to criticize others who honestly provide the service and bill honestly.
Ed

Result number: 156

Message Number 162331

Re: Can someone explain? View Thread
Posted by Lynn F. on 10/28/04 at 11:35

Echoing what Vince said. I paid $500 which was my dr's fee. U/S sent their ($6800) bill to my ins co. and THEY called me prior to my treatment, to assure me I would NOT be billed for any uncovered expenses. I'm just 3 1/2 weeks post treatment, still sore but noticing few bad days. Vince, I'm so glad to hear your success story! One can get pretty disillusioned reading some (not all) of the posts here.

Result number: 157

Message Number 162300

Re: epf surgery View Thread
Posted by Ron B. on 10/27/04 at 23:08

To Millie: in your original post you asked about whether your procedure (EPF) was done correctly. You received a response from Dr. Wanders and he told you:

1) Following an EPF scar tissue can form and the fascia can basically reattach.

2) He said if you weren't happy with your doctors,you should see new doctors

3) You wrote back to him saying that it didn't reattach, because the fascia was never cut and he billed for a procedure he didn't perform. How can you justify this statement? How do you know what was cut and what wasn't cut? You're statement is bizarre.

4) You had a nerve conduction study and were told you have RSD. Nerve conduction studies help diagnose tarsal tunnel syndrome, and not RSD. If you had RSD the pain from the test would probably be unbearable.

5) You state that you found out that your doctor is "gay" and if you knew that you wouldn't have used him. Are you living in the right century? Do you expect anyone to take you seriously when you call your doctors crack heads, make analogies to you making car hoses and then state that you wouldn't go to your doctor if you knew he was gay?

6) Pauline, I can't believe that you've given this women advice, but did not mention anything about her "gay" comments.

7) I'm happily married, so I'm only defending your "gay" doctor because this is the year 2004.

8) Millie, in addition to a new doctor, make sure you make an appointment with a better psychiatrist. I'm sure that ANY doctor that takes you on as a patient will be very sorry in the long run.

Result number: 158

Message Number 161529

MBT shoes View Thread
Posted by josh on 10/14/04 at 17:37

Any doctors familiar with these shoes from Switzerland? I bought a pair today and they do, as advertised, strongly encourage one to walk erect and with a shorter, less jarring stride. They may help, as the folks at the shop claim, with foot problems as they have a radical rocker bottom sole that simulates walking on a forgiving, forest-floor surface. The shopkeepers said that workers of all types were snapping them up faster than they could order them. This was in Norfolk, Virginia. Apparently they are popular in Europe among physiotherapists.

They may be of particular value to those with hallux rigidus as the design produces a rolling over the toes at terminal stance. However, my concern, and I'd like any opinions on this, is that removing the necessity to flex the toes in order to advance the step bypasses the windlass mechanism and might, in the long-term be a bad thing - compromising the passive support mechanisms of the foot and allowing a "loose-packed" foot during late stance phase.

They are billed as "trainers" and not, I think, to be worn continually, but only as a proprioceptive and gait training device. In this case, alternated with normally flexible shoes, they may be of great benefit to some. Any thoughts?

Result number: 159

Message Number 160130

Re: What is Heel Pain? View Thread
Posted by Cyndi on 9/18/04 at 17:52

NO, the thin feeling is not just in the morning. I am still waiting to see my DR while he is running blood tests. I gave 5 viles and I got the info from Insurance they billed $3500.00 for it. The insurance paid $400.00 and they accepted it. Wow, what kind of blood test are they doing I wonder? I even had to go back and they took two more viles for a
sub-test.
I am still waiting to see him to find out why. My feet also still tingle
like lightning. The nerve test did show damage to my back and I wonder how much this is connected. Just playing the waiting game still......

Result number: 160
Searching file 15

Message Number 158983

Re: Heel Spur Still There! View Thread
Posted by Pauline on 8/30/04 at 13:43

Les,
I'm not a doctor, but if you're saying that you were billed for a service not rendered you need to talk to your doctor.

Perhaps at the time of surgery he felt your spur didn't need to be removed. Sometime after they open to do a surgery they find things better than they thought or somethimes worse. Doctors have to deal with the situation they find once inside and may opt to change a surgery as it proceedes.

If you're still in pain it may not be related to your P.F. surgery at all. Communicate with your doctor and maybe check your bill too as one person suggested. That's always a good idea no matter what type of surgery or medical treatment you have.

Result number: 161

Message Number 158638

I did it and got in paid for! View Thread
Posted by Heidi on 8/24/04 at 18:38

Today I had ESWT. I have some pain, probably due to the position of my foot during the procedure. I am walking on crutches as before but slightly more dependent on them. I suspect that tomorrow will be better. The Dr. gave me a prescribtion for pain, but I don't need it. I slept well after the procedure, and I am optimistic about the results, hey why not, it beats thinking it won't work. Anyway I had to fight like heck with the insurance company, but they did all they could do. In fact the problem lied with the Ossatron people. They just refused to do there job. They didn't even pursue me getting this coverage. If fact, they basically told me that due to the fact that my company didn't pay in the past they didn't even try. My compnay has over 200 different policies. I confonted them and in the end they moved the location of the procedure and had it billed in the In-Network rate. I honestly feel that I cought them doing or not doing what they were supposed to and they is why they gave in. In fairness to my insurance company, they did what they had to do. I will be sending them thank-you notes. I suggestion to all you need this to be covered, PERSERVERE. I spent many hours, but I manage to cook, clean, get laundry done, and do some work I get paid for at the same time. Good luck to all of you.

Result number: 162

Message Number 158258

Re: To Pauline: View Thread
Posted by Pauline on 8/17/04 at 13:17

Dr.Z,
I don't think this long drawn out discussion about United is simply do to the necessity of your response to a poster's question. If that were the case, you'd have given him the answer and dropped the subject.

I think you do care what United does and that is why it's become an issue and a topic on this board. If no one cared, why would it be a topic for conversation?

I don't have an answer for the poster that asked the question because I don't know the "inside" story on United's ESWT offer. Apparently you do and do not agree with their marketing methods. From your tone and assertions I assume that you may even feel that there is an illegal component to their current operation.

As I said before, if this is true and you have the proof then become a whistle blower and go to the proper authorities.

Prior to MARK L. first offer to inform our readers how to achieve less expensive ESWT, I don't recall one single post about United's ESWT offer. How did we go from MARK's offer, to having a poster feel they needed to get something in writing from United?

My interest now is on the poster, Scott. Did he have the treatment with United and was he billed thousands of dollars afterwards? Perhaps when he returns from his trip he can provide those answers for us.

Result number: 163

Message Number 157101

Re: No charge to patient for ESWT, if no insurance coverage? View Thread
Posted by Dr. Z on 8/06/04 at 17:57

My personal opinion is that I would never agree to a fee that is thousands of dollars and not in writing, but if you are comfortable and confident then go for it. Old saying buyer beware. This is my own opinion and you are free to pick and chose anyone opinion on this board. There are cases I am not sure if its your dornier provider or not that have billed the patient after stating the same fact. Go search posters from heelspurs.com.
I am not a lawyer but I have been told that the type of billing that you are talking about where they you won't balance bill the patient may be against local anti- knickback laws and therefore could be problem. What if this is true what are the ramfications with the doctor, company , and patient.
I still repeat< this is your decision and I would get this in writing just my opinion I am sure other will have a difference. Isn't sad when you may have to consult an attorney to see if this is kosher and should you get this in writing.? Speaking as a doctor I am very strongly against pf surgery and for you getting ESWT.

Result number: 164

Message Number 155827

Re: Medicare View Thread
Posted by Janice N on 7/19/04 at 11:12

That was the drs answer when he called in reply to my letter to his office. That it could be coded under three different ways. And who was I say to no it isn't if I didn't know. He is the one that would be out the 1,000 bucks because it was billed through his office. Now I am hoping it is something in the code. And I can say from personal experience that wrong codes get used all the time and have to be redone. I am sure I will be finding out real soon. He will be here I think next week to see patients in my building and I will make an appointment to see him. If we both agree I need ESWT again I sure won't get it if he doesn't get paid for it.

Result number: 165

Message Number 155352

Re: hospital based ESWT or physician office? View Thread
Posted by Ed Davis, DPM on 7/13/04 at 19:40

Dr. Z:
It is true that we may bill the same amounts to different insurance companies but we have signed agreements stating the amount we actually are to accept from each company which vary greatly. So the fact that we write down a "standard" fee for a procedure is truly meaningless when we have, before hand, agreed to accept something different with each company. If regulations are on the books which appear to prevent that, they are meaningless and based on an antiquated understanding of the system, simply because the fee we charge is meaningless -- we are charging one fee but have agreed, ahead of time to accept something different from each insurance company. The average practitioner's office thus has dozens of different fee schedules, predetermined by insurance company contracts. The use of a "standard" fee is an exercise in futility as that fee has no real meaning other than that is what we would like to get. If someone was to buy your A/R, they would have to convert all the data from the amount "billed" to the amount each insurer will pay broken down by insurer.

Now, if each insurer can "negotiate" a unique and different fee schedule with a medical office why cannot an individual patient do the same? The non-legal answer to this is self evident because insurers really don't "negotiate" with us, they "tell" us what the fees will be, take it or leave it. By the same reasoning, what would prevent a person uninsured for ESWT come to you and make you an "offer?" As an individual, they would have less clout than the insurer but could you not consider their offer if it was different than the "standard" fee charged? You already have given some insurers, perhaps a lower fee as they have so "negotiated" it with you, different from that "standard" fee.
Ed

Result number: 166

Message Number 155346

Passing interest on Medicare Payments View Thread
Posted by john h on 7/13/04 at 15:56

I recently had a 3 level Discogram on the back and a lower back MRI. I thought it might be of interest to note what the Hospital charged and what Medicare paid. This will not supprise the Doctors on this board:

Discogram charges: $6019.22 What Medicare actually will pay: $1324.23

MRI: $3548.54 What Medicare actually will pay: $780.68


I guess some insurance companies will pay the full amount and if you have to pay yourself you will be billed the full amount.

Result number: 167

Message Number 154967

Re: Delaying the inevitable? View Thread
Posted by john h on 7/09/04 at 14:36

John from Mn you are clearly a walking testimonal for Dr. Sandell. Since a reported 6 million people a year come down with PF and 10% of those become chronic I am left to wonder why a procedure that is 99% effective in curing PF is not all over the world. Why has this not appeared in some scientific journals or papers presented to backup a 99% cure rate. I think one could become a multi millionaire if he/she comes up with a 99% cure rate for PF. I remember once offering an ESWT clinc $10,000 if they would cure me vs no charge if they could not. I have no doubt you are cured but I remain a skeptic at heart when anyone offers up a 99% cure rate for PF. This disease has been around since man has walked on two feet and Doctors all over the world hold seminars on the disease. Some institution is going to have to do a controlled study and provide conclusive evidence for me to believe a 99% cure rate. If Dr. Sandell was in Little Rock I would stand in line to try his procedure but I need more evidence than several people reporting a cure for me to fly off to MN for several weeks. The old addage that if it seems to good to be true then it probably is not sticks with me. I am very happy for you and sincerely hope Place and others who are trying this procedure have your success. Along the way on this board I have seen to many things that were billed as procedures that would cure PF. I remember when endoscopic surgery for PF came along. It was billed as a no sweat procedure that would have you walking out of the Doctors office and back to running promptly. One Doctor wanted to do both of my feet at once and said I would be running 10K's in a month. Fortunately I found this board before I let him do his thing. ESWT was over hyped in the begining. I still think it is a viable procedure but it is not the cure all we all thought it would be. When I find something that helps me I post it on the board because it might help someone else. Then again it might make them worse so in the end we as patients must make a choice. The good thing about Dr. Sandell is there is no knife involved and at the worst you will be no worse and maybe he can cure you but I just am not ready to accept a 99% cure rate for any known procedure for PF. This would be a major medical break through. I know you fully believe in Dr. Sandell and your post is a welcome post for the board because it provides hope and we all need that. From what I am reading we are only dealing with a hand full of people on this board who are working with the Doctor. I will look forward to seeing how we all view this 6 months from now. Dr. Z and Dr. Ed can throw away their ESWT machines and go back to school if this turns out to be the final solution. In the mean time my feet hurt.

Result number: 168

Message Number 154733

Re: Health Care View Thread
Posted by Janice N on 7/07/04 at 11:01

I cant imagine going into the hospital and your doctor who tells you to go there won't be there to care for you. One of my close friends who has a chronic lung disease is in this situation. She has gone to this doctor was twenty yrs. But when she has pneumonia or another severe lung infection she is under the care of a different doctor. Another friend of mine has a daughter in law who is a doctor and she doesn't care for patients in the hospital. My doctor sees patients in the hospital as long as it is Monday - Friday. Should you have to stay through the weekend or get sick on the weekend then forget it. I remember being hospitalized one time and I wasn't even told she was going out of town and another doctor would be seeing me. All the times I have been in the hospital under her and others they always say that they will not be on call that weekend and dr so and so would see me. Now that I understand. Being on Medicare I am able to pick all my own doctors. And don't need a referal unless one of the doctors won't see you without one. I stick to regular Medicare for this reason. I could get prescription coverage and other benefits but then you are limited to which doctors and hospitals you can use if you go to managed care. I saw things really begin to change in the mid 1980s as far as relationships with doctors and care in the hospitals while I was a nurse. I graduated from nursing school in 1980. It wasn't but a few years when things really started to go down. Nurses started having less time with their patients and more time doing paperwork. A much heavier patient load. Doctors don't get to know much of anything about their patients. The doctor I go to may see 50 patients a day. I can remember when they thought 25 patients a day being seen in their office was a heavy load.
When I see my pain dr every two months I spend up to 30 minutes in the waiting room. Then put in an examing room and wait. He comes in and says how are you? Well keep doing what you are doing. Doesn't matter what I said to him. He is gone in two minutes. And that is no lie. And that may be a long visit. The cost billed to Medicare is $150.00 To which he is paid a little over 45 dollars and I pay 10. But he shares office space and staff with several other drs. I know rent is not cheap. But he has very little staff and they do mostly paperwork. The receptionist puts patients in the room. And there is a recording on the phone when you call. Very seldom do you hear a real voice. I wonder how many patients he sees an hour? It used to be 1-2 every fifteen minutes was the norm for a dr. I just don't think you can learn anything about a patient in two - five minutes. And now I know how my diabetes got over looked for five months. The time is not taken to review the notes and labs ordered from the previous visit. If you are not seen by the PA before the dr there maybe not even be harldy anything written by the dr. No wonder so many things happen. And the cost of mal practice is high.
When I hear someone say the dr wasn't in the room with me 15 minute I say you got a dr to talk to you for 15 minutes? who? Now one thing I can say is the podiatrist takes all the time I need. My internist charges for an extended visit for anything over five minutes. Things have really changed through the yrs.
There is always two sides to every story. The high cost of practicing medicine etc. It sure is not easy though when you are on the receiving end of some bad care though.

Result number: 169

Message Number 154447

Re: ESWT and Insurance View Thread
Posted by Janice N on 7/03/04 at 10:55

Well Dr. Z if it is not covered then I sure won't be having a second one done. At my internist office things are constantly being coded wrong. So I didn't panic the first couple of days after I got the notice. And if it is not covered there is not one thing I can do. Now my question is how did it get preapproved if not covered? If indeed it was not a covered item then the answer should have been Janice, Medicare doesn't pay for ESWT. The podiatrist said he had 15 patients who had ESWT. Of course it didn't come up if these were persons with insurance or medicare coverage. I was inquiring about this since I read about ESWT here. I was talked to about surgery.
So when he said yes he had good luck with persons who had it done the office staff was to set it up and get it approved. In ten days when she didn't call back and didn't know anything about what I was talking about she read the chart and said it needs to be pre approved by Medicare. In three more days she didn't call back I called and she said yes it was preapproved. Now since all this I didn't know anything about it and I was standing there when the dr said set it up I wouldn't be at all surprised if
a mistake in billing was done. Do to this fact and some other problems coming from there. Also I would be surprised if the company who brought the machine would even come out if they didn't think they would be paid. But now that I think about it the ESWT was billed through the drs office and not the company.
If not covered I don't know as far as paying. I did have it done. Medicare says I am not required to pay it because I was not informed. But is it the right thing to do? That is the question. If I do pay it will be ten dollars a month for life or until it is paid. WHich ever comes first. Sorry this is so long.

Result number: 170

Message Number 152167

Re: VAS scores View Thread
Posted by Ed Davis. DPM on 6/06/04 at 19:45

Elliott:

I have not changed my approach to the treatment and advice I provide for treatment of PF. I still recommend trying all reasonable conservative conservative modalities first. Nevertheless, when those modalities fail we have two choices remaining: surgery and ESWT. For some reason all the negatives associated with surgery including costs cannot produce comment from you but ESWT does. The costs associated with surgery are a factor in your health insurenace premiums but you will not comment on that.

New technology is one of the largest reasons for medical inflation. we soon will have artificial discs to replace the ones that wear out. I would imagine that they will be expensive. But stopping coverage of new medical devices and procedures is not the answer for making your health insurance bills more affordable. It is the medical politics of the US that turns a several hundred dollar procedure into a several thousand dollar procedures that is a big part of the problem. Why do you think that so many have opted to go to Canada for ESWT?

At a point, I looked at ESWT as new, unproven technology but it has clearly proved its efficacy. I expected some early resistance from insurers but actually find insurers becoming more resistant and having to LIE about the efficacy of this modality to their insured by relying on one failed study. I am not claiming "conspiracy" but when collective adverse action is taken by the Blues Tech Committee on flawed evidence just to let third parties get out of paying for a legitimate treatment we have a problem. We also have a dangerous precedent in that an industry has found a means to raise the "bar" for acceptance of new technology in a means to avoid payment. Research and experiments do not come cheaply and the costs of that will be included in the cost of the procedures that are offered. If you want another 15 million to study ESWT, then expect ESWT to be yet more expensive -- you just cannot have it both ways.

ESWT at this point in time, is clearly the standard of care for the treatment of intractable plantar fasciitis, not plantar fascial release surgery. I probably could not have made that statement 3 years ago. There is adequate evidence out there, cumulatively, to convince any reasonable doctor who treats this problem regularly to this effect. The insurance industry cannot determine what the standard of care is. They, as payors, have a stake in direct treatment costs yet no stake in indirect costs, ie. the loss of productivity, work, pain and suffering by their insured. They cannot be the final arbiters of treatment efficacy nor have a right to place undue financial barriers to their insured from getting proper treatment. If a new tactic is to ask for an unrealistic expendiure of time and money from those practicing a newer medical art, then they are in part to blame for the increased costs of that treatment.

I just got back from a tour of a local hospital that invested 76 million dollars in a new state of the art surgical suite, much of which is devoted to cardiac surgery. Billions will be billed out for such procedures while all too little has been done to study the means of prevention of heart disease.

So we have a system that basically writes a blank check for surgery while holding legitimate non-surgical treatments up to unreasonable scrutiny and yet, "no comment" on this from you.

Yes, this whole site is about patients in pain from PF, many with intractable PF. We have a cure for most people that has had unreasonable financial barriers thrown in front of it. People like Dr. Z and I are speaking out -- more people should.
Ed

Result number: 171
Searching file 14

Message Number 141643

Re: So what is your point Larry? View Thread
Posted by Larry T on 1/08/04 at 14:42

My point was that there are far too many Podiatrists providing poor devices. I have even seen pre made cheap shells that were billed as custom. I dont know how much actual time is spent in podiatry school making orthotics, casting, material choices etc.

My point is that too many of them have forgot what they learned in regards to orthosis. Sad to say but there are too many making little 3/4 shell leather top with a bit of posting for $350+

Result number: 172

Message Number 141003

Re: Cats and vacuum cleaners View Thread
Posted by marie on 12/31/03 at 10:48

I believe that animals have their own personalities. Just because one dog is bad doesn't mean the whole breed is bad and the same with cats. Of course an animal's environment can affect an animal. All of our animals are very sweet and loving. In fact my hubby uses our pets to calm toddlers when they get their portrait done. If a toddler is crying and upset during a photo shoot all he has to do is call in Meisha, our siamese girl. She is sweet and loving. As soon as those toddlers see one of our cats or dogs in the room they immediately stop crying....it somehow distracts them and calms the situation. Our cocker spaniel, Katie loved toddlers so much that whenever she escaped from the back yard she'd high tail it to the day care across the street. As long as the little ones were outside playing she'd stay at the fence with them. The daycare manager would always give us a call when she showed up. In fact there are a few of my hubby's clients who have portraits of their toddlers with their arms around Katie.....she was such a ham.

We are working with our new puppy, Heidi. She is a mini dachsund. We were careful to find a puppy of a very social and sweet mother. So far she is working out well.

Our oldest cat is Hannah. Hannah doesn't like me but loves my hubby and my youngest son Michael. She is in charge of all the other pets...they stay out of her way.

Chloe is Meisha's daughter. She is Himalyan and Siamese. She is bigger than her mom and to this day she and Meisha have a very strong bond. Chloe isn't attached to any person in the house she is most loyal to Meisha. She is sweet but doesn't like to be held for very long. She is very playful and is most interested in playing with the puppy.

We have only had one dog that we had problems with. She was a mutt and we knew nothing about her when we adopted her from the humane society. She was an outside dog but had a nice house and of course we had her inside in the winter. We both worked during the day so we thought she would work out. After we had her for about a year we just couldn't get her agressive behavior trained out of her. I was afraid she'd really hurt someone and after she went after the cable guy I knew we couldn't keep her. He was on the roof of his truck yelling for help. She attacked anyone with a baseball or billed cap on. We figured her previous owner must have abused her and probably wore a baseball cap. We had to return her to the shelter. It was awful and that's why I always insist on meeting the puppy's or kitten's owners and mother.

Result number: 173

Message Number 140450

Re: just me checking in View Thread
Posted by bluestella on 12/20/03 at 20:05

I can not really notice a difference with the horse chestnut. Like i said my pain is still very tender and sensitive and numb!!! That is the part i hate! And has zingers once in awhile or targeting pain. Yes the wheelchair was so nice cause i was getting billed 170 a month!! Thats a car payment ha ha but that was a nice xmas gift :) take care thanks for writing

Result number: 174
Searching file 13

Message Number 138683

Leave L.King alone.... View Thread
Posted by Scott R on 11/25/03 at 16:23

Don't reply to L.King's threads unless you're a doctor.....she/he's getting an email everytime someone posts a reply. Remember, I've billed the doctor's message board as specifically for Dr's to help and reply. We decided not to enforce "doctor's only" though. So, do not bug L.King or i'll have to disable the automatic email reply system, or enforce "Dr's only"

Result number: 175
Searching file 12

Message Number 129157

Re: costs of ESWT View Thread
Posted by Ed Davis, DPM on 9/08/03 at 14:51

Dennis:
The range of cost is very broad, depending on the technology used. For example, with Ossatron a surgicenter, anesthesiologist, surgeon and possibly the company owning the machine are billing -- 4 entities. With Dornier, it is 2 billers, usually the surgeon and the company owning the machine. With Sonocur, it is just the surgeon's fee.
Ed

Result number: 176

Message Number 129103

costs of ESWT View Thread
Posted by Dennis M. on 9/08/03 at 07:31

Understanding that such things vary, what is a typical cost of ESWT? My physician has billed the insurer slightly over $10,000.00, which may or may not be covered. I am of course concerned that if coverage is denied, I may be facing a substantial bill.

Result number: 177

Message Number 122499

Re: How do they get patients for ESWT -Sonocur View Thread
Posted by Dr. Z on 6/20/03 at 21:27

Hi

That is a code that the APMA has warned doctors that this is considered fraud and shouldn't be billed. Are you sure that this is the correct code
ESWT isn't considered ESWL. The codes that is used is 0020T

Result number: 178
Searching file 11

Message Number 119570

Re: New developments on Medicare coverage of ESWT... View Thread
Posted by Ed Davis, DPM on 5/21/03 at 20:38

Brian:

When a doctor accepts assignment on a Medicare claim, the patient cannot be balanced billed for the difference. The doctor may decide that he cannot afford to provide treatment at a particular rate and, as such, refuse to offer the treatment. It is fairly common for Medicare to set reimbursement rates at below the cost price for a number of procedures.
A provider then can take a loss assuming that it will be made up by those procedures which have an adequate profit margin (depends on the specialty), refuse to offer the procedure or, at times stop taking Medicare patients altogether. Most of the family doctors in my town have stopped accepting new Medicare patients.

Ed

Result number: 179

Message Number 119543

New developments on Medicare coverage of ESWT... View Thread
Posted by Ed Davis, DPM on 5/21/03 at 15:56

Medicare Part B
Extracorporeal Shock Wave Therapy – Clarification and Expansion of Coverage
This article will replace the article previously published in Medicare B News, Issue No. 188, March 15, 2001, and will cover both the use of this therapy for plantar fasciitis AND lateral epicondylitis.



For Treatment of Plantar fasciitis:



On October 12, 2000, the FDA approved a device that, much like the lithotripsy device which breaks up kidney stones, delivers extracorporeal shock waves to the heel with the aim of resolving pain from chronic proximal plantar fasciitis. This treatment claims to "promote revascularization, which promotes healing". This Carrier will allow payment for this service when the following guidelines are followed.



Indications (all three must be present):



Proximal plantar pain for at least six months
Failure to respond to two courses of physical therapy, e.g., stretching, massage
Failure to respond to pharmacological therapy, e.g., cortisone injections, NSAIDs
Contraindications:



Previous proximal plantar fascia surgery
Other foot or ankle pathology, e.g., osteomyelitis, recent fracture
Neurological or vascular disease that has affected the foot
History of plantar fascia rupture


Retreatment: This Carrier will allow a second treatment at 14-16 weeks after the first, if response is not acceptable. We will not allow a third treatment.





Billing:

This service should be billed with the Category III code 0020T, appending modifiers LT (left) or RT (right) to indicate the site. If the indications listed above are met, ICD-9-CM 728.71, chronic proximal plantar fasciitis, should be used. Reimbursement will currently be $375.00 and includes all follow-up care for 90 days. Anesthesia services may be billed separately, as appropriate.

Result number: 180

Message Number 119196

A tiny excerpt on medical fee setting ---- View Thread
Posted by Pauline on 5/18/03 at 14:18

Knowing what your services pay and how your services are billed will give you more control and knowledge of your practice and your income in this setting as well. While antitrust issues disallow you to find out what a colleague on the other side of town charges, you fortunately have a standard by which to measure what you can charge.


The RVU or relative value unit system exists to create more uniformity based on regional, demographic data that allows you to standardize your office fees. Most practices have an RVU schedule for standard E&M (evaluation and management) services and another for procedural services.


For example, a 99213 is worth approximately one RVU. If you charged $70/RVU, the 99213 would be billed out as $70. If your procedure codes were set at $100/RVU and you did a procedure that was worth 2.5 RVUs, then the bill would be $175 (2.5 x $70 = $175). The amount designated to multiply against the RVU is up to your practice. It should never be less than what Medicare will reimburse you and really should be at least as much your best payor reimburses.


The only downside to having it set rather high is the write off at the end of the year. However, as you will see below, depending on your payor mix, it could benefit you to have higher rates in the long run.


This article will focus on issues surrounding reimbursement and help to more clearly elucidate, and correct some routine practices that could border on illegal or potentially fraudulent practice. Remember that these are general guidelines. Each state varies in its individual regulations. Thus, check with a healthcare attorney, your specific payors and/or your state and specialty medical societies for more specific information as it pertains to your particular practice issues.


Interesting:
"The amount designated to multiply against the RVU is up to your practice. It should never be less than what Medicare will reimburse you and really should be at least as much your best payor reimburses".

Result number: 181

Message Number 118750

Re: CPT codes View Thread
Posted by Ed Davis, DPM on 5/14/03 at 15:40

Elliott:
Series of 5 nerve blocks??? Do you want to tell us what you are getting into now?

Peripheral nerve blocks may be billed with the CPT code 64450. It happens to be a code with an unusually high cost -- don't ask me why -- ask Dr. Hsu or the other rocket scientists who came up with the RBRVS system. There are codes that carry too high of a cost and many that carry too low of a cost. I, and others, are often embarrassed about codes like 64450 but have to explain to patients that for every overpriced code like that there are a couple of underpriced ones so the whole thing balances out in the end. The rationale behind the value on certain codes is that there is a certain skill level and hazard level associated with the code. Taking out a plantar wart is a lot more work than, say, 64450 but less skill is involved....
Ed

Result number: 182
Searching file 10

Message Number 107064

Re: I am going to be getting ESWT treatment in March....... View Thread
Posted by Dr. Z on 1/27/03 at 19:28

EOB is the information that is mailed to the doctor and one to the patient. It shows the amount billed by the doctor and the amount paid by the insurance company. IT is like a receipt you would get after a purchase in any department store except it take a rocket scientist to read it

Result number: 183

Message Number 103334

Re: Pods & Orthopods View Thread
Posted by Sheila S on 12/16/02 at 18:12

John, I had my first neuroma surgery (11/00) in the Pods. office, he agreed to this to save me money. His preference was the hospital, but said he's done a number of them in his office. It went without any problems (except I had to say "Hey! stop cutting there it's not numb in that spot. Whereby he shot me some more.....lol) The cost was $700 or so.

I had my second surgery (1/02) in the hospital. This Pod. does not do the surgery in his office, ever. The bill for the Pod was about $7-800 again. The total bill was $5,300!! The charges from the hospital and staff were incredible. And I was billed for the anesthesiologist AND a helper anesthesiologist (sorry, don't know what the official term is...). Ridiculous...especially since I already knew what a relatively minor surgery (as compared to heart surgery) it was since I'd already been wide awake through one.

However, in the first surgery there was no one in there except me and the doc. That kind of situation could put a doctor in a terrible compromise if he operated on someone that drank McDonald's coffee.....(which I don't like). If I were him, I'd do the surgery in the hospital if only for the expert medical witnesses in the event I had a McDonald's coffee drinker...

I'm in Virginia. Seems it's normal here for any and all surgeries to be in the hospital.

Result number: 184

Message Number 102166

Re: WARNING ABOUT BIZARRE SURGERY View Thread
Posted by Dr. Z on 12/07/02 at 20:50

Here is the post. The Blue Shield MD has the duty to report this doctor if he feels that something is wrong. I just hope this MD knows feet and knows the facts
Query*: ESWT & Fenestration, Fraud
From: Kirk Allen, DPM

I recently performed extracorporeal shockwave therapy along with
fenestration procedure for heel spur syndrome. I billed an osteotomy
procedure code with a "-52" modifier, in addition to the ESWT code.
The Blue Cross MD review called me to tell me that not only going to
recommend non-payment, but that this was fraud.
Needless to say I have not been paid for either procedure on
this, as well as similar procedures performed on three other
patients. What do you recommend? Thank you.

Kirk Allen, DPM
Monterey, CA

Result number: 185
Searching file 9

Message Number 99838

DIABETIC SHOE BILL SCAM? View Thread
Posted by BGCPed on 11/11/02 at 20:17

I was wondering if Richard or someone else that deals with this bill. I had a pt in today that was an elderly diabetic. A company that adverises to take care of your diabetic supplies with no hassle had a person come out and fit her in an off the shelf depth shoe that retails for about $100 and a off the shelf insert that was sorbathane with a plastizote top, about $20 retail.

When her daughter got the bill that medicare paid it was for $240. I realize there is a combination of inserts/shoes they can receive but at that cost and none of it was custom or molded just off shelf I was wondering if that price is overcharge. I thought a code of A 5500 is for off shelf shoe and that pays about $110 a pair or so I was told by a biller for an O&P near me

Result number: 186

Message Number 95786

Re: BC / BS of Massachusetts version of the study View Thread
Posted by BGCPed on 9/19/02 at 22:17

Well I would like a study done to explain why there is such a discrepency between mail rooms at BC/BS. I have mailed bills 3 and 4 times only to be told "sorry we didnt get it, mail it again" some of my bills are over 4 months old form this nonsense.
On the other hand the same company will send you a cancel notice like an atomic clock or cash your premium check the day they get it. You get a late notice if you dont get payment to them in time but you dont get a notice when they are going to pay you a few months after you billed them.

My question is does the technology exist to coordinate the billing AND receivable people that are served by the same mail room to get on the same program?

Result number: 187

Message Number 91672

Re: Orthotics for feet View Thread
Posted by BG CPed on 8/05/02 at 18:34

Well the Footmax are not custom. They should be called custom fit perhaps but they are not custom in the true sense. They use a statis mat and have you walk over it. This gives a crude topograph or cast like image. If a person has a hypermobile foot that overpronates then taking a "snapshot" of the foot in that poor position is a bit flawed, much like taking an eye exam while you squint a bit.

Thjat info is sent to Canada where the techs will look at the colors e.g. elevations and shapes. Techs then pick out the closetst shell from a selection of pre-made shells. There is never an actual positive mold made and no milling is done either so they are modified pre mades.

I am not trying to flame here and if the devices work and they are made from an old frisbee and cost $600 then they are worth it, that said the wholesale and ultimately retail cost for them is expensive for what is actually done. You could fill a cookie pan with kitty litter, walk through it, fill it with plaster and have a similar result.

The points about giving refunds has two sides. Orthotic therapy can be very effective, it can also fail in some cases. Failures depend on many factors and PT compliance is one aspect. Skill level or lack thereof on the Practitioners part is also a factor. I give both verbal and writen instructions. I also measure the pt feet both arch and heel toe as well as go over proper footwear.

As much as I dislike the Gov I would welcome an orthotics certification board that would cover all practitioners. There are too many slimey types in the business as well as folks with good intentions just lacking the skills and tools to do a proper job.

I have had my share of failed orthotics but I have had many morepostive results. I dont think anybody gets a refund when your Stockbroker, Lawyer or Teacher does not "fix" the problem or get 100% results. If you get a reaction from say Celebrex and break out in hives after 3 days, you dont return it to pharmacy for a refund. It was givin to hopefully relieve symptoms, as it does in many thousands. Unfortunatly it doesnt have a 100% success rate.

I only charge $175 a pair and do them in an hour. Because of insurance company nonsense I dont accept any insurance and only will bill for work comp or auto.

I used to charge $175 for auto thinking I was being nice and I would get taken care of since my competitors charge $350 plus. The last straw was from State Farm dragging out a claim that they originally approved and it took over 6 months to collect after tons of paperwork and calls. Now they all get charged what my competitors charge. Since I dont participate in medicare/medicaide I can do that. Many pt have no idea what extra crap you can be subject to when doing billing, just ask a medical biller I think they rank up with air traffic controllers.

Result number: 188
Searching file 8

Message Number 82716

Re: new job / netzero internet providor View Thread
Posted by linda a on 5/06/02 at 19:49

well i am had no luck in contacting someone from netzero support on line , so decided to call their phoneline . i happened to notice that i was being billed twice for two separate accts , which started in Febuary when i had to download the internet providor . it would not take my original member id , so i came up w / a new memberid . i didn't realize the billing problem until i was looking at my acct billing history and notice the two accts . the guy on the support phoneline said i could get credit for one month and i said what about the months march and april that was doubled billed . he explained that he could not help me w/ that problem and give me a internet connection to contact the billing dept . well , that site did not even come up on the address bar . now i am very frustrated that i am not getting anywhere w/ this internet providor . i did type a note to their feedback site , only to receive a note that they do not personnally e-mail people about their comments . sorry to ramble about this problem but i thought anyone having a bad day could get a chuckle from this sad pathetic story . THanks all ! i was just watching the news about the tornado that hit Texas and i was thinking of Necee and Texas Barb . i am so excited to be working again , still have not heard when the actual day will be . i am looking forward to the 4 days off and a SIT down job . i really don't know how much longer my feet will hold on out . i have been working in my flower/vegetable garden and my poor feet have been killing me . i forgot which one commented being a sleep study candidate . did they find any sleep apnea problems ? it is kind of ironic working in a sleep disorder clinic when i have a terrible time sleeping . when i was young i used to watch my sisters sleep wondering why i could not fall asleep . take care . linda

Result number: 189
Searching file 7

Message Number 77640

"high fashion shoes for problem feet" View Thread
Posted by Suzanne D on 3/26/02 at 17:21

Has anyone seen this site before? If someone has already posted it, I am sorry that I missed it.

http://www.comfortable-shoes.com/

It is stated that all shoes sold accomodate orthotics and have orthopedic features. The shoes are billed as "high fashion shoes for problem feet". On the home page of the site, there is a seal with the initials PFA and the words Pedorthic Footwear Association. This would seem to be a good seal of approval, but I don't know anything about such an association.

I thought others might be interested in this site and also wondered if anyone had any experience with the shoes advertised here. There are dress as well as casual shoes available.

Result number: 190
Searching file 6

Message Number 66982

Re: In office shoe sales View Thread
Posted by Pauline on 12/14/01 at 16:20

I find no fault with the program, but again unfortunately it's a case of buyer beware. Sadly the most vulnerable are usually the one's taken advantage of. They are the one's that have no way to compare prices or products and are often offered inferior products without knowing it, but
having Medicare billed the higher costs.

With the physician mentioned the diabetic patient is getting an OTC heat and serve orthotic, but the billing code is the same as the custom one. No one knows what the patient received except for the physician.

I'll agree the the program was established to save people from having amputations, but I still question the ethics of many of the physicians involved in the program.

You have to admit for a person with diabetic foot problem it is much easier to sell them shoes from the office mainly because of convience as compared to a healthy person who can shop to compare the cost of all the products that are available.

When dealing with Medicare Patients many feel as long as Medicare is picking up the bill, they are not paying for it so they don't care. The real truth of the matter is that someone is paying for it and we do care that the patient receives the quality for the costs that are billed.

Result number: 191

Message Number 65888

i like the x-mas donation idea for orthotics View Thread
Posted by linda a on 12/02/01 at 06:40

even though i had three orthotics made ; 1 ) before the PF surgery --- hard orthotic 2) after the surgery --- hard 3) a soft orthotic that my pod doc paid for out of his generous wallet along w/ some other stuff like tapping my foot almosr every week . some times the insurance was not billed . there are great podiatrist out there . i am thankful for dr. tipton in louisville , ky . he is my heroe . he also sounds like dr Zuckerman and a few other good docs out on the western coast ( laurie R ) . i am hoping to send a few cash thru the mail to dr Z . thank you for thinking of it . linda A

Result number: 192

Message Number 64913

RE: insurance reimbursement View Thread
Posted by Karen K on 11/17/01 at 13:03

Hi All,

I found this info interesting from the Healthtronics website dated Sept 20th:

CPT Code 0020T has been designated for extracorporeal shock wave therapy for plantar fasciitis. . .
CPT Code 0019T will apply to extracorporeal shock wave therapy involving the musculoskeletal system. Such applications would include tendonopathies such as tennis elbow, patellar tendonitis, shoulder tendonitis and Achilles tendonitis. Additionally, certain bone conditions such as non-union and delayed union fractures and avascular necrosis of the head of the femur would be billed under this code. HealthTronics plans to seek FDA approval for all of these conditions.

Argil Wheelock, Chairman and CEO of HealthTronics, commented, "The initiation of the these new CPT codes is an important step in our efforts to establishing reimbursement from insurers for OssaTron treatments. Until now, we have had to use a miscellaneous code which almost always led to initial rejection of precertification by the insurance companies. By having a code specific for the service we are providing, much of the confusion associated with this new, innovative procedure will be overcome."

It can't hurt mentioning the CPT code during your plea for reimbursement.
I'll be calling Harvard Pilgram Health Care this week myself and I'll let the board know how I make out.


Take Care,
KK

Result number: 193

Message Number 64880

My story... View Thread
Posted by Nicole K. on 11/16/01 at 15:12

Hi all. I am so thankful I just found this bulletin board when I was looking for SAS shoes (someone had recommended them to me) on Google. I have had PF for 5 yrs now. I am 25 now, so my pain started when I was 20 yrs. old. I am not overweight; I am 5'1" 105lbs. I believe the pain started when I used to wait tables in bad shoes every day and do step aerobics. Between those two activities, and the fact that I believe that I am predisposed to it; with high arches, and my father has also been through surgery.

One morning I just woke up with that sharp pain in my heel when I stepped on a hard floor. After a month of putting up with the pain, I went to see the doctor (a Podiatrist)who told me what my problem was. We tried for 1 yr. to treat without surgery. I did pt, had orthotics made, had probably about 10 cortizone shots, which brought some temporary relief, with the pain returning in 3-5 days, taping, anti-inflammatories, and night splints. So after 1 yr. of putting up with miserable pain I finally decided to have surgery. My doctor was one of the first in my area to do the endoscopic plantarfasciotomy. So I went under the knife. Went through PT after surgery, and the pain never went away. So 1 yr. later I had another surgery with a different doctor (a Orthopod - well known one, one who works on the LA Lakers) who believed I had a trapped nerve and scar tissue... This was only after more pt, taping, and cortizone shots of course. This surgery was a little more severe, it was open surgery and I was in a cast for 2 months. Then I went through more pt, and again, the pain never went away. My doctor basically told me I had two options; put up with the pain, or have another surgery where it could potentially get worse.

So I went a year with putting up with the pain. I tried acupuncture, Yoga daily for stretching, Reiki. Glucosamine, MSM, Pineapple Enzymes... Of course Advil and Aleve as well...Now I am back with my original doctor who did the endo PF and we have been through it all again. I've also had two nerve tests, an MRI. What the x-rays show is that I have a 3/4 inch spur on my left heel. The doctor told me my ligament is trying to reattach itself. He wants to do a third surgery to remove the spur now. I don't want to have a third surgery; one and two haven't worked, why would a third? The nerve conduction test doctor suggested possibly numbing the nerve. So the podiatrist tried it, and that night I went dancing and I didn't care for it; my foot was lame and slow and uncoordinated. Then the pain came back and it was worse! I guess my doc called this rebound pain. So, I don't think this is an option. Has anyone out there had this?

These last five yrs. have been horrible. This is like someone has put this horrible curse on me; what have I ever done to deserve it? All of my memories are tainted with this horrible pain. Even though I've tried to live as "normal" of a life as possible through all of this. I rarely complain about it, most people who know me don't even know I have it. I can't run, but I try to do everything else (I play basketball, do kickboxing, yoga, etc), and stay active so I am not trapped by this pain.

Thankfully now I have a desk job but I used to work as a bartender which I'm sure did not do wonders for my PF.

So my podiatrist sent me to someone new, to make me new orthotics. I have very little hope that it'll make me better, but it's better than having a third surgery. They also cast me a night splint, which is certainly more comfortable than the last one I had.

As a result of this terrible PF experience I have gone through, I completely dislike the whole beauracry of going to the doctor's office - not really them as people, but just the whole experience. I hate going in, filling out forms, waiting for hours on end only to be billed. I hate how my Podiatrist makes 5 appointments for 2pm. Sometimes I wish I could bill for my time!! I have spent so much time and energy on this PF/spur that I just don't really know what to do anymore. Do you think a third surgery would be successful? I am curious about this "ESWT" and not really sure what it is, but I suppose I could give it a try. Anything's better than another surgery. I fear that a third one could put me in a wheelchair. I am only 25 yrs. old and really don't want to have this pain anymore. Anyone have any ideas for me? Thanks for listening and I hope I didn't ramble too much.

Result number: 194

Message Number 63848

girlfriend ----- you need to stop missing w/ my mind --- i forgot ya were talking about a dream . View Thread
Posted by linda A on 10/30/01 at 20:18

here i am manic . no sleep reading these post . trying to figure out this bin laden video that dr Z never did comment on . i was at the library today . and the gentleman on my left said the site came from finland . so, we broke it down half way . pulled up the finland site . could not read the jibberish . of course i am still manic . i can read anything . i read dr seuss books . i finally gave up and went to the good pysch doc . remember i ramble when i am manic , so i even told him that i did not take all my meds last night . that i stayed up all night . i think he could tell the second i walked into his office . non-stop talking . when i am in a good mood it makes people happy . he laughs alot . HA HA ! i am a charmer . needless to say i will be going to work tomorrow . look out world . oh, i forgot to tell you the highlight of the day . i went to see the previous pain mgmt clinic , because they falsely billed my insurance co and got paid for it . you see i never saw that doc and i never saw the nurse . remember i was so manic and agitated that i got into it w/ the sectretary . . well things didn't go so well again . when i told them it was medical fraud in front of full waiting room . they told me to call there billing office . and there was no need to bring it up in front of everyone . i said they had a nasty staff . they threaten me w/ security . i threaten them w/ 60 minutes . did that take BALLS !!!!! i am truly manic !!!! i better get some sleep , so i don't get into trouble tomorrow w/ the anesthesia doctors . linda

Result number: 195
Searching file 5

Message Number 58646

Re: question for the Drs here on the efficacy of orthotics View Thread
Posted by Ed Davis, DPM on 8/31/01 at 19:36

Paula:
Its about 5:25 PM here on the West Coast. Had to wait for the mail to come in today, make a bank run and finally had to dip into my line of credit in order to make payroll--my employees are just getting their checks now.
We are doing a booming business, seeing lots of patients, giving them good service but the d-mn insurance companies are taking too long to pay us. They make us spend too much money to chase them down. I have 6 employees in my office--2 help me with patients, one receptionist, one office manager and one biller--- in other words 2 out of 6 employees directly involved with patient care. Healthcare is not broken; the third party system is broken. How much better patient care could we provide if 4 out the 6 employees were focused on patient care? Not chasing insurance companies!
Ed

Result number: 196

Message Number 58532

Re: Impact of Managed Care on Quality of Care View Thread
Posted by BG CPed on 8/30/01 at 21:36

Another aspect since I am wound up and Richard is also (must be that combative Scotsman blood) You have prices that are in a way set. The amount a insurance will pay regardless of the skill of the practitioner making them. Can you imagine if Lawyers for intance were told you can only bill $400 to handle a divorce regardless if you are Joe Schmo or F Lee Bailey do you think the quality of representation would be the same?

Managed care has the same effect. If you owned a restaurant across from the GM plant and were told you will get paid $100.000 a year to feed all of the employees whenever they came in. If you bought Steak and Lobster how long would your restaurant be open? You would have a better chance to have some money to pay your bills if you gave them mac n cheese or hotdogs.

Now say lots of folks liked to have a jello cup for desert, your nice guy you want to make them happy so you serve jello on Fridays. Now after you have paid all your bills at the end of the year some twit from resorce managment says "you did an ok job but those little jello cups were not authorized, they cost money. I know we agreed to pay you $100.000 but we will have to take 5% off of your pay, try not to do it next year"

I bill the work comp and auto about 35% less than allowable and what they pay all day long to others. I have been getting screwed by them. I have only been paid on about 7 of the 25 I have submitted since January. Many have been billed and called more than 2 times. They say "oh we never got a invoice , mail it again" So as of tomorrow I will raise my rate to the FULL amount since I have to spend extra time/money to chase them. See the logic? I do a better job and charge less and they screw me. Try telling them you "didnt get the invoice" on your next insurance bill and see how they treat you.

I know I posted part of this rant a week ago, I just am geting tired and frustrated at the system and some people in it. If the politicians were worried about more than interns getting screwed they would make a reasonable reimbursment law. Maybe tell ins providers you have 15 days to pay on a claim or there will be a fee of prime rate + 3% tacked on. The technology exists. We as practitioners are giving the Ins an interest free loan. They call it "floating" they sit on payment but are VERY efficient on the collection of premium end, why do you think that is?

I had a work comp that stiffed me due to instructions by her lawyer. I finally tracked her down, she has not worked in a year cause she stepped on a stone and "bruised her arch" She is wearing them, says they work but wont pay because a, the insurance said they would pay for it and b, her Lawyer said she didnt have to????

Sorry about the ramble but I just wanted to give a few examples to understand what we go thru, for the Docs it is way worse. So I dont know but I do think a reasonable time to pay would be a great idea ansd easy to impliment

Result number: 197

Message Number 58375

Re: question for the Drs here on the efficacy of orthotics View Thread
Posted by BG CPed on 8/29/01 at 16:10

That is a good question and it is a two sided answer. I think basic sthics or lack of are in a large part how you were raised. Generally speaking if you are an "ethical" person it would/should carry over in most of your life how you conduct yourself.

There are practitioners in all feilds of orthopedics from CPed to Surg that agreat, some ok and some stink. This is just like the general cross section of auto mechanics, teachers or engineers. If you have a pre-disposition to being greedy or lazy. If you dont take pride in what you produce or dont study beyond what is demanded then you would probably fall into that catagory.

When you take something that can be billed for or charged alot of money for it can make it easier for these types to take advantage of the system. In medicine this is precisley what the Stark Law was intended to curtail.
This is why in my opinion there is less reimbursement for orthotics. The didnt deal with the weasels so they threw the baby out with the bathwater.

Another type is the ones that mean well but just dont think they need to learn more or are too busy to learn more. There also are probably many that mean well just dont know what else is available material wise or device wise so they stay comfy with what worked some 15 years ago.

Orthotics should not be dispensed like drive thru burgers get em in get the money and get em out. You will not last long and will have to spend lots of time fixing them.

So more regs may help but there will always be a percentage that dont care or are greedy, lazy whatever that will find a way to cut corners. Again it is a reflection on society in general. Regulation doesnt always work when the government gets into it. Look at the penalty for medicare/caide fraud. Some guys steals 3 million over 5 years and gets work release and $250,000 fine.

In surgery a fellowship is a great program. There are few fellowship trained foot surgeons around. You take an extra year out of your life to live somewhere and get extra training. This is above and beyond med sch hool, residency, intership etc.
It is easier and more comfortable to stay put and earn more money for that year. The one that do it are demonstrating they care more and want to learn more, you also earn more but it is not the lazy way so many wont pursue it.

I wish there was a higher standard in Pedorthics, they do a good job but something akin to a fellowship or higher level of credential/ testing for folks that wanted to go higher. It is a big issue and I am not sure how to start to fix it

Result number: 198

Message Number 57928

Re: workman's comp woes View Thread
Posted by BG CPed on 8/25/01 at 12:21

That is tough. There was a study done on inserts with postal workers that was rather impressive. Showed help in a large percent, also improved complaints on backs and knee. I think one aspect with reluctance of insurance coverage on orthotics is that they got hosed for several years by scammers doing orthotics.

Unfortunatly it was not uncommon for some to make a poor fo out of prefab or close to prefab shell, cover with leather that had the guys name on it and bill for $350 + . Poor device x high cost x poor results = no payee.

It could be compared to a Doctor writing scripts for meds when he owns a pharmacy next door, paying peter to pay paul more. I realize Stark Law eliminates most of that. The insurance co instead of weeding out the ones that were costing them and ripping them AND the patient off they just said hey we wont cover orthotics unless they are attached to a brace or you are a diabetic.

Between the Docs that refer to me I save several pt a week from having surg, that saves lots of money in the long run. That said I am fortunate that my referal base are very ethical guys and are too busy to begin with, they dont need to cut on every pt that walks thru the door.

The reason I dont bill at my facility is that it is too much hassle in my neck of the woods. I only do bill for work comp and auto. To give you an example I did 25 of these types of claims between january and may. As of last week I have been paid on 8 of them. I had my billing person call all the outstanding providers and out of the 18 unpaid about 6 said "mail it again, we never got your invoice" Some of those had been called and rebilled more than once in that time. It is not uncommon to wait over 90 days for some to pay. What other business can you provide a service have a rep from the company tell you it is covered then have to sometimes wait months and send several bills to get paid? You cant do that at the Grocery or auto repair, why should it be different.

They use the standard stall and play dumb to earn interest on the money and to encourage some to write it off. I would like to have a law inacted that the same folks that process and send out bills to collect insurance premiums be the same folks that pay out claims. For some odd reason one department is MUCH more efficent than the other...wonder why?

So we need a few more studies done that will prove that proper orthotic treatment is a viable and cost saving treatment. One problem is that orthotic care is not standard, like drug prescription were you can go anywhere in the country and get same consistant script filled.

Orthotics are not standardized. Thats why there are so many varied results with orthotics. I hate gov regualation but maybe there needs to be a standard practice sode writen. Needs to be evaluated fitted by a certain professional. Needs to be made a certain way etc. And have hugh nasty penalties for ones that violate it
my .02 which is really about .01 canadian

Result number: 199

Message Number 51456

Order # 66774 dated 6/20/01 View Thread
Posted by Frances Tylenda on 6/25/01 at hrmin

I ordered 2 of the Pro Stretches. I was billed for 2 and only received. I don't know where to go on your sight to find out about this order. Please let me know why I only received one.

Thank you.

F. Tylenda

Result number: 200
Searching file 4

Message Number 49509

What would you guys do in this situation? View Thread
Posted by Nancy N on 5/31/01 at 19:57

Hi, everybody. I'll try to make this short, since it is a source of major annoyance to me and I don't want to put you through all of it!

Anyway. In January 2000, I got my first pair of custom orthotics from my pod. These were the ice-scrapers that I paid $280 for. I could never wear them for more than a week without being worse off than before, but that's a side issue. I paid for them out of my pocket because I thought, at the time, that my insurance would not cover them. The $280 was a discounted rate because I was paying for them myself.

In July of 2000, I was talking to my insurance company any found out that, in fact, the orthotics should have been covered completely. I called the doctor's office, explained the situation, and picked up a bill I could send in for an insurance claim to get my money back. The amount on the bill was the $280. At this point, my pod had left the group and I hadn't been back to their office in quite a while.

August 2000--I get a check for $110 and change from the insurance company. I call them up to find out what the deal is, and they tell me that I need to get the rest back from the doctor's office. And so the nightmare begins--I call the doctor's office, and of course I get nowhere. They tell me that they can't do anything because the amount on the claim was the discounted rate, and not what they'd have billed the insurance company for (which would have been $350). I send certified mail to their billing company, etc, and get nowhere.

Finally, early this year, they send in a new claim for the full amount, which of course has really confused things. Last month, I get a check from the insurance company for another $37, and I'm still baffled. I decide to wait a few weeks to see if I hear anything from the doctor's office. I should mention here that the woman I am dealing with is surly, rude, and downright mean-spirited and succeeds in ticking me off in a really BIG way. She even accuses me of deliberately trying to cheat them out of the money they'd have received from the insurance company, even though THEY were the ones who gave me the bill in the first place!

Never heard anything, so I called the insurance company yesterday to find out what I should be expecting from the doctor's office. They tell me that the $147 I've received is their contracted rate with the doctor's office, and that I need to get the balance of my $280 back from the doctor. (Why they are dealing with me instead of the doctor is beyond me--maybe because I sent in the original claim??)

So.... I call this awful, surly woman again this morning and tell her what the insurance folks told me. It takes her a minute to remember me, but then her nasty old self comes back out, and she tells me that she spent DAYS working on this because I screwed it up the first time and that the insurance company told her that they'd take it from there, that she shouldn't do anything else, and that the $147 must be all I'm going to get back from them (even though I shouldn't have paid anything in the first place!). Then, to top it all off, she tells me that she's spent too much time on it already and she's not spending any more on it because it's just not worth it, whereupon I informed her that it's worth a lot of money to me (I can think of some things to do with $133!!). She repeated (ad nauseum) that it just wasn't worth it to her and that the only way she'd do anything else for me was if she received a letter from the insurance company saying telling her what she had to do. She would not even agree to get in touch with the people she'd dealt with at the insurance company. I told her that I would do that if she would tell me who I needed to talk to, though I think I may just call their Provider Relations number tomorrow and make a stink.

So, given all this, and the rise in my blood pressure every time I deal with these people, here's my question. This battle-axe told me she would swear to the doctor in the practice that she had told me she wasn't doing anything more for me, if I felt like complaining to him. I am seriously contemplating sending him a letter about her--he is a respected podiatrist around here and most people with foot problems seem to know who he is. Since my initial run-in with this woman earlier this year, I have told people not to go there because of the trouble I've had, and I am thinking that perhaps he should know that his staff is awful enough for patients to be warning people away from their office.

But at the same time, I am not sure if it is worth it to me to go through the aggravation of doing this or not. It may be more hassle than it's worth, but I also don't want anyone else to have to go through this kind of anguish.

What do you think? If you were in my shoes, what would you do? If you were the doctor, would you want to know?

I really appreciate your thoughts on this one. Thanks in advance.

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