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Healthtronics

Posted by john h on 2/06/01 at 10:31 (038293)

On 5 Feb 01 Healthtronics announced an affiliation with Healthsouth to do the Ossatron procedure for PF in their surgery centers throughout the USA. They have a lot of centers. This would seem to me to get the procedure more on track to receive coverage under insurance.

Re: Healthtronics

Dr. Zuckerman on 2/06/01 at 11:29 (038295)

Hi,

How would this help get them on track with insurance paying for ESWT.
I have been asked for advice in my area by Health South for getting Podiatric and orthopedic docs on board at the local Health South ASC's So long as there are major HMO insurance companies such as USA HealthCare and Independance Blue Cross and Blue Shield, I don't believe that there is going to be any Insurance interest in ESWT whether the FDA has approved the the ossatron or not . I hope I am wrong but only time will tell. Most insurance companies consider this to be an investigative procedure regardless of whether it is FDA approved or not. This seens to be the position of most medical directors that I have spoken with on behalf of the patients.

So keeps us updated if you hear of any specific insurance company in my the USA that has paid for ESWT.

Thanks

Re: Healthtronics

Karin L. on 2/06/01 at 12:20 (038301)

Dr. Z,
United Health Choice Plus paid for my ESWT which was done the end of Dec. I have never received a bill from them or Health South Surgery Center. I don't want to talk to loud, but as far as I know they covered the procedure 100%.

Re: Healthtronics

Kim B. on 2/06/01 at 14:23 (038306)

Yeppers, I agree John. Thanks for keeping us all up to speed. KIm B.

Re: Healthtronics Attn Dr. Z

Kim B. on 2/06/01 at 14:39 (038307)

Well, Dr.Z., it indicates to me that they've done the homework and want to advance the use of ESWT. This benefits them because if it more quickly proves to be more beneficial and less expensive and risky than traditional foot surgery, they're costs and liabilites would go down. That's my initial impression on it.

Insurance Companies might be only willing to pay when it is done in a surgery center, or hospital, where crash carts and personal are there to handle any possible scenarios. For example, Liposuction can be done at a Plastic Surgeons office, but we all know, it is safer in a hospital. Insurance Co.s probably feel the outcome is better because there are more people cross checking things, more details reports in the event that something goes wrong, etc.

I get the impression that if this is the way they decide to go, it would leave you in a catch 22 situation. You have a machine and the technique, but your patients, may have to pay completely out of pocket. I'm just thinking out loud on this, of course, and I may be way off base. Just something to keep in mind incase I am on the right track. In the future, you may find it more pratical and profitable to have ESWT surgeries priviledges at the hospitals or surgery centers as well. The more insurance pays, the more people will take a chance on the proceedure. And you would probably have more work than you could handle. (lots of little piggies staring at you!)

What ever the long term situation, I hope it doesn't leave you out in the cold. You will always be a trail blazer in our eyes, you know.

Regards, Kim B.

Re: Healthtronics

Richard Perez, DPM on 2/06/01 at 17:57 (038312)

Here in Texas, we have had numerous health insurance companies pay for the procedure. Overall we have been very surprised at the willingness of 3rd party payers to cover this service. As the demand for this service increases, more and more payers should continue to come aboard.
Richard Perez, DPM
http://www.podlink.com

Re: Healthtronics

Dr. Zuckerman on 2/07/01 at 07:37 (038334)

I have no problem doing ESWT in the ASC's. My mision has always been to reduct chronic heel and foot pain in people. So if the insurance will only pay for this in an ASC then that is where I will do the procedure.

I still remember years ago doing in- office procedure that take about ten minutes to do and only under local in the ASC so that the the patients
could have the procedure done and paid for by their insurance company

I can just see me having to form an ESWT department in the ASC. Going to the ASC everyday. Running the program . This sounds like alot of fun. No
I could really get into this.

I have always had a practice that was in the office in the hospital and in the ASC So in my practice the patient could have a procedure any where that was in their best interest.

So the war on pf won't stop with ESWT in the ASC. I really don't agree with ASC and ESWT but if it stops pain for heel pain that it fits into my
plan . So I have to leave right now I am off to the office.

And next week off to the ASC

Will love to have a copy of the EOB of paid ESWT procedures by the insurance companies.Would help to show this to the big insurance payors in my area. My area happens to be the East Coast.

Re: Healthtronics

JudyS on 2/07/01 at 11:11 (038355)

Richard, can you name a couple of those insurance carriers for us?

Re: Healthtronics

Dr. Zuckerman on 2/06/01 at 11:29 (038295)

Hi,

How would this help get them on track with insurance paying for ESWT.
I have been asked for advice in my area by Health South for getting Podiatric and orthopedic docs on board at the local Health South ASC's So long as there are major HMO insurance companies such as USA HealthCare and Independance Blue Cross and Blue Shield, I don't believe that there is going to be any Insurance interest in ESWT whether the FDA has approved the the ossatron or not . I hope I am wrong but only time will tell. Most insurance companies consider this to be an investigative procedure regardless of whether it is FDA approved or not. This seens to be the position of most medical directors that I have spoken with on behalf of the patients.

So keeps us updated if you hear of any specific insurance company in my the USA that has paid for ESWT.

Thanks

Re: Healthtronics

Karin L. on 2/06/01 at 12:20 (038301)

Dr. Z,
United Health Choice Plus paid for my ESWT which was done the end of Dec. I have never received a bill from them or Health South Surgery Center. I don't want to talk to loud, but as far as I know they covered the procedure 100%.

Re: Healthtronics

Kim B. on 2/06/01 at 14:23 (038306)

Yeppers, I agree John. Thanks for keeping us all up to speed. KIm B.

Re: Healthtronics Attn Dr. Z

Kim B. on 2/06/01 at 14:39 (038307)

Well, Dr.Z., it indicates to me that they've done the homework and want to advance the use of ESWT. This benefits them because if it more quickly proves to be more beneficial and less expensive and risky than traditional foot surgery, they're costs and liabilites would go down. That's my initial impression on it.

Insurance Companies might be only willing to pay when it is done in a surgery center, or hospital, where crash carts and personal are there to handle any possible scenarios. For example, Liposuction can be done at a Plastic Surgeons office, but we all know, it is safer in a hospital. Insurance Co.s probably feel the outcome is better because there are more people cross checking things, more details reports in the event that something goes wrong, etc.

I get the impression that if this is the way they decide to go, it would leave you in a catch 22 situation. You have a machine and the technique, but your patients, may have to pay completely out of pocket. I'm just thinking out loud on this, of course, and I may be way off base. Just something to keep in mind incase I am on the right track. In the future, you may find it more pratical and profitable to have ESWT surgeries priviledges at the hospitals or surgery centers as well. The more insurance pays, the more people will take a chance on the proceedure. And you would probably have more work than you could handle. (lots of little piggies staring at you!)

What ever the long term situation, I hope it doesn't leave you out in the cold. You will always be a trail blazer in our eyes, you know.

Regards, Kim B.

Re: Healthtronics

Richard Perez, DPM on 2/06/01 at 17:57 (038312)

Here in Texas, we have had numerous health insurance companies pay for the procedure. Overall we have been very surprised at the willingness of 3rd party payers to cover this service. As the demand for this service increases, more and more payers should continue to come aboard.
Richard Perez, DPM
http://www.podlink.com

Re: Healthtronics

Dr. Zuckerman on 2/07/01 at 07:37 (038334)

I have no problem doing ESWT in the ASC's. My mision has always been to reduct chronic heel and foot pain in people. So if the insurance will only pay for this in an ASC then that is where I will do the procedure.

I still remember years ago doing in- office procedure that take about ten minutes to do and only under local in the ASC so that the the patients
could have the procedure done and paid for by their insurance company

I can just see me having to form an ESWT department in the ASC. Going to the ASC everyday. Running the program . This sounds like alot of fun. No
I could really get into this.

I have always had a practice that was in the office in the hospital and in the ASC So in my practice the patient could have a procedure any where that was in their best interest.

So the war on pf won't stop with ESWT in the ASC. I really don't agree with ASC and ESWT but if it stops pain for heel pain that it fits into my
plan . So I have to leave right now I am off to the office.

And next week off to the ASC

Will love to have a copy of the EOB of paid ESWT procedures by the insurance companies.Would help to show this to the big insurance payors in my area. My area happens to be the East Coast.

Re: Healthtronics

JudyS on 2/07/01 at 11:11 (038355)

Richard, can you name a couple of those insurance carriers for us?