RE: united shockwave billing policyPosted by vince on 11/29/04 at 14:18 (164856)
Is there any poster who has had ESWT provided through United Shockwave and has been told any financial info that has proven to be false? If so please it here. I doubt that there will be any such posts and that will show that the detractors of United's policy are doing nothing more than constant muckracking because they are afraid of the competition that UNITED SHOCKWAVE presents.
MY ONLY ASSOCIATION WITH UNITED SHOCKWAVE IS THAT I WAS A PATIENT AND EVERTHING CONCERENING THEIR FINANCIAL POLICY THAT I WAS TOLD BY THEM WAS THE TRUTH INCLUDING AND NOT LIMITED TO THE POLICY REGARDING THE TECHNICAL FEE
Re: RE: united shockwave billing policyDr. Z on 11/29/04 at 14:39 (164860)
Don't you think that common sense would tell you to get the fees or lack of fees in writing? If the company won't place an estimate in writing that is a red flag.
Re: RE: united shockwave billing policyEd Davis, DPM on 11/29/04 at 14:43 (164863)
They have clearly placed their policy in writing. Their letter specifically states that they will hold patients responsible for copayments and deductibles but hold patients harmless for the amount that the insurance company should pay for. Perhaps you need a copy of that-- just contact me...
Re: RE: united shockwave billing policyDr. Z on 11/29/04 at 14:51 (164866)
Would you please fax this over to me at 1-856-848-5122
Re: RE: united shockwave billing policyEd Davis, DPM on 11/29/04 at 15:05 (164869)
Re: RE: united shockwave billing policyDr. Z on 11/29/04 at 16:18 (164874)
I received the letter.Thanks. How do we know that all providers beside your self are giving this to patients.
The board knows my opinion about free tech services so there is no point in reviewing this.
Re: to Dr, ED DAVIS: RE: united shockwave billing policyvince on 11/29/04 at 16:45 (164881)
Dr. Davis- You are listed as a provider on the United Shockwave website so you must know that they back up their verbal promises. Why are you playing dummy up about this matter? You have seen their documents- you must know all about their polcy- I am curious about your silence- can you please explain?
Re: to Dr, ED DAVIS: RE: united shockwave billing policyEd Davis, DPM on 11/29/04 at 18:33 (164890)
What are you talking about? Why are you insulting me for no reason at all?
First, I have been a provider for United and listed on their website for quite some time. I have reiterated their policies to my patients and on this website multiple times. If you think that I am being 'silent' then you are simply too lazy too read my posts.
Re: readHenry on 11/29/04 at 22:18 (164925)
Are you just here to pick a fight? If you are, then go away. You can use the search feature here to see a lot of Dr. Davis' discussions about this.
I think he has been anything but 'silent' on this matter.
Re: readvince on 11/30/04 at 05:07 (164934)
Re: readEd Davis. DPM on 11/30/04 at 09:12 (164949)
I have repeatedly stated that United Shockwave is being honest about their policies. Each of my patients who have opted for United has a copy of the letter containing their policy. My posts here, if you have read them, have always supported United and have reiterated their stated policies.
Re: RE: united shockwave billing policyVirginia C. on 12/03/04 at 17:14 (165149)
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.....
Re: RE: united shockwave billing policyEd Davis, DPM on 12/04/04 at 15:51 (165188)
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.
Re: RE: united shockwave billing policyVirginia C. on 12/12/04 at 18:09 (165539)
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.
Re: RE: united shockwave billing policyDr. Z on 12/12/04 at 20:21 (165546)
Thanks for the information. WOW bilateral plantar fascia release. That is a big,long term healing ordeal.
Interesting that Coresourse made this specific comment that ESWT isn't any more effective then convervative treatment. I just don't get it. Insurance companies have no proof that this is true. I would have much more respect if the insurance company just states Hey patient sorry we don't want to cover this ELECTIVE treatment instead of the investigational, experiental misleading statements they use. Insurance are under no obligations to cover elective procedures such as ESWT. I guess if they just told the truth they would look good and then subscribers would get mad. So back to the made up stuff. I love the no more effective then conserative treatment. If took alot of imagination to make that one up
Re: RE: united shockwave billing policyEd Davis, DPM on 12/15/04 at 10:45 (165666)
But what did Coresource pay (in total -- hospital, surgery, anesthesia) for the plantar fascial releases; How much time did the patient lose from work after the procedures and did the procedures actually work? Of course this is only one case but statistically surgery is much more expensive and has a lower success rate so why on earth should insurers cover surgery for plantar fasciitis?
Re: RE: united shockwave billing policyDr. Z on 12/15/04 at 16:05 (165682)
Would you point to the literature that evaluates plantar fascia release surgery costs. I agree with the total cost picture pf release could be more expensive. Do we have literature showing that ESWT is more effective then pf release
Re: RE: united shockwave billing policyEd Davis, DPM on 12/15/04 at 21:47 (165704)
I am not aware of any papers that directly compare surgical results to ESWT. We can easily estimate surgical costs by looking at the average surgical fee, anesthesiologist fee and the largest fee of all, the hospital or surgicenter. Those are only the direct costs. Indirect costs which are often not looked at include the cost of handling complications and the potentially significant time loss which equates to an income loss to the patient who needs time off from work after surgery.
Re: RE: united shockwave billing policyDr. Z on 12/15/04 at 22:40 (165714)
There is an abstract on ISMST web site that shows that ESWT for shoulder calcified tendinois is not only more effective but alot less money.
Re: RE: united shockwave billing policyVirginia C. on 12/22/04 at 18:36 (166006)
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).
Re: RE: united shockwave billing policyDr. Z on 12/22/04 at 19:24 (166009)
FDA approved ESWT for chronic plantar fasciosis is NOT experimental or inconclusive. The purpose of the FDA study was to prove its efficacy and safey ,that is what a PMA is all about.
The medication problems are so different and misunderstood by the public. The removal of Vioxx etc had nothing to do with Flawed studies.
Are you celebrating Christmas early I hope so cause we don't need fear, mis- understanding about ESWT on this holiday.
I do agree that the total cost of a procedure should be know including the cost of loss of time from work.