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Starting and maintaining a pain management practice based on non-narcotic options is an attractive option for many medical practices these days. Neurostimulation is a good alternative that can provide the patient much needed relief while decreasing overall treatment costs and risks. However, many practices have been burned by devices that aren’t covered by most policies or medicare.
The medical device category of electrostimulators is very large and includes options that are poor choices for many medical practices. Unfortunately, it can be difficult to use simple product descriptions to identify practical options for use in a traditional clinical setting. Products within the same classification may differ in their status with insurance companies and billing codes. But why?
Understanding why is key to understanding how most of these devices are looked upon currently by the provider and carrier community and whether or not they’re viable for use in your practice.
Neurostimulation works by sending an intermittent electrical impulse through any number of nerve networks, depending on the pathology or symptoms of the patient. Because every patient is a bit different, a stimulator should be adjustable. If a device is not adjustable, the doctor could do little to change the outcome if the patient didn’t respond to this treatment.
Adjustable devices are another story. Adjustable current levels allow the physician to optimize treatment for better outcomes. Many devices can be set to different levels, allowing the doctor to respond to sensation and efficacy feedback from the patient. An adjustable neurostimulator may allow clinicians to set the amount of current emitting at 5, 10, 15 or even more different levels. The greater flexibility the device provides, the greater power the clinician has over the patient’s experience.
Water resistance is an important consideration when working with neurostimulators. At a minimum, patient satisfaction is at risk if a non-water-resistant device is in use – it can limit efficacy and lifestyle options, keeping them from going out in the rain and away from loved activities where some amount of water may be present. It should not be surprising either that insurers take issue with non-water-resistant devices, simply due to the replacement costs.
Neurostimulation as category probably suffered some setbacks early on due to extremely high costs of surgically implanted spinal stimulators. While insurance carriers covered the treatments, the copayments could be challenging for many patients. As with anything you’re considering for use within your practice, it’s important to have an understanding of how downstream costs will be experienced by your patients. We all know that even though it’s their insurance policy that’s calling the shots, the provider can sometimes shoulder the blame.
It’s generally advisable to have lower-cost options available when discussing treatment methods with your patients. If they can find pain relief with a lower cost option, they’ll appreciate it and may produce referral patients as a result.
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