The World Leader In Endoscopic Laser Spinal SurgeryToll Free: 1-888-MicroSpine (1-888-642-7677) |
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Insurances Not Contracted With MicroSpine
Medicare is a bureaucratic system that often is motivated
by corporation lobbyists. There are separate billing codes for hospitals
versus surgery centers and the large hospital corporations do not want
surgeries performed in surgery centers since it means less business for
their hospitals. The lobby is so strong that when we questioned the
politicians about this matter, they didn't even reply to the questions. As long as large
corporations run the government, these types of situations won't change. One
might ask "Why doesn't MicroSpine convert to a hospital?" We would love to
convert to a hospital but this too is regulated by the state government to protect
the hospitals from competition. Why does an aspirin cost $5 dollars at the
hospital? Because most hospitals have protective monopolies that prevent
other hospitals from coming into their markets. It is a very un-American
practice but, as usual, Big Business runs everything. We
suggest that you contact your state of Florida representative or senator and
request that MicroSpine be given a CON (certificate of Need) so that
MicroSpine can convert to a hospital and thus accept Medicare entirely.
Some ask why don't we operate on Medicare patients at the local hospital,
but to do so would require us to double what we charge regular insurance
patients to cover the lost revenue at our surgery center. Even if surgeries
aren't being performed, nurses and staff want to be paid and thus any
surgeries that are done outside of our facility only make costs for regular
insurance people more expensive. Nonetheless, currently Medicare pays around
20 cents on the
dollar and reimbursement is less than half the amount of our costs. They
expect the small amount they pay the surgeon to cover all the costs of
caring for the patient. This would be fine except they only pay the surgeon
about $1000 per surgery and they expect that amount of money to pay for the
employees salaries, utilities, supplies, etc. which is at least 5 times that
amount. If they would pay us what they paid a hospital to perform the same
service then that would be fine, but the hospital lobby spends millions to
prevent such actions. This is
why recently Dr. Mork decided to "opt-out" of Medicare. We didn't want to do
this but Medicare itself doesn't understand their own rules and we would get
different responses from different people which would amount to getting paid
only some of the time. Unfortunately, at the end of the
month, our employees want to get paid, utilities want their reimbursements,
and the government wants their taxes and at 20 cents on the dollar for
outpatient spinal surgery, Medicare just cannot be accepted. The IRS doesn't
view "free or discounted healthcare" as charity and thus you can't even get
a tax break for lost revenue. We are still contracted with Medicare for
every other issue, except for Dr. Mork's services. We truly want to help the elderly population but
unlike the government, we cannot run a deficit and survive. the only
solution for us is to eventually buy or convert to a hospital and given the
government regulations this won't happen soon.
BCBS has decided not to contract with MicroSpine even
though several state senators, local businesses, and nearly a thousand
potential patients requested it. Their reasons included that they have an
over-abundance of spinal surgeons in our area and there is currently no
further need. This is amazing when the media states that there is a doctor
shortage. We continue to request that patients and potential patients call
or write their BCBS representative and request that BCBS contract with
MicroSpine. We will continue to attempt to contract so as to reduce your
expenses and ask you to call or write your BCBS provider and ask them to
contract with us. CLICK HERE to see the denial
letters from BCBS. |
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