Three spine surgeons discuss best tips for developing productive relationships with payors. Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses. Next week's question: What advice would you give to a spine surgeon just beginning his or her career?
Please send responses to Heather Linder at hlinder@beckershealthcare.com by Wednesday, Jan. 27, at 5 p.m. CST.
Jeffrey Wang, MD, UCLA Spine Center: I think communication and education are the keys. [Insurance companies] are trying to make a profit and still satisfy their customers. We are trying to do the best for our patients, and doing what is right. We also want to mindful of the costs, but our patient's well-being comes first. I would hope that they understand these concepts and try to make it easier for us to take care of our patients. The best tip is to understand their point of view and try to communicate with this in mind. Unfortunately, often times the representatives of the payors are looking at cost savings rather than patient care. If you try to see their viewpoint, it will help you understand why they do what they do. You still may not agree with them, and often I do not agree with them, but I try to understand them.
Jeffrey Goldstein, MD, Director of Spine Service, NYU Langone Medical Center's Hospital for Joint Diseases: Try to work "with" payors and not against them. If you approach a payor with disdain it only makes it easier for them to respond to your fury and not to your concern regarding your patient. Understand the level 1 evidence that supports your treatment plan. Always advocate for your patient and follow through on appeals. Remember, your patient is their best advocate. Keep them involved. You are your patient's physician and nobody knows your patient's condition and treatment options better than you. There is help out there. There are advocacy resources such as the International Advocates for Spine Patients, an affiliate of ISASS. Additionally, there are other resources to help you and your patients achieve their goals such as the Better Way Back. Take advantage of these resources and focus on what is best for your patient.
Ara Deukmedjian, MD, Neurosurgeon and CEO, Deuk Spine Institute, Melbourne, Fla.: Go out of network. Payors simply don't want a productive relationship with you if you plan on costing them any money. I recommend you approach your payor relationships with caution. There are many ways to not get paid for the services you render and only one or two to get what you deserve.
More Articles on Spine:
8 Payor Trends for Spine Surgery to Watch
CEO Daniel Goldberg to Advise Physicians on Generating Patients at ISASS Conference
Dr. Morgan Lorio: Current Concepts in Vertebral Augmentation
Please send responses to Heather Linder at hlinder@beckershealthcare.com by Wednesday, Jan. 27, at 5 p.m. CST.
Jeffrey Wang, MD, UCLA Spine Center: I think communication and education are the keys. [Insurance companies] are trying to make a profit and still satisfy their customers. We are trying to do the best for our patients, and doing what is right. We also want to mindful of the costs, but our patient's well-being comes first. I would hope that they understand these concepts and try to make it easier for us to take care of our patients. The best tip is to understand their point of view and try to communicate with this in mind. Unfortunately, often times the representatives of the payors are looking at cost savings rather than patient care. If you try to see their viewpoint, it will help you understand why they do what they do. You still may not agree with them, and often I do not agree with them, but I try to understand them.
Jeffrey Goldstein, MD, Director of Spine Service, NYU Langone Medical Center's Hospital for Joint Diseases: Try to work "with" payors and not against them. If you approach a payor with disdain it only makes it easier for them to respond to your fury and not to your concern regarding your patient. Understand the level 1 evidence that supports your treatment plan. Always advocate for your patient and follow through on appeals. Remember, your patient is their best advocate. Keep them involved. You are your patient's physician and nobody knows your patient's condition and treatment options better than you. There is help out there. There are advocacy resources such as the International Advocates for Spine Patients, an affiliate of ISASS. Additionally, there are other resources to help you and your patients achieve their goals such as the Better Way Back. Take advantage of these resources and focus on what is best for your patient.
Ara Deukmedjian, MD, Neurosurgeon and CEO, Deuk Spine Institute, Melbourne, Fla.: Go out of network. Payors simply don't want a productive relationship with you if you plan on costing them any money. I recommend you approach your payor relationships with caution. There are many ways to not get paid for the services you render and only one or two to get what you deserve.
More Articles on Spine:
8 Payor Trends for Spine Surgery to Watch
CEO Daniel Goldberg to Advise Physicians on Generating Patients at ISASS Conference
Dr. Morgan Lorio: Current Concepts in Vertebral Augmentation