A day trip thru the medical swamp: sites, acronyms
Post# of 7807
(Total Views: 411)
Posted On: 07/17/2022 9:08:44 AM
A day trip thru the medical swamp: sites, acronyms, costs, jargon, options, menus, privatize me!, and other assorted mind-blowing garbage. IOW, anything besides clear, understandable information presented in a way that an average human being might have a chance of deciphering their inflated medical bill. This is what is facing BIEL as they try their level best to obtain the prized CPT code for insurance billing and coverage. And you wonder why they need outside help (consultants) to navigate this quagmire? Stay tuned and read on if you dare. It ain't pretty.
I typed in "CPT I codes" to search using DuckDuckGo search engine. I think BIEL has a better than average chance of getting the CPT I code but who really knows, eh? Will they try only for RRx or try for PEMF in general? Does it make a difference if RRx is prescription only? Does this low vs high frequency play into it? I opened the AMA site, then the CPT option. I know, I should have known better. The following is typical of why the med system is such a fawckin' mess.
Yea, good luck w/ that. $30 billion for health startups, whatever that means. Go ahead, click on it, see what you get. It's sickening to read. All about helping doctors, like they need it, and practically nothing about providing, you know, actual healthcare to the patient.
Back to the CPT business. The actual wording of requirements for a CPT I are encouraging. The following link gives a decent, understandable rundown of CPT categories I & III. It looks like it is from 2019 so it is 3 yrs old. Items (a) - (f) are the CPT I requirements.
https://medicarepaymentandreimbursement.com/2...s-and.html
a) the service/procedure necessary for the procedure has received approval from the Food and Drug Administration (FDA) for the specific use of devices or drugs;
b) the suggested procedure/service is a distinct service performed by many physicians or other qualified health professionals across the United States;
c) the suggested service/procedure and clinical efficacy of the service/procedure is well established and documented in peer review literature that meets the requirements set in the code change proposal form;
d) the suggested service/procedure is performed with the frequency consistent with the intended clinical use;
e) the suggested service/procedure is neither a fragmentation of an existing procedure/service nor currently reportable by one or more existing codes; and
f) the procedure or service is consistent with current medical practice.
These fit us (BIEL) like a glove. Now you can see why we are so keen to get physicians (and practices) using it in as many places as possible and fund as many studies as we can afford. The more the better to further the idea of a viable alternative to opioids and to establish RRx as a Standard-of-Care.
Here is the official website for CMS.gov. Medicare & Medicaid Services. Wade into the murky depths at your own risk. No lifeguard on duty.
https://medicarepaymentandreimbursement.com/2...s-and.html
Whether or not TENS is covered by insurance is indeterminate for me. I have tried to figure it out and got conflicting answers. If anyone has actual experience w/ this, or anything that sheds light on the whole insurance/CPT mystery, give me shout, please. It may have been at one time covered by CMS but now it seems to be on a case-by-case basis, however that is interpreted. The whole entire medical system was started by quacks and charlatans and continues to this very day. Money and control is first and foremost. Your good health is last, and in many cases, dead last.
I think now would be a good time to look at the competition. https://www.amazon.com/TENs-devices/s?k=TENs+devices - take a look at it, please. Several things can be learned examing all the available stuff. Each one has a controller, wires attached to pads (electrodes), controllers, and tubes of gel. Some of the brand names are: Belifu, Auvon, Neu medics, PUREMED, iReliev, iStim A6, Brilnurse, VPOD, Roscoe, Hollywog, MEDVICE, NURSAL, & MASTOGO. There were at least 6 more pages w/ even more brand names. Some packages included everything, others had bits and pieces for replacement. Controllers have a mash-up of dials, knobs, settings, etc. (on a 'smart' phone or separately) and is anybody's guess what works with what kind of ailment. No, thanks. I like the simplicity of my Actipatch. It works all the time, every time.
I don't know the origins of TENS or who was the first but this tangle of offerings can't be good; or not? Some of these had tens of thousands of 4-5 star ratings. One called 'TENS 7000' (made by Roscoe) had over 72,000 ratings, 79% w/ 5 stars! What to make of this? Is TENS that good? I don't really know as I have never used one. This one claims to have begun in 2008 but does not claim to have FDA clearance. For $29 (reg $37) you get 4 electrode pads, dual channel controller, a battery, 2 lead wires, user manual, and a carrying case. It does not say how long it will last and the legal disclaimer is enough to put anybody off.
TENS will never have what we have - Affordability, Convenience, Effectiveness (A.C.E.). For TENS, how portable is it? Can't use it for more than 60 min at a time w/ no claims to treat or heal the underlying reason for the chronic pain. Forget about wearing it discreetly to work; or while playing sports w/ it on; or wearing it continuously for 30 days, or wear it to bed. Adverse effects include painful vibration and tingling to actual skin burns to shoddy quality.
So, why are people buying all these TENS devices and giving it 5 star reviews? They are desperate to find relief, that's why. Chronic pain has been around for decades. Pills, lotions, gadgets & contraptions, injections are expensive, have limited and temporary effect, don't address the underlying issue, and many have dreadful, long-term side effects. It goes to show you to what lengths sufferers will go to for some relief. With insurance coverage, worldwide distribution network, and a continued awareness campaign (like Twitter currently, which is excellent), Actipatch & RRx will siphon off many TENS users much to the users' relief.
All the things I have mentioned above are addressed by BIEL's Actipatch and RecoveryRx, and all the other products we will offer. No adverse side effects ever reported in over a decade of use; full complete well-documented science in multiple studies easily available at bielcorp.com, more ongoing; well known companies as OEM partners (KT Tape, DonJoy, SAI, PRIM, etc.); available in 38 countries and many online outlets.
Assuming we do obtain a CPT I code (esp'ly RRx) this makes us a prime buyout/merger target; definitely on the auction block and in a very good way. Our value as a company would soar right off the page in a northward direction. I understand completely why the company will not just blurt out info in ref to where we are in the process. There is too much at stake. We still have to submit payment proposals to the insurance companies and negotiate from there. So there is work to be done. Counting chickens ... and all that. Seeing the finish line is no time to slacken the effort and assume victory. The last inch is as important as the first.
It is my belief BIEL will be successful in getting the CPT I code. If big pharma, AMA, FDA, had their way there would be no change at all. The medical establishment, especially in the last 2 yrs, has erased any credibility there might have been left over from the (ongoing) opioid disaster. As far as I'm concerned their collective reputation is in the toilet, where it belongs.
Let me say this in closing (about time!). Bringing in RecoveryRx as an antidote to the opioids would be a win-win-win. For the patients (w1); for us, the investors (w2); for the industry (w3). I'll leave you w/ these parting words -
BUY_MORE_SHARES
later, WBeacham
p.s. - if you are int'd in getting a copy of a prev post (R.I.P.) send me a pm.
I typed in "CPT I codes" to search using DuckDuckGo search engine. I think BIEL has a better than average chance of getting the CPT I code but who really knows, eh? Will they try only for RRx or try for PEMF in general? Does it make a difference if RRx is prescription only? Does this low vs high frequency play into it? I opened the AMA site, then the CPT option. I know, I should have known better. The following is typical of why the med system is such a fawckin' mess.
Quote:
Medicine’s language—CPT—opens for developers to test innovations - Digital health startups got nearly << $30 billion >> last year, but too often turn out products that burden doctors. AMA effort aims to help change that.
Yea, good luck w/ that. $30 billion for health startups, whatever that means. Go ahead, click on it, see what you get. It's sickening to read. All about helping doctors, like they need it, and practically nothing about providing, you know, actual healthcare to the patient.
Back to the CPT business. The actual wording of requirements for a CPT I are encouraging. The following link gives a decent, understandable rundown of CPT categories I & III. It looks like it is from 2019 so it is 3 yrs old. Items (a) - (f) are the CPT I requirements.
https://medicarepaymentandreimbursement.com/2...s-and.html
a) the service/procedure necessary for the procedure has received approval from the Food and Drug Administration (FDA) for the specific use of devices or drugs;
b) the suggested procedure/service is a distinct service performed by many physicians or other qualified health professionals across the United States;
c) the suggested service/procedure and clinical efficacy of the service/procedure is well established and documented in peer review literature that meets the requirements set in the code change proposal form;
d) the suggested service/procedure is performed with the frequency consistent with the intended clinical use;
e) the suggested service/procedure is neither a fragmentation of an existing procedure/service nor currently reportable by one or more existing codes; and
f) the procedure or service is consistent with current medical practice.
These fit us (BIEL) like a glove. Now you can see why we are so keen to get physicians (and practices) using it in as many places as possible and fund as many studies as we can afford. The more the better to further the idea of a viable alternative to opioids and to establish RRx as a Standard-of-Care.
Here is the official website for CMS.gov. Medicare & Medicaid Services. Wade into the murky depths at your own risk. No lifeguard on duty.
https://medicarepaymentandreimbursement.com/2...s-and.html
Whether or not TENS is covered by insurance is indeterminate for me. I have tried to figure it out and got conflicting answers. If anyone has actual experience w/ this, or anything that sheds light on the whole insurance/CPT mystery, give me shout, please. It may have been at one time covered by CMS but now it seems to be on a case-by-case basis, however that is interpreted. The whole entire medical system was started by quacks and charlatans and continues to this very day. Money and control is first and foremost. Your good health is last, and in many cases, dead last.
I think now would be a good time to look at the competition. https://www.amazon.com/TENs-devices/s?k=TENs+devices - take a look at it, please. Several things can be learned examing all the available stuff. Each one has a controller, wires attached to pads (electrodes), controllers, and tubes of gel. Some of the brand names are: Belifu, Auvon, Neu medics, PUREMED, iReliev, iStim A6, Brilnurse, VPOD, Roscoe, Hollywog, MEDVICE, NURSAL, & MASTOGO. There were at least 6 more pages w/ even more brand names. Some packages included everything, others had bits and pieces for replacement. Controllers have a mash-up of dials, knobs, settings, etc. (on a 'smart' phone or separately) and is anybody's guess what works with what kind of ailment. No, thanks. I like the simplicity of my Actipatch. It works all the time, every time.
I don't know the origins of TENS or who was the first but this tangle of offerings can't be good; or not? Some of these had tens of thousands of 4-5 star ratings. One called 'TENS 7000' (made by Roscoe) had over 72,000 ratings, 79% w/ 5 stars! What to make of this? Is TENS that good? I don't really know as I have never used one. This one claims to have begun in 2008 but does not claim to have FDA clearance. For $29 (reg $37) you get 4 electrode pads, dual channel controller, a battery, 2 lead wires, user manual, and a carrying case. It does not say how long it will last and the legal disclaimer is enough to put anybody off.
TENS will never have what we have - Affordability, Convenience, Effectiveness (A.C.E.). For TENS, how portable is it? Can't use it for more than 60 min at a time w/ no claims to treat or heal the underlying reason for the chronic pain. Forget about wearing it discreetly to work; or while playing sports w/ it on; or wearing it continuously for 30 days, or wear it to bed. Adverse effects include painful vibration and tingling to actual skin burns to shoddy quality.
So, why are people buying all these TENS devices and giving it 5 star reviews? They are desperate to find relief, that's why. Chronic pain has been around for decades. Pills, lotions, gadgets & contraptions, injections are expensive, have limited and temporary effect, don't address the underlying issue, and many have dreadful, long-term side effects. It goes to show you to what lengths sufferers will go to for some relief. With insurance coverage, worldwide distribution network, and a continued awareness campaign (like Twitter currently, which is excellent), Actipatch & RRx will siphon off many TENS users much to the users' relief.
All the things I have mentioned above are addressed by BIEL's Actipatch and RecoveryRx, and all the other products we will offer. No adverse side effects ever reported in over a decade of use; full complete well-documented science in multiple studies easily available at bielcorp.com, more ongoing; well known companies as OEM partners (KT Tape, DonJoy, SAI, PRIM, etc.); available in 38 countries and many online outlets.
Assuming we do obtain a CPT I code (esp'ly RRx) this makes us a prime buyout/merger target; definitely on the auction block and in a very good way. Our value as a company would soar right off the page in a northward direction. I understand completely why the company will not just blurt out info in ref to where we are in the process. There is too much at stake. We still have to submit payment proposals to the insurance companies and negotiate from there. So there is work to be done. Counting chickens ... and all that. Seeing the finish line is no time to slacken the effort and assume victory. The last inch is as important as the first.
It is my belief BIEL will be successful in getting the CPT I code. If big pharma, AMA, FDA, had their way there would be no change at all. The medical establishment, especially in the last 2 yrs, has erased any credibility there might have been left over from the (ongoing) opioid disaster. As far as I'm concerned their collective reputation is in the toilet, where it belongs.
Let me say this in closing (about time!). Bringing in RecoveryRx as an antidote to the opioids would be a win-win-win. For the patients (w1); for us, the investors (w2); for the industry (w3). I'll leave you w/ these parting words -
BUY_MORE_SHARES
later, WBeacham
p.s. - if you are int'd in getting a copy of a prev post (R.I.P.) send me a pm.
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