Actipatch/RRx vs (Diapulse, Sofpulse, etc.) At
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Posted On: 10/11/2022 3:35:26 PM
Actipatch/RRx vs (Diapulse, Sofpulse, etc.)
At first glance, I am cautiously optimistic. It is dated 01 Sept '22, calls itself a medical policy, # CS035.K and does provide 5 actual HCPCS Code for an "Electrical stimulation or electromagnetic wound treatment device ". It looks like an official document. I very much want to be over-the-moon excited.
The underlined phrase describes RecoveryRx, perfectly. And CEO Kelly has stated that RRx is to be insurance reimbursable, or words to that effect. Bureaucrat-ese is not my forte. Thank God for small favors. The document seems to focus on ulcers that are unresponsive after 30 days of conventional treatment. BIEL has had clinical evidence on their website for years directly related to unresponsive ulcers and how PEMF provided unparalleled healing in record time. And this is where my cautious optimism ends, unfortunately. The following paragraph, taken from pg. 2.
I wonder if they say the same for opioids??? They cover opioids, don't they? This is exactly why I hate insurance companies. 'Yes' is not in their vocabulary. But they damn sure have a kazillion ways of saying "claim denied!". They love covering treatments that manage your condition but not curing it. There's no money in cures. Deceit is massively profitable. The ninth circle of Dante's hell is too good for these effin' pieces of shite. Insurance companies are notorious for implying one thing and doing another.
I know for a fact that claims reps for WellPoint (competitor of United Healthcare) are 'incentivized' for minimizing claims dollar amount. It was told to me face-to-face by an actual claims rep. They will cut off your coverage if you are late one minute in paying premiums but take months for the tiniest claim. I have experience w/ that, too. There are many evils in our world today and insurance companies are very near the top of the list.
The lukewarm, milquetoast statement from - Clinical Practice Guidelines American College of Physicians (ACP), pg. 7 - provides no relief. At the end of the same page, FDA section ironically enough, they mention 2 devices, Diapulse and Sofpulse (Endonovo, remember them?). Diapulse received a device class 3 license in 1987 and in 1996 for Sofpulse. In 1997, Sofpulse got a FDA 510(K) clearance. Over 20 yrs ago, ouch! At least they didn't mention TENS. Not a word about Actipatch, RecoveryRx or Bioelectronics. We got full musculoskeletal clearance in Jan 2020, have 4 other clearances, product sold worldwide, and yet not a word. An oversight, I'm sure. We are in the politics business.
So, I went to the Diapulse website (www.diapulse.com) and typed in 'FDA' into the site's search engine to get "Nothing Found". Fancy that, nothing found related to the FDA, as in they don't have FDA clearance but that didn't stop United Healthcare from citing said company, Diapulse, in this report. Diapulse also has Medicare coverage. The company has been in existence for 60 yrs. There's your answer. They've kissed more ass and greased more palms. Go to https://www.sofpulse.com/fda-statement and read their FDA statement. CYA, much? What a farce. Yet both of these companies were mentioned specifically in this UnitedHealthcare® Community Plan Medical Policy.
Think VHS vs BETAMAX. (https://medium.com/swlh/vhs-vs-beta-the-story-of-the-original-format-war-a5fd84668748) We have the far superior technology, by a long shot. The V vs B analogy is apt. We need to be smart and do what needs to be done. Insurance reimbursement is a must-have. OEMs are great as are distributor agreements but reimbursement is a whole other level. It pains me to be so cautious when reviewing this document but 'counting chickens ...' and all that. Experience is a harsh, unrelenting teacher. When BIEL issues the press release announcing insurance coverage, or the equivalent, I will celebrate along w/ all of you. Fingers crossed.
later, WBeacham
At first glance, I am cautiously optimistic. It is dated 01 Sept '22, calls itself a medical policy, # CS035.K and does provide 5 actual HCPCS Code for an "Electrical stimulation or electromagnetic wound treatment device ". It looks like an official document. I very much want to be over-the-moon excited.
The underlined phrase describes RecoveryRx, perfectly. And CEO Kelly has stated that RRx is to be insurance reimbursable, or words to that effect. Bureaucrat-ese is not my forte. Thank God for small favors. The document seems to focus on ulcers that are unresponsive after 30 days of conventional treatment. BIEL has had clinical evidence on their website for years directly related to unresponsive ulcers and how PEMF provided unparalleled healing in record time. And this is where my cautious optimism ends, unfortunately. The following paragraph, taken from pg. 2.
Quote:And this from pg. 6 -
The following list(s) of procedure and/or diagnosis codes is provided for reference purposes only and may not be all inclusive. Listing of a code in this policy does not imply that the service described by the code is a covered or non-covered health service. Benefit coverage for health services is determined by federal, state, or contractual requirements and applicable laws that may require coverage for a specific service. The inclusion of a code does not imply any right to reimbursement or guarantee claim payment. Other Policies and Guidelines may apply.
Quote:
Electromagnetic Therapy - There is limited evidence in the published scientific literature to support the use of electromagnetic therapy for treating chronic wounds and ulcers. The data from clinical trials are insufficient to prove efficacy or to evaluate the effects of this therapy compared with other treatment options. << 100% pure bullshit >>
I wonder if they say the same for opioids??? They cover opioids, don't they? This is exactly why I hate insurance companies. 'Yes' is not in their vocabulary. But they damn sure have a kazillion ways of saying "claim denied!". They love covering treatments that manage your condition but not curing it. There's no money in cures. Deceit is massively profitable. The ninth circle of Dante's hell is too good for these effin' pieces of shite. Insurance companies are notorious for implying one thing and doing another.
I know for a fact that claims reps for WellPoint (competitor of United Healthcare) are 'incentivized' for minimizing claims dollar amount. It was told to me face-to-face by an actual claims rep. They will cut off your coverage if you are late one minute in paying premiums but take months for the tiniest claim. I have experience w/ that, too. There are many evils in our world today and insurance companies are very near the top of the list.
The lukewarm, milquetoast statement from - Clinical Practice Guidelines American College of Physicians (ACP), pg. 7 - provides no relief. At the end of the same page, FDA section ironically enough, they mention 2 devices, Diapulse and Sofpulse (Endonovo, remember them?). Diapulse received a device class 3 license in 1987 and in 1996 for Sofpulse. In 1997, Sofpulse got a FDA 510(K) clearance. Over 20 yrs ago, ouch! At least they didn't mention TENS. Not a word about Actipatch, RecoveryRx or Bioelectronics. We got full musculoskeletal clearance in Jan 2020, have 4 other clearances, product sold worldwide, and yet not a word. An oversight, I'm sure. We are in the politics business.
So, I went to the Diapulse website (www.diapulse.com) and typed in 'FDA' into the site's search engine to get "Nothing Found". Fancy that, nothing found related to the FDA, as in they don't have FDA clearance but that didn't stop United Healthcare from citing said company, Diapulse, in this report. Diapulse also has Medicare coverage. The company has been in existence for 60 yrs. There's your answer. They've kissed more ass and greased more palms. Go to https://www.sofpulse.com/fda-statement and read their FDA statement. CYA, much? What a farce. Yet both of these companies were mentioned specifically in this UnitedHealthcare® Community Plan Medical Policy.
Think VHS vs BETAMAX. (https://medium.com/swlh/vhs-vs-beta-the-story-of-the-original-format-war-a5fd84668748) We have the far superior technology, by a long shot. The V vs B analogy is apt. We need to be smart and do what needs to be done. Insurance reimbursement is a must-have. OEMs are great as are distributor agreements but reimbursement is a whole other level. It pains me to be so cautious when reviewing this document but 'counting chickens ...' and all that. Experience is a harsh, unrelenting teacher. When BIEL issues the press release announcing insurance coverage, or the equivalent, I will celebrate along w/ all of you. Fingers crossed.
later, WBeacham
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