Pain Management Insurance FAQ - Post by Teresa McPherson, CEO

 

 
In today’s world and the ever changing coverage and rules of health insurance it is sometimes difficult to know if you are choosing the right medical coverage for yourself.   Here are the most common questions patients ask me:

How can I find out if a doctor is in network with my Insurance plan?

This information can be found online these day’s via your insurance plan website.  If unsure about how to access and find this information as some sites may not seem user friendly you can also call your insurance carrier and inquire.  There is a member phone number on the back of your insurance card.  Once you confirm that your doctor or doctor you are being referred to is in network this means services provided to you will be processed at a contracted fee schedule.  Co-pays, Co-insurance and Deductibles will still apply to the patients responsibly per the plan you have chosen.

Is my doctor’s office responsible for checking my coverage and benefits?

 

No.  As with most insurance the patient’s benefits can be quite vast with all the different plans available to choose from.  Also some insurance plans require prior authorizations for certain or all services rendered depending on your chosen plan such as HMO’s and Managed Care and Replacement plans for Medicare.  However, here at Central Florida Pain Management we verify your coverage and any prior authorization as a courtesy to our patients to help ensure your services will be reimbursed by your plan and also to help eliminate any unexpected out of pocket cost to you.  Remember coverage can change between the time it is verified and services are rendered.  The benefits are the patient’s responsibility to know and understand.

 What if my policy changes?

Your insurance carrier must notify you of any changes to your policy or coverage cancellation.  However, keep in mind it is ultimately the patients responsibility to keep current on any and all changes.

How will I know if I need Prior Authorization?

Some insurance plans require prior authorization for certain or all services in order for the services to be paid. We here at Central Florida Pain Management will call to obtain authorization with the many plans we are participating with.  However, it is your responsibility as the patient to know if your insurance requires prior authorizations.

 

Remember all insurance plans should provide you with a policy and coverage handbook.  You can also contact your health plan via phone by calling the member phone number on the back of your insurance card and customer care will be able to answer any questions you have regarding your policy.

 

 

Blog by: Teresa McPherson, CEO

Bella's second PlayDate!

Bella's second play date. This time with Jazmine.  Ashley, our office mangers, Catahula Leopard Dog. 

Bella is loving her vacation!

Bella Pain Management Therapy Dog on a PlayDate!

Bella's Playdate video!

Bella and Emmy playing together during a sleepover. 

Emmy is Teresa, our CEO's, yellow Lab.

Spinal Cord Stimulator Central FL Pain Management - Blog by Cesar A. Euribe, M.D.

WILL a Spinal Cord Stimulator HELP MY PAIN??

 

Amongst the different modalities that help our patients in pain, there is one that stands ahead of the rest. IT CAN BE TRIED BEFORE IT IS ACUALLY IMPLANTED.  

 

A trial of spinal cord stimulation is always done on patients that we consider good candidates for neuromodulation.  The trial helps us determine the benefits our patient can get with SCS  therapy. 

The indications to consider the use of SCS for pain control have increased over the last 25 years. It is available to patients with CRPS,  post Herpetic Neuralgia, failed back surgery syndrome, phantom pain, lumbago, radicular pain (sciatica), claudication  secondary to poor perfusion.

Also the technology has exponentially gotten better in the last 10-15 years.  Making amazing progress in the quality, size, number of electrodes in a lead, paddle leads for implants, computer programs and algorithms, battery capacity and many other improvements. A comparison can be made to the improvements that cell phones have been through in the same period of time.

 If you suffer from chronic pain caused by one of the conditions described above, you are concerned about using powerful and dangerous drugs, the procedures no longer help you and pain is still limiting your life, CONSIDER A TRIAL OF SCS.

 NEUROMODULATION via spinal cord stimulation is one very important tool in the available therapies used by Pain management specialists.

Go online, learn more and remember YOU WILL ONLY COMMIT TO TRYING IT FIRST AND SEE IF IT WORKS.

WE CAN HELP YOU

FIRST DO NO HARM

 

 

 

Blog by: Cesar A. Euribe, M.D.

Comprehensive Care - Mr. Dan McLaughlin PA-C

Comprehensive Care

 Video: Mr. Dan McLaughlin PA-C

Plan of Care

Why a “plan of care”

FIRST DO NO HARM                                    

After an appropriate evaluation, diagnostic studies and assessment, providers present their patients with a plan of care. Plans of care should be based on the patient’s “needs” not “wants”. The current scientific knowledge, training and experience of the provider will govern the best plan for that particular patient. Some plans are very clear cut and based exclusively on science and findings such as surgically removing the appendix on a patient with appendicitis. Others are more complex and hard to be universally accepted and subject to many opinions by the patient, the provider, the family and even sometimes the insurance companies.

Unfortunately pain management plans of care are more like the latter. Subject to controversy and debate by many.

Those who are trained and boarded as subspecialists in pain management, try very hard to deliver a plan of care that is within the current science and acceptable pain practice. Experience and training play a very important role in the development of a scientific good treatment plan. However we constantly face challenges because of the different “opinions” that some patients and some providers have. They go from one extreme to another, nothing more controversial than pain drugs. 

A good, scientific plan of care must

a)     establish medical necessity.

b)     prescribe appropriate medications for the medical condition.

c)      obtain diagnostic tests that are needed

d)     prescribe any procedure or intervention needed

e)     refer in consultation for other services that might benefit the patient.

f)       provide follow up care and future support.

 

Most of all we must follow the accepted reasoning of FIRST DO NO HARM when we develop a scientific plan of care.


Cesar A. Euribe, M.D.

A doggie named Max - Post by Cesar A. Euribe, M.D.

 

A DOGGIE NAMED MAX

 

About 12 years ago I made the decision to get a dog. I had been reading about how appropriately trained dogs were helping care for patients suffering chronic pain, cancer or other debilitating conditions. Doggies were able to provide calmness, comfort and emotional support to many of these patients.

So, a 2 ½ month old yellow lab became part of my life both at home and at the office. Any possible doubt about my decision, disappeared from my mind after my new friend “Max” met most of the expectations we had for a therapy dog.

As a young puppy Max underwent several months of crate training, obedience and therapy schools.  My wonderful co-workers helped me so much and delivered consistency. After all of that, out emerged a wonderful, comforting, well trained and liked dog.

Max served our patients for the rest of his privileged life, he provided comfort and attention to so many people, and yes he was privileged for having been well cared and actually have added purpose to his comfortable life. I am not a dog lover who fanatically considers dogs as almost human. Max did teach me a lesson of respect for animals and being responsible for another life.

Max passed from complications of diabetes and seizures. He was made comfortable and remained working during the 2 years he lived after his diagnosis.

We now welcome BELLA a sweet puppy who if lucky, will have the same wonderful life Max had, Her master is Mr. Dan McLaughlin, PA. She has been coming to the office for over a month now. Looks very promising.

 WELLCOME BELLA to the CFPM family.

 

 

Remembering Max - A video segment in honor of our very own Max

 

Written by: Cesar A. Euribe, M.D.

Why can't you believe me? - By Cesar A. Euribe, M.D.

Todays Blog:

Why Can't you believe me?

Written by: Cesar A. Euribe M.D.

 

Pain has only been considered more then just a symptom for the past 30-40 years.  During this time we have been able to learn and discover many amazing things.  Scientists began to identify how many pain conditions were actually unrelated to the cause of pain initially.  They also have identified how our bodies neurological pain pathways are different than the sensory pathways physicians have always considered the same.  Pain was thought to be the over-stimulation of the sense of touch and traveled to our brain by using the same nerves as touch.  We recently discovered the multiple opioid receptors we have which when activated they produce profound pain relief.  Since they also induce the release of the most powerful "pleasure" producing substances in our brain, they can be highly addictive. "They are like the good, the bad, and the ugly".
 

The study of pain is still in its early phases. We have learned and understand a lot more, however, we are like the treatment of diabetes was at it’s early beginnings.  People have been aware of diabetes for thousands of years but it took ages to discover how to completely treat it as we do today. 

Unfortunately, scientists have not discovered tools to measure or document pain as of yet. Pain Management physician's have to simply accept the patient’s description of pain and believe it as true and accurate.  The patients explanation of how much pain they are in or if the patient is even in pain, becomes a pure act of faith.   Therefor, as any subjective situation in medicine it becomes complicated and for the “pure scientists” find this fact difficult to accept.  Because of the medications we use it also lends itself to manipulation and lies of the part of a few.

 

WE IN PAIN CARE WANT TO BELIEVE IN ALL OUR PATIENTS’ COMPLAINT OF PAIN, but because of the bad apples who complain mainly for secondary gain (like money, work, etc.) we are forced into questionable doubt.

Do you have questions?

 

Contact our doctors here at Central FL Pain Management here in the contact us section, or give our office a call.

  

 

Our Therapy Dog - Bella

Central Florida Pain Management - Treating Pain