Insurance companies are often their own worst enemies when dispensing prosthetic care. It is based on ignorance, preconceived notions, and the desire to save money every time as opposed to overall. The truth is, good care saves money, not cheap care. And the sooner they realize this, the better off everyone will be... including the insurance companies!
Over half of the time I work with insurance companies they have over-paid for patient services prior to working with me. This takes many forms, some subtle, some not-so-subtle. Honesty in your business relationships should be most important. Without that, you have no hope of achieving a fair deal. For insurance companies it mean abiding with your agreements, keeping your word and not covering your behavior with technicalities and caveat's. For prosthetists it means doing a quality job.
Many insurance companies are shocked to find that large prosthetic companies cannot provide many of the services that Genesis provides in house, and that they pay top dollar to these companies that will resort to mail order care that needs to be marked up so that they can profit as a middle man. While "customary" care definitely has its place, on average the unique services Genesis offers can save money overall to insurance companies or at least give better value. Networks only assure agreements, not quality.
All of Genesis legs are offered with a cosmetic finish as standard, and at no extra charge. Since our prices are typically average, paying network providers for less care means less value for the patient and for you!
Anaplastologists and maxillo-facial prosthetists are very rare throughout the United States and abroad. I, David Van Auker, am one of those practitioners. I have seen insurance companies pay for expensive ear reconstructions (approximately $30K, and with little hesitation) that need to be redone, and have led to these patients to finally being referred to an in-network "prosthetist" who will provide an ear prosthesis through a mail order fabrication service for almost 50% more than I charge so they can profit in the transaction. The insurance company overpays, and the patient receives a piece that usually does not fit properly or match them in shape or color. Good prosthetic care would have saved the insurance company considerable costs, approaching the cost of the better part of a lifetime of prosthetic care by a qualified facial prosthetist! And with a life potential for income from a potentially insured patient! Now it will take years to recoup that from the insured payments, if they continue to be carried!
More examples coming soon....
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