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 is the number one thing spine practices should look for in electronic medical records?
by Thursday, Nov. 21, at 5 p.m. CST.
Q: What regulations cause the most headaches at your spine practice?
A. Nick Shamie, MD, American College of Spine Surgery President: I am getting more denials for advanced imaging and surgeries than ever before. This takes time away from patient care and is disruptive. I spend time in the middle of my day speaking to payor representatives who are physicians or ancillary care providers who have very little to no experience in spinal disorders. It takes longer to try and explain a condition to these individuals who have limited training in the field of spine care. These are regulatory burdens than are placed on us by the payors and can create inefficiencies and are counterproductive.
One suggestion would be to have spine specialists review authorization requests; this would avoid unnecessary denials and would allow us to focus our efforts on patient care. Also to have these representatives available before and after the regular working hours so we don't have to take time away from our patients.
Jeffrey Wang, MD, UCLA Spine Center: The documentation issues and the requirements are probably the biggest headache. The arbitrary decision that certain things in a review of systems that have to be mentioned, even if they are negative and have nothing to do with the acute problem, has been a big problem. We find physicians in our practice charging less for their services just because of concerns with following specific documentation rules that appear to be quite arbitrary.
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What Regulations Cause the Biggest Headaches for Spine Surgeons? FeaturedWritten by Laura Miller | Wednesday, 14 November 2012 11:04
Two spine surgeons discuss the regulations that cause the biggest headaches at their practices.Last modified on Wednesday, 14 November 2012 11:09
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