Back to the billing of insurance issue. I do not know Dr. Denkler but I work in a field where insurance is used. We do not accept insurance, nor do we bill insurance. We provide forms for clients to send into their insurance for reinbursement. We will help the client to get reinbursed.

It can take up to 6 months or more for insurance to reimburse a patient, and who knows how much the insurance company will or if ultimately pay. Then you have to chase the patient down to hopefully get the balance due.

Accepting insurance or not has nothing to do with being competent. If a practioner can survive without accepting insurance, then why would they?

I imagine Dr. Denkler would rather practice than become a collection agency.

Lori

Randy H wrote:
"Typically NA is charged by the finger, regardless of the degree of contraction. At no charge, Eaton did some palm work on tissue leading to fingers other than the one he straightened. This kind of consideration and dedication to the patient is common among American NA surgeons. I've personally met three of them and talked to a number of others. A "self selecting" good bunch of guys. No one forces them to do NA."
Well said. I fully agree that these "self-selecting" doctors are in a class by themselves.
The NA done by Dr. Denkler on my hand released cords 4 cords - one affecting my thumb and one affecting my pinkie, and 2 others in the palm not yet causing contraction.

Just found out that my insurance (HMO plan) won't cover NA because there are other more traditional options and it has a high recurrance rate. They will cover the surgery for over ten thousand, but not an $1150 NA charge ($850 for one finger and a $300 surgery center charge.) I expected the $850 fee but I was disappointed at the extra $300 charge. I thought the NA docs could do this procedure easily in their office exam room. My options are waiting and changing my ins. plan next year to BC or going through with the NA and filing an appeal with the HMO. I don't want to wait since my contracture seems to be worsening. Anyone make a successful appeal for coverage of NA?

I successfully contested my HMO's refusal to cover NA four and a half years ago. The letter is to bigger than what is allowable on this website. Send me your email address and I will send a copy of it.

Steve Abrams
smabrams at chorus.net

Just so you guys know, the local BC/BS insurer here reimburses surgeon just under $500 for NA and about $675 for open procedure. All the other costs paid (and for open, that means hospital or day surgery OR costs) do not go to the surgeon. In fact, usually the hospital gets about $5000 and the anesthesiologist gets a little more than the surgeon.
As a surgeon, I would much rather you come to my office and we fix this directly with you or your insurance company paying $500 for the procedure and $125 for the office eval than you or your insurace company spending $5-7000 of which 90% goes God knows where. This is why the health care system is broken.
When I first opened my private practice, I was cash pay - we bill your insurance once but you are responsible for collecting from your insurer. This allowed me to avoid having an office staff hired solely to deal with insurance companies. It was great. Very direct patient care. Unfortunately, it is not a sustainable model anymore and we're doing things the traditional way now, you pay just the co-pay, my fees are much higher, insurance is billed, they pay 6 months later, I pay billing company, pay my interest for floating the insurance company a loan, pay my office staff for dealing with insurers and end up with slightly less than when I was cash pay. But the system pays about twice what it cost when there weren't 600 middlemen and 200 pieces of paper/electronic data exchanged.
Since every insurance company has about 100 different plans with different rules and different payment rates and there are probably 20 insurance companies covering N CA, I imagine Denkler just wants to simplify life. Extra paperwork and headache equal wasted time and money.
Insurance companies unload this burden on the doc, some docs then unload this onto the patient. Docs and patients suffer while insurance companies and hospitals make money. Sorry for the downer slightly-off-topic post, but the system is definitely broken.