Auto Insurance Primer What is auto insurance? Auto insurance (or car insurance, motor insurance) is insurance consumers can purchase for cars, trucks, and other vehicles. Its primary use is to provide protection against losses incurred. By buying auto insurance, depending on ... Health Insurance Lead and Health Insurance Leads Health insurance lead generation systems provide a stead stream of potential clients for health insurance brokers. Health insurance leads are considered to be people who may need health coverage to supplement the health coverage provided by their ... Life Insurance Benefits Life Insurance is a legal contract between you and a life insurance company with the purpose of providing an income to spouse, children or other beneficiaries in the event of your death. There are two different categories of Life Insurance. Term Insurance ...
Laser Eye Surgery – Will Insurance Pay? Determining the Medical Necessity of “Cosmetic” Treatments
Eye wear may be a fashion accessory, but when you depend on it for seeing the world, it's a lot more. Today, many people are turning to refractive laser eye surgery, such as Lasik surgery, to improve their vision. However, this high-cost surgery is normally not paid for by insurance because it fails to meet the conservative therapy test and is classified as cosmetic. This trend is shifting. We are seeing an increasing number of circumstances where refractive eye surgery is determined to be medically necessary and, therefore, payable by the insurance provider. For example, if conservative therapy treatments fail or if a patient is intolerant of contact lenses and cannot wear glasses because they might pose a risk in their job (e.g. police or firefighters), refractive eye surgery may be the most medically viable treatment option. Conservative Therapy Options: Examples of conservative therapy treatments include the following: Photorefractive keratectomy (PRK) – a refractive laser surgical procedure that is often done (and covered) for a patient that suffers from recurrent corneal erosion (e.g. diabetics). With PRK, a laser is used to remove corneal tissue to correct vision problems. Patching, epithelial debridement (mechanical removal of faulty tissue), and bandaged contact lens placement – treatments that often don't work. Stromal puncturing – a procedure involving the physician puncturing the anterior corneal stroma – can also be used but can fail or result in permanent vision loss. In such cases, PRK is the best alternative for removing the damaged cells (or membranes) and possibly correcting the vision problems. Physicians can help patients who are in medical need of laser eye surgery make a stronger case by initiating the following: Document a full medical history of the patient's eye complaints Show proof that the patient has not responded to conservative treatments and that the purpose of the surgery is for medical reasons other than simply improved eyesight Still, even when the physician does this, each decision is taken on a case-by-case basis and is subject to the extenuating circumstances clearly noted in the patient's medical record. For more information about medical necessity reviews on cases like this, visit our website or call us at 1-800-400-9916.
About The Author
AllMed Healthcare Management Founded in 1995, AllMed (http://www.allmedmd.com, http://www.allmedmd.com/blog/index.htm) is a URAC-accredited Independent Review Organization (IRO) serving insurance payers, providers, TPAs and claims managers nationwide. Reviews are conducted by board-certified physicians in active practice. AllMed's growing customer base includes premier organizations, such as Educator's Mutual Life, IMS Managed Care, Tenet Healthcare Corporation, HealthGuard, several Blue Cross Blue Shield organizations, TriWest Healthcare Alliance, Allianz and many other leading healthcare payers. info@allmedmd.com
Insurance News
Aon’s bribery fine is a major milestone - Global Reinsurance Online The Financial Services Authority’s (FSA) £5.25m fine against Aon for failing to prevent bribery overseas is a step forward in the fight against corruption, but the UK authorities still have much work to do. Unlike the US, which takes enforcement ...
PennyMac, Led by Ex-Countrywide Head, Sees Promise in Bad Loans - Bloomberg Jan. 8 (Bloomberg) -- Stanford Kurland, the former Countrywide Financial Corp. president, says his new company’s purchase of $558 million in home loans issued by a failed Nevada bank will be a springboard for further growth. Private National ...
Pink slips pile higher amid deepening recession - Asbury Park Press WASHINGTON — Pink slips are piling higher as companies scramble to cut costs even deeper to survive the country's economic and financial storms. Just days into the new year, managed care provider Cigna Corp., aluminum producer Alcoa Inc., data ...
Did Ramalinga Raju siphon off money? - Economic Times MUMBAI: Did Satyam Computers promoter-chairman Ramalinga Raju pick the lesser of two crimes when he decided to confess to India’s largest-ever corporate fraud of Rs 7,136 crore? That’s a question that had begun to niggle a few people on Wednesday ...
Obama Plan for Government Insurance Criticized by GOP (Update2) - Bloomberg Jan. 8 (Bloomberg) -- President-elect Barack Obama’s plan to have new government health insurance compete with private coverage drew Republican fire at a nomination hearing for Thomas A. Daschle to run the Health and Human Services Department ...
Is it time to ditch medical insurance? - Times Online This time last year the UK's private health industry was on a roll. The number of people covered by medical insurance (6.5 million) was at a record high, with many more dipping into their own pockets to “go private”. Today the future is not so ...
