Ask Dr. C: Episode 9-Imaging Guidance and Insurance Coverage

It’s ask Dr. C time again! Here are our questions for today:

When getting stem cells and PRP, is it necessary to use the guidance system or can the Doctor simply look at MRI and use it to inject?

This is a great question as it gets to one of the points that I’ve been discussing for many years. Imaging guidance is absolutely required to perform stem cell procedures correctly and with the highest chance of success. So what does that mean exactly?

Imaging guidance is like driving your car to a specific destination. Now imagine that someone painted your front windshield and side windows black and asked you to drive to that same destination? Could you get there? Unlikely. That’s what trying to guide a needle to a specific site is like without imaging guidance. Would it be easier if you had a map and a blacked-out windshield? Nope.

In this analogy, the ability to see where you’re going is the clear windshield, which represents imaging guidance. The blind injection off an MRI without imaging guidance is the map with your windshield painted black. So no, having an MRI and no imaging guidance wouldn’t help to get the cells into the right place.

Let me give you another example. To help heal the ACL ligament, you must inject stem cells exactly into the ligament. Even with an MRI, without imaging guidance, what’s the likelihood that the doctor will be inside the ligament when the stem cells are injected? 1 in 10 or less. With imaging guidance (in this case fluoroscopy) what’s the chance that the doctor will be in the ACL? If he or she is properly trained, 100%

Are you guys actively pursing insurance companies to be a part of your network. I have wanted to go to you again, but unfortunately my United Healthcare insurance does not cover your services.

Regenexx is the only provider network offering orthobiologics like PRP and stem cells that has legitimate insurance coverage tied to various employers. We have been able to do this by having:

• A national provider network with very strict education requirements for doctors
• Standardized high-quality, image-guided procedures throughout the network
• Standardized processing of patient samples and treatment protocols
• Published research on exactly what we do
• A registry going back 15-years tracking patients

These contracts are with specific employers. We have about 7-8 million people covered now, but that’s just a drop in the national bucket. We will continue to expand that coverage and have been speaking with various insurance companies as well.

In the meantime, does any stem cell provider or solution have insurance coverage? NO! Why then do you hear from some clinics that they can get insurance companies and Medicare to cover amniotic or umbilical cord “stem cells”? That’s a billing scam that’s tricking these companies into inappropriately paying for something that they don’t actually cover. What will happen when they realize that they paid for something they shouldn’t? A clawback, which means the doctor and then you will be required to pay for this expensive procedure. To learn more, follow the link above or watch my video:

So while we may not yet have you covered, we’re working on it. If you want to check to see if your employer has decided to cover Regenexx, click here. In the meantime, don’t fall for Medicare or insurance billing scams where you will be in the middle of billing fraud and have to pay a bunch of money back!

Thanks for giving me great questions. I have some more good ones picked out to highlight this week!