The ESWT Company, LLC
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- Dr Adams DPM, Wauseon, Ohio
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- Dr Patel DPM, Cincinnati, Ohio
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Insurance Issues
Money Issues
Is shockwave therapy covered by most health insurance companies?
Presently, most health insurance companies consider Extracorporeal Shock Wave Therapy (ESWT) as either an elective treatment option or experimental. Therefore, just like many other FDA approved medical procedures, ESWT falls into a cash-pay category akin to laser eye surgery, infertility procedures, orthodontics, hair replacement and cosmetic surgeries.
The ESWT Company, LLC strives to make ESWT affordable for every patient. In fact, cash pay patients make up 86% of our caseload. Otherwise, patient financing is available for those who qualify.
The ESWT Company is not affiliated with any insurance companies. Our business plan is strictly cash-pay.
If shockwave therapy is so good, then why is it not covered by health insurance?
This is a good quesiton and The ESWT Company, LLC cannot provide a definate answer, but an answer based on speculation can be provided. Remember, this is an opinion and nothing more!
There are two sides to every coin and this story has two sides to it. On one side of the coin there was some isolated billing abuse going on when ESWT first started in the United States. It could be that this billing abuse may have been enough to throw up red flags when health insurance companies heard the term "shockwave therapy". As a result, there has been emnity between shockwave therapy and health insurance from the beginning, but that does not change ESWT's effectiveness.
Now for the other side of the coin.
Most health insurance companies are "for-profit" organizations. Like any company who is in business to make money, these for-profit health insurance companies are always looking out for the bottom line. In insurance it is all about numbers so look at the question from a numbers perspective. Assume 100 patients failed conservative treatments for plantar fasciitis and need to go on to a more aggressive treatment option. Most physicians say that 10 to 15 patients out of 100 are willing to have invasive surgery, which is covered by their health insurance, for plantar fasciitis. The rest decide to live with the problem. Why live with the problem? Click here to find out! However, given the option of ESWT, 100 out of 100 patients would elect to try shockwave therapy. Why? Click here to find out! Anyway, this may be the answer to the question of why insurance companies would rather pay for a more expensive treatment option. It is cheaper for them to pay for 10 to 15 patients having invasive surgery then it is to pay for 100 patients having ESWT. Once again, this is speculation, but it makes sense out of a system that makes no sense.
