October 14, 2009

PRP - Maybe Not For Me

I finally got the call today I've been waiting for - my podiatrist's office letting me know if I could move forward with the PRP treatment. Similar to an MRI, the procedure requires pre-authorization that can take a few business days. It sounded fine to me, but then the office called and explained the process: I pay a deposit and have the procedure; they submit the claim to my insurance company; they reimburse me when the claim is paid. The catch? The deposit is $1,200 and the timing of the claim can be three months or more. Even more troubling is that the insurance company could reject the claim.

I've already paid out of pocket for my orthotics and am really not in the mood to do the same for an interesting, but definitely unproven treatment. Here is an article. What would you do?

NY Times


  1. Ouch. For several reasons. I think I'd want to have a pretty good idea that the insurance company was going to cover this before signing up. And given that health insurance companies pay people very good money to deny claims, I think it's a safe bet they won't cover it. At least not willingly. The treatment sounds interesting. Not sure I'd want to be a guinea pig for it though.

    the word verification is hozin. Not sure if that's a sign or not.

  2. Very interesting. At first glance it almost looked like blood doping: remove blood, enhance it, reinject it. Of course, its not a lot of blood and its going right into a damaged area. I would hope it worked for the cost.

    What other treatment options are there for you?

  3. I'm in a similiar situation with my bum foot. We know that my insurance will not cover PRP, so we are trying to have them cover Prolotherapy. I guess there has been more work done with Prolo than PRP at this point so insurance is more willing to work with you on that, but it's still like 50-50 split of expenses. When the treatment is upwards of a 1000.00 and may or may not work, it's hard to commit to it.....

    My PT is trying Iontophoresis, which is covered by most insurance companies, to reduce inflammation and pain. So far it seems to be helping so I'm holding off for another week or to on more expensive out of pocket procedures...

  4. No clue on PRP, but I used prolotherapy very effectively for PF (mine was not ruptured). The office visit was covered, but the injections were not. In Madison, the injections are around $100 per site location so the out of pocket was reasonable. Since then I have been using prolo for a few other things, again with great success.

    Good luck.

  5. Sounds nothing like what I would term a "pre-authorization." My bet is this won't be approved. Plan on eating that expense, or try some good old fashioned rest instead.

  6. This is REALLY random, but if you have Suzy's email/blog I would love to know more about her experience with Prolo. Or anyone else that has gone through Prolo with positive or negative results.

    Or if you see this Suzy, shoot me an email! katietris@gmail.com

    Thank you bloggers. Ya'll rock! :

  7. Sounds like a promising treatment. Are there any studies going on in your area in which you could participate? Treatment would be free although you might have to take the risk that you were not randomized to active treatment. But if you were thinking of not getting the treatment it would not be a burden. Worth looking into.



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