$30,000 down to $1,000, and we put more patients on payment plans."
Further straining operations were new ICD 10 and 11 codes, a new
EMR system and insurers requiring additional nerve testing before
they would cover a procedure.
"Things got very convoluted," says the former employee. "Before,
the patients showed stenosis on an MRI and boom, surgery. Now we
had to show additional nerve testing. A lot of insurance requirements
muddied the waters."
Laser Spine tried to counter by taking advantage of ancillary billing
opportunities (first-assist billing codes, for example) and different
staffing models (instead of using an anesthesiologist in every case,
they'd use CRNAs with an anesthesiologist supervisor), says the for-
mer employee.
There were always skeptics of Laser Spine's clinical model, namely
competing surgeons who doubted the lasers were anything more than
a marketing gimmick. "In my opinion, I feel it had no merit, and it was
extremely expensive," says Stephen Banco, MD, president of
Keystone Spine and Pain Management Center in Wyomissing, Pa. "I'm
not sure any of it was clinically proven ever. I think laser surgery is
dead."
3. Litigation woes
The company didn't just have problems changing its business model.
It also faced mounting costs from litigation.
For years, the company fought a lawsuit from a competing surgical
group that claimed the founders of the Laser Spine Institute stole its
business idea and owed a large share of its profits. In December, a
Florida appeals court ruled against Laser Spine in the years-long legal
battle, saying it owed at least $264 million in damages.
Last year, a jury awarded $20 million to the family of an Ohio
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