tract.
"Some insurers will pay only the cost of the implant, some will
include an extra 1% to 3% for processing charges and some will reim-
burse a higher overall rate for the procedure to help offset the implant
costs," explains Dr. Bettin. "You need to have good communication with
your payers, a solid precertification process and make sure the cost of
the implant is covered before performing procedures."
Surgeons need to be aware of the cost of implants and the reim-
bursement contracts with third-party payers, adds Dr. Romeo. He
says, "When the cost of one implant is remarkably different than
another, and they both provide the same outcomes, the cost of the
more expensive device has to be negotiated lower, or the surgeon
should switch to the less expensive but equally effective device."
Seamless transition
When patients arrive for surgery, Dr. Bettin says they receive a nerve
block in pre-op to dull sensation in the injured extremity. The surgeon
fixes the fracture, and patients recover in PACU before being visited
by a physical therapist, who makes sure patients who suffered lower
extremity injuries can safely use crutches. Patients are then dis-
charged home with appropriate blood clot prophylaxis and receive a
phone call from the facility's nurses the next day to make sure recov-
ery is going well.
Aside from the ache of the injury, it's a painless experience for
patients.
"They're often discharged within 2 hours of leaving the operating
room," says Dr. Romeo. "If it's a hand or wrist fracture, we have them
in the center by 6 a.m., in the OR by 7, the case completed by 8:30 and
send them on their way home by 11."
Though it might seem like the unpredictability of fracture repair
cases would be chaotic to manage, Dr. Romeo says performing the
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