Tailbone Pain: New Jersey, New York, Pennsylvania, Connecticut
INSURANCE:
Summary:
Dr. Foye's office accepts most insurance plans, but please check with your insurance companybefore your visit. Also check with Dr. Foye's office (973-972-2802) before
your visit.
Also, many insurance
plans require a referral (consult request) from the primary care physician
(your primary doctor) or other treating doctor. Please check on this with your insurance company so that you can obtain the necessary paperwork prior to your visit.
After the
consult by Dr. Foye, you may also need additional, separate authorization for treatment to actually begin,
depending on your insurance.
Again, please
check with your insurance company and also Dr. Foye's office staff. That way you can get the most out of your visit and avoid
unnecessary delays in treatment.
Dr. Foye’s
primary hospital affiliation is UMDNJ: University Hospital, Newark, N.J.
More Details About Insurance: My general
preference as a treating physician is to focus mainly just on the medical care,
rather than insurance issues. But I do understand the realities of patients
needing some guidance on these issues. This is especially important for patients who are flying in or driving in from out-of-state to be seen here for coccyx pain, since we want to be sure that you get the most out of your long trip to get here. BEFORE you come to my
office, my office staff can look into whether your insurance company requires
pre-authorization for the injections that I find most commonly help relieve
coccyx pain (e.g., ganglion Impar injections). Some insurance
companies do not require pre-authorization, in which case we do not have to face
the delay of waiting for the authorization. The authorization almost always
comes through eventually, but it is a matter of waiting for it. Recently, I had
another patient fly in from out-of-state and her insurance company did NOT require pre-authorization, so
when my consultation (office visit) with her revealed that she was a good
candidate for injection, we moved ahead with performing the injection the next
morning (when the fluoroscopy room was available), without having the delay of
waiting for a reply from the insurance company. Some insurance companies require
authorization in advance (pre-authorization), in which case they usually want to
see my consultation report. But it is theoretically possible
that my office staff could request the authorization from your insurance company
even before you come to the office, and if it is granted then that is one less
thing to delay care once you are here. That approach will not always work, but
it is worth a try for patients who are flying in or patients who are driving
more than two or three hours each way to get here. Anyway, my office staff can
check with your insurance company and see what steps we would need to take.
Just
gather together your insurance information (insurance card, etc.) and then call
my office staff (973-972-2802) and explain that you want them to find out if
your insurance company requires preauthorization for coccyx injections (in
addition to the authorization for the office visit).
For the injections, typically the three procedure codes
("CPT codes") are: 77003 (fluoroscopic guidance), 64520 (sympathetic nerve block,
which is the ganglion Impar block), and 64450 (somatic nerve block at the
coccyx). We request authorization for performance of these injections on a
series of three (3) dates (but if the patient experiences enough relief with
injections on one or two dates, then of course we do not perform any more). Some
insurance companies will not authorize a whole series, but rather will only
authorize one date at a time. Again, just call my office staff and they can look
into it. INSURANCE: UNITED HEALTHCARE and
OXFORD. Special handling and considerations are needed for patients who have
insurance through United Healthcare or Oxford. The issue is that personally I
(my medical office) participate in those insurance plans (along with accepting
most other insurance plans too), but the outpatient fluoroscopy room where we
usually perform the injection (affiliated with University Hospital, Newark) apparently
does NOT accept those particular insurance plans. Thus, although my physician
office will generally accept the discounted/insurance reimbursement rate, the
Hospital facility does not. We point this out in advance so that patients with these
insurance plans are aware and can plan accordingly. If this issue is not handled in advance, this can
result in the patient facing a large and unexpected bill from the hospital
(since the Hospital is not giving the discounted/insurance rate). Call my office
staff (973-972-2802) and they can check with your insurance company and see what
steps would need to be taken.
Patrick Foye, M.D., Director of Coccyx Pain Service PM&R at UMDNJ: New Jersey Medical School 90 Bergen St, DOC Suite 3100, Newark, New Jersey, USA, 07103
Disclaimer: This web site is for general informational purposes only. The information should not be considered as medical advice. The information is not a substitute for appropriate in-person care by a healthcare provider with expertise in evaluating and treating tailbone pain.