Insurance covers Rosacea Laser treatment

[momsdoc]

I am aboard certified Internist in New Jersey. I have been successfully treating Rosacea and acne with the Candella V-Beam laser for over ayear. I have performed more than 500 such treatments and the results have ranged from moderate to spectacular improvement. This treatment by itself or in conjunction with oral or topical antibiotics has changed the lives of my patients. It is nothing short of miraculous. The best part is almost every insurance company fully cover these treatments. I know other doctors say they are not covered, they just don't want to make the effort necessary to convince the insurance of the medical necessity of these treatments. To date we have been almost universally successful in getting this coverage. We are taking new patients and participate with almost every insurance company. I perform all the proceedures personally on alternate Wednsdays. In addition to the V-Beam I have Alex lasers for brown spots and tattoo removal, Smooth Beam for skin tightening and acne treatment, Gental Yag and Gental Lase for hair removal and the Fraxel laser for complete skin resurfacing. The purley cosmetic proceedures are obviously not covered by insurance, but Rosacea, Acne, warts and most red scars are. To change your life please contact my office at the number or address below.

Robert Shavelson MD
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[Peter]

Hello Robert

Welcome to the Forum.

Sorry but I do not wish to come over as being sceptical but there have been people before promising the world with laser treatments for rosacea, insurance cover etc, taking peoples money and then making them far worse.

Given you have performed over 500 treatments do you have any before and after pictures of patients that could be released on here plus some written testimonials about the results? I have controlled my rosacea without having to resort to laser treatment but I am sure there are members on this Forum who would be interested in further information.

Regards

Peter

[momsdoc]

Dear Peter,
I would have to ask my patients for permission to release their photos. I will ask them for written testimonals also. I always get insurance authorizations before begining treatments. The only payment required is the co-pay, usually 10 - 30 dollars depending on your plan. You will need a refferal from your primary care physician if you have an HMO. This is a medical condition and not cosmetic, that is why doctors are paid for performing treatment with other modalities. New Jersey is unique, in that only doctors are allowed to operate medical lasers in this state, as opposed to aestheticians or laser technicians. There are only a few instances where I have found the proceedure not covered, and those patients were aware of this beforehand and were able to decide if they wanted to pay and recieve treatment or not. The fact that I perform the proceedures and not a technician seems to be the reason coverage is available.
Robert Shavelson MD

[julie9536]

Hi,
I've been diagnosed with type I Rosacea. I'd be interested in talking with you further, but I agree...do you have anything that would give me confidence in your procedures? Also, what is the difference, if you're able to tell me, between a V-beam laser and an IPL...which is better?
Please get back to me.
Thanks,
Julie

[xtina057]

i would really like to read some testimonials and see some pictures too. i live in ct and would definitely take the time to drive to nj if i really believed i would get good results. especially if insurance would cover it. the place i go to does not and each time i go its 675 dollars .

[momsdoc]

Thank you all for your interest in the Laser treatments I have been doing in my office. I apologize for the delay in response. I will ask my patients to join the forum and post some testemonials to the success we have had with Laser treatments, as well as the success we have had in the office in billing insurance and obtaining reimbursement. In the meantime, if you have any specific questions or would like my office to send you some information on the treatments we provide, please feel free to contact my office manager, Sharon @ 732-9xx-xxxx. She can also work on obtaining precertification from your insurance company for Rosacea or any other type of treatment you are interested in. In addition to the Rosacea treatments with the Candela VBeam, we offer Acne treatments, Hemangioma treatments, Wart treatments, Spider Veins, and a few others most often covered by insurance. As well, purly cosmetic treatments, such as skin tightening, hair removal, brown spot removal and the Fraxel Laser treatment. I hope we can help you with your needs, look forward to hearing from you.

[CrabbyCathy]

Seeing before and after photos would be nice, particularly since I've never heard of this particular type of laser and rosacea; you so often only hear about IPL.

I'm glad you're so willing to help people in the local area; I myself had to pay out-of-pocket for my laser treatments, since despite clearly having rosacea, they were seen as "cosmetic" by my insurance company.

But, as of October of last year, there still have been no photos, testimonials, etc. and what with the new post, it again sounds like a wee bit of an advertisement for your clinic, particularly with mentioning all the other non-rosacea procedures performed. I understand about HIPAA laws and all that, but without more information, it can't help but look a bit suspicious. If I am wrong, I apologize, but for now, that's my view.

[Aurelia]

Hi David,

It is intriguing that Dr Shavelson reports almost automatic insurance coverage for V-Beam treatments when most patients and most laser and IPL docs say they have a real battle to get coverage.

Were you able to find out what codes Dr Shavelson uses so other rosaceans could put them on their claims, or even ask their doctors to code in the same way?

Kind regards,

Aurelia

[David Pascoe]

He did mention that he uses diagnosis code of rosacea, and a procedure code for laser ablation but that most other doctors simply couldn't believe that would work / was possible.

[lookout14]

I had this same discussion with my last VBeam office....the PA does the tx's....and she looked at me like I was crazy for asking WHY it couldn't be submitted to my insurance company as it is clearly evident I have a real disease and not a cosmetic problem like a wrinkle! She said the doc wouldn't risk being in trouble with ins co for me and could only give a dx code of rosacea and not the payable code for laser procedure! There is a code but I have no clue what it is that can get these paid for....it makes me sooooo upset that these doc's won't use it!

I know another lady in NJ who got some of her laser paid for but they did contact her later and say that the tx is considered experimental so they wanted the money back!

So they have us.....if we get a doc to use the "right" code then they will deny it as experimental!