BackTalk with Jay Resio releases its first episode on Artificial Lumbar Disc Replacement
Jay Resio founded SpineNation due to his own back pain journey. He had been diagnosed with degenerative disc disease in 2007 and in 2013, herniated his L4-5 disc. He tried conservative therapy to alleviate the pain. However, nothing worked and Resio had to jump through eleven months of insurance hoops before they would approve the surgery. By the time he had surgery, Resio could hardly walk.
The frustration and pain that Resio experienced on his journey to better spine health was the catalyst for the creation of SpineNation. He was exhausted and overwhelmed not just by the pain he was in, but by the lack of access to resources, experts, and answers to the array of questions he had regarding his care options and choices.
The mission of SpineNation is to empower people with the knowledge, tools, and resources they need to overcome their back, neck, and spine conditions. The BackTalk podcast is an extension of that mission.
BackTalk provides listeners direct access to leading industry experts without an appointment
Dr. Scott Blumenthal is a board-certified spine surgeon at the Center for Disc Replacement at the Texas Back Institute. He also happens to the surgeon who has placed two lumbar artificial discs in Resio’s spine. Both disc replacements have been highly successful and restored much of Resio’s daily quality of life.
In this debut episode, listeners learn from Dr. Blumenthal what physicians mean when they talk about degenerative spinal discs, degenerative disc disease, and the various therapies and treatment options. Artificial disc replacement is not the immediate first step when patients experience bulging or herniated spinal discs. All conservative therapies are tried, first.
You may be surprised to learn that this 2020 marks 20 years since the first lumbar artificial disc placed in the United States. In other words, this is a very well-tested treatment option. Listeners will also hear from Jay Resio firsthand about his recovery and experience with his artificial disc surgeries. The phrase “life-changing” is used frequently. Resio and Blumenthal also discuss the difference between spinal fusion and spinal disc replacement.
Will my insurance company cover the cost of Artificial Disc Replacement?
This is a great question and one that is sent to the team at SpineNation often. The second half of the episode features Kim Norton as a guest. Norton is the VP of Reimbursement for Simplify Medical, as well as an insurance reimbursement consultant specializing in artificial discs.
Norton has been doing this work for more than a decade, so she has a lot of experience. Norton explains that there is about a 73% coverage rate for commercial health insurance plans for artificial lumbar disc replacement. Aetna is the largest commercial insurance company that does not provide coverage for artificial disc replacement.
Norton believes that as the industry continues to produce long-term data for surgical success, eventually, commercial insurance hold-outs will be forced to begin covering artificial disc replacement. Listeners will learn a bit about the motives behind decisions regarding patient treatment plans by insurance companies.
Why don’t all insurance companies cover Artificial Disc Replacement?
In short, insurance companies are trying to save money in the long-term. Because the average consumer will carry a commercial insurance plan for 1.5-2 years, that company is trying to delay surgery for as long as possible so that the cost is passed on to the next company.
Norton’s advice for those seeking artificial disc replacement in place of spinal fusion surgery should be prepared to fight and advocate for oneself. Listeners will hear Norton explain why most spine surgeries are considered elective, even if they don’t feel elective to the patient.
Just like all other services provided by SpineNation to its members, the BackTalk podcast is available to listen for free. Listen to the first episode and subscribe today to ensure that you are staying up-to-date on relevant topics and issues impacting your spine health now and into the future.