Kimberling Vision Center, INC.

This is the debacle in insurance today… and why I had to walk away… no I dont do breast reconstruction, but in the same vain… The insurance industry is making it impossible to run, manage and successfully have medical practices. Its sad! https://www.instagram.com/reel/DVwuMPiCFRH/?igsh=b3ZsMzA4MW1obDg2

Over the past week I’ve seen several patients with Medicare or TRICARE who were told they were not candidates for breast reconstruction using their own tissue. But that wasn’t the real story. The reality is that reimbursement from Medicare and TRICARE for these procedures is very low, and some surgeons simply cannot afford to perform them. That is a real system problem that needs to be addressed. But telling a patient they are not a candidate when they actually are is not the answer. Patients trust what their doctors tell them. When we say someone isn’t a candidate for a procedure, many people never seek another opinion. So if you are a patient with Medicare or TRICARE and you are being told you are not a candidate for DIEP flap breast reconstruction, ask a very direct question: “Is reimbursement affecting this recommendation?” Patients deserve honesty and transparency when it comes to their care. And we also need to have an honest conversation about fixing the reimbursement system so that surgeons can provide these procedures without being financially penalized for doing the right thing.

https://www.instagram.com/reel/DVwuMPiCFRH/?igsh=b3ZsMzA4MW1obDg2

Over the past week I’ve seen several patients with Medicare or TRICARE who were told they were not candidates for breast reconstruction using their own tissue. But that wasn’t the real story. The reality is that reimbursement from Medicare and TRICARE for these procedures is very low, and some surgeons simply cannot afford to perform them. That is a real system problem that needs to be addressed. But telling a patient they are not a candidate when they actually are is not the answer. Patients trust what their doctors tell them. When we say someone isn’t a candidate for a procedure, many people never seek another opinion. So if you are a patient with Medicare or TRICARE and you are being told you are not a candidate for DIEP flap breast reconstruction, ask a very direct question: “Is reimbursement affecting this recommendation?” Patients deserve honesty and transparency when it comes to their care. And we also need to have an honest conversation about fixing the reimbursement system so that surgeons can provide these procedures without being financially penalized for doing the right thing.