Cash Prices for Ehlers-Danlos Clinic...Better than a 99214?

[drusso]

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Pricing - P.R.I.S.M.

Just another WordPress site

prismspineandjoint.com

Dr. Zingman initial evaluation​

• $225 / 30 min - Isolated injury in otherwise healthy patient (ex: tennis elbow), Comprehensive evaluation of single joint.
• $425 / 60 min – Isolated injury management with head-to-toe assessment of root cause and plan, Injury Prevention Assessment and Plan, Chronic Pain with no history of surgery or other diagnoses (not diagnosed with Ehlers Danlos/Fibromyalgia/etc.)
• $625 / 90 min – Comprehensive complex evaluation such as for patient with prior surgeries, long-standing pain, additional diagnoses such as Fibromyalgia or Ehlers Danlos, or multiple sites to examine. Note: For EDS patients we can do either diagnosis only or EDS MSK eval only in 90 min**
• $750 / 120 min – EDS diagnosis and focused MSK eval**
• *If you are unsure which length of appointment you need, please call our office.
  **For new patients there is often an additional 30-60 minutes of administrative time following an initial evaluation

Dr. Zingman follow-up​

• $225 / 30 min (25 min face to face, 5 min documentation and cleaning)
• $425 / 60 min (50 min face to face, 10 min documentation and cleaning)
• $625 / 90 min (80 min face to face, 10 min documentation and cleaning)
• $750 / 120 min (110 min face to face, 10 min documentation and cleaning)

Osteopathic Treatment​

• $200 / 30 min (25 min face to face, 5 min documentation and cleaning)
• $350 / 60 min (50 min face to face, 10 min documentation and cleaning)
• $500 / 90 min (80 min face to face, 10 min documentation and cleaning)
• $650 / 120 min (110 min face to face, 10 min documentation and cleaning)

Physical Therapy or Muscle Activation Technique​

• $105 / 30 min (25 min face to face, 5 min documentation and cleaning)
• $180 / 60 min (50 min face to face, 10 min documentation and cleaning)
• $260 / 90 min (80 min face to face, 10 min documentation and cleaning)
• $340 / 120 min (110 min face to face, 10 min documentation and cleaning)

“I decided when we opened that I could practice medicine the way I know it should be and get the best possible result. Or I could have it be based on high volume and insurance and not do what’s needed,” Zingman said. Her first appointments with patients often run two hours long. She hired athletic trainers, physical therapists and an osteopathic doctor who often work weekly with patients to realign joints and train their bodies to stay in place."

https://www.washingtonpost.com/dc-md-va/2021/12/27/ehlers-danlos-syndrome-alissa-zingman-treatment/?fbclid=IwAR3YQ7F4SiD1mt0586QN97-q4NzjCd9humAY-ryRLeAtwvagXI9NrEzM3Pg

 

[cowboydoc]

Pricing - P.R.I.S.M.

Just another WordPress site

prismspineandjoint.com

Dr. Zingman initial evaluation​

• $225 / 30 min - Isolated injury in otherwise healthy patient (ex: tennis elbow), Comprehensive evaluation of single joint.
• $425 / 60 min – Isolated injury management with head-to-toe assessment of root cause and plan, Injury Prevention Assessment and Plan, Chronic Pain with no history of surgery or other diagnoses (not diagnosed with Ehlers Danlos/Fibromyalgia/etc.)
• $625 / 90 min – Comprehensive complex evaluation such as for patient with prior surgeries, long-standing pain, additional diagnoses such as Fibromyalgia or Ehlers Danlos, or multiple sites to examine. Note: For EDS patients we can do either diagnosis only or EDS MSK eval only in 90 min**
• $750 / 120 min – EDS diagnosis and focused MSK eval**
• *If you are unsure which length of appointment you need, please call our office.
  **For new patients there is often an additional 30-60 minutes of administrative time following an initial evaluation

Dr. Zingman follow-up​

• $225 / 30 min (25 min face to face, 5 min documentation and cleaning)
• $425 / 60 min (50 min face to face, 10 min documentation and cleaning)
• $625 / 90 min (80 min face to face, 10 min documentation and cleaning)
• $750 / 120 min (110 min face to face, 10 min documentation and cleaning)

Osteopathic Treatment​

• $200 / 30 min (25 min face to face, 5 min documentation and cleaning)
• $350 / 60 min (50 min face to face, 10 min documentation and cleaning)
• $500 / 90 min (80 min face to face, 10 min documentation and cleaning)
• $650 / 120 min (110 min face to face, 10 min documentation and cleaning)

Physical Therapy or Muscle Activation Technique​

• $105 / 30 min (25 min face to face, 5 min documentation and cleaning)
• $180 / 60 min (50 min face to face, 10 min documentation and cleaning)
• $260 / 90 min (80 min face to face, 10 min documentation and cleaning)
• $340 / 120 min (110 min face to face, 10 min documentation and cleaning)

“I decided when we opened that I could practice medicine the way I know it should be and get the best possible result. Or I could have it be based on high volume and insurance and not do what’s needed,” Zingman said. Her first appointments with patients often run two hours long. She hired athletic trainers, physical therapists and an osteopathic doctor who often work weekly with patients to realign joints and train their bodies to stay in place."

https://www.washingtonpost.com/dc-md-va/2021/12/27/ehlers-danlos-syndrome-alissa-zingman-treatment/?fbclid=IwAR3YQ7F4SiD1mt0586QN97-q4NzjCd9humAY-ryRLeAtwvagXI9NrEzM3Pg

Better than a 99214 or 99215, but still not enough to pay for the therapy I would require. I'm going to print this and refer my remaining EDS patients to this cupper doctor.

 

[Orin]

It's a nice option if patients can afford it.

It does self select and rule out a lot of those losing in our system due to lack of resources, but who's treating the doctor is the question

 

[Agast]

What is “cleaning”? Like sanitizing between appointments?

She was partway through an orthopedic residency before she had to stop due to her own problems with EDS.

I wouldn’t be surprised if her patients feel benefit with this, she probably sees the ones who are the worst off and they’re glad to have hands on, face to face attention. She can space the patients far enough apart to take her own breaks for self care and still afford the clinic and staff overhead.

I know someone with EDS who couldn’t finish their ER residency because it got so bad. Another ER doc who is limited due to POTS (also common in EDS) after a freak carotid dissection.

 

[nvrsumr]

I dont engage when a patient mentions Eds. Just pretend it never happened (which ofttimes is the truth).

 

[deleted875186]

Honestly, what can be done for hyper mobility or EDS. I have several of these that I have on a TCA or cymbalta or something, but typically always end up on tramadol and or Butrans. Just took one patient from a PCP that was on tramadol and oxycodone that I already regret.

 

[Ferrismonk]

Honestly, what can be done for hyper mobility or EDS. I have several of these that I have on a TCA or cymbalta or something, but typically always end up on tramadol and or Butrans. Just took one patient from a PCP that was on tramadol and oxycodone that I already regret.

For real EDS, physical therapy and prolo to help tighten ligaments. Not opioids.

Keep in mind that sero-negative EDS is the new fibro.

 

[deleted875186]

For real EDS, physical therapy and prolo to help tighten ligaments. Not opioids.

Keep in mind that sero-negative EDS is the new fibro.

Insurrance will not cover prolo I thought?

 

[adiradirim]

We see this all the time in pediatric pain. People got diagnosed on old criteria and show up with "EDS type 3" or "Hypermobile EDS" when actually they only fit criteria for Hypermobility Spectrum Disorder. Of course, nobody re-evaluates them so they go around saying they have EDS since that's a part of their identity now. What they really need is intense education on the nature of hypermobility and the importance of lifestyle modification to strengthen muscles and maintain activity. Of course this condition goes along with several other related conditions including POTS, gastroparesis, fibromyalgia, etc so they end up seeing multiple specialists. In my experience they are either super deconditioned from zero activity or high level competitive athletes with no middle ground.

Treatment is mostly hypermobility PT, aquatic therapy, strengthening, pain psychology, and education. Occasionally we use pain modulating medications (gabapentin, TCAs, LDN, SNRI) with moderate success along with PRN NSAIDs.

 

[soccrwz]

We see this all the time in pediatric pain. People got diagnosed on old criteria and show up with "EDS type 3" or "Hypermobile EDS" when actually they only fit criteria for Hypermobility Spectrum Disorder. Of course, nobody re-evaluates them so they go around saying they have EDS since that's a part of their identity now. What they really need is intense education on the nature of hypermobility and the importance of lifestyle modification to strengthen muscles and maintain activity. Of course this condition goes along with several other related conditions including POTS, gastroparesis, fibromyalgia, etc so they end up seeing multiple specialists. In my experience they are either super deconditioned from zero activity or high level competitive athletes with no middle ground.

Treatment is mostly hypermobility PT, aquatic therapy, strengthening, pain psychology, and education. Occasionally we use pain modulating medications (gabapentin, TCAs, LDN, SNRI) with moderate success along with PRN NSAIDs.

Can you enlighten us how you diagnosis they patients now?

 

[adiradirim]

Can you enlighten us how you diagnosis they patients now?

"Hypermobility" usually just means a positive Beighton score or signs of hypermobility in affected joints. What are the hypermobility spectrum disorders?
"Hypermobility Spectrum Disorder" means you have hypermobility plus some kind of dysfunction including pain or dislocation.
"Hypermobile EDS" has very specific criteria to meet. https://www.ehlers-danlos.com/wp-content/uploads/hEDS-Dx-Criteria-checklist-1-Fillable-form.pdf

Most people who do not fulfill all the hypermobile EDS criteria will likely fit Hypermobility Spectrum Disorder. Usually we let genetics take care of that at our hospital since they have time to sit and discuss specifics with the patient and families and they're expecting that conversation when they go. In our pain clinic, it is usually enough to acknowledge the hypermobility as the underlying cause of pain.

 

[cowboydoc]

"Hypermobility" usually just means a positive Beighton score or signs of hypermobility in affected joints. What are the hypermobility spectrum disorders?
"Hypermobility Spectrum Disorder" means you have hypermobility plus some kind of dysfunction including pain or dislocation.
"Hypermobile EDS" has very specific criteria to meet. https://www.ehlers-danlos.com/wp-content/uploads/hEDS-Dx-Criteria-checklist-1-Fillable-form.pdf

Most people who do not fulfill all the hypermobile EDS criteria will likely fit Hypermobility Spectrum Disorder. Usually we let genetics take care of that at our hospital since they have time to sit and discuss specifics with the patient and families and they're expecting that conversation when they go. In our pain clinic, it is usually enough to acknowledge the hypermobility as the underlying cause of pain.

Lucky! Or geneticists stopped seeing these folks. Send a 1 page education sheet/denial of referral.

 

[Peterluger]

What is the cleaning fee? They charge the patient extra for floor-mopping?

 

[RoloTomassi]

What is the cleaning fee? They charge the patient extra for floor-mopping?

My dentist charges for PPE now

 

[drusso]

My dentist charges for PPE now

We're charging for PPE too.

 

[10KHertz]

We're charging for PPE too.

99072….boom

I have EDS patients that would pay this comprehensive myofascial tx all day long .

Reminds me of the ‘comprehensive migraine’clinic out of Michigan…some amazing cottage hospital that “cures” migraines.

Btw, Long Covid is the new fibromyalgia…

 

[po_boy]

Lucky! Or geneticists stopped seeing these folks. Send a 1 page education sheet/denial of referral.

Can you please share (publicly or privately) what this education sheet/denial looks like?

I've been getting a lot of these referrals, and am getting nowhere with the patients.

Thanks

 

[cowboydoc]

Can you please share (publicly or privately) what this education sheet/denial looks like?

I've been getting a lot of these referrals, and am getting nowhere with the patients.

Thanks

I’ll see if I can find it…

 

[paindoctor2014]

For real EDS, physical therapy and prolo to help tighten ligaments. Not opioids.

Keep in mind that sero-negative EDS is the new fibro.

Mayo Clinic: you have zero-negative EDS. Sends patient home w no treatment.

Me: I have nothing to offer

Patient: trashes me online for not accepting referral

Rinse and repeat

 

[cowboydoc]

Mayo Clinic: you have zero-negative EDS. Sends patient home w no treatment.

Me: I have nothing to offer

Patient: trashes me online for not accepting referral

Rinse and repeat

Those are the reviews I appreciate, as they speak to “their people” and keep them out of your practice.

 

[PikminOC]

Pricing - P.R.I.S.M.

Just another WordPress site

prismspineandjoint.com

Dr. Zingman initial evaluation​

• $225 / 30 min - Isolated injury in otherwise healthy patient (ex: tennis elbow), Comprehensive evaluation of single joint.
• $425 / 60 min – Isolated injury management with head-to-toe assessment of root cause and plan, Injury Prevention Assessment and Plan, Chronic Pain with no history of surgery or other diagnoses (not diagnosed with Ehlers Danlos/Fibromyalgia/etc.)
• $625 / 90 min – Comprehensive complex evaluation such as for patient with prior surgeries, long-standing pain, additional diagnoses such as Fibromyalgia or Ehlers Danlos, or multiple sites to examine. Note: For EDS patients we can do either diagnosis only or EDS MSK eval only in 90 min**
• $750 / 120 min – EDS diagnosis and focused MSK eval**
• *If you are unsure which length of appointment you need, please call our office.
  **For new patients there is often an additional 30-60 minutes of administrative time following an initial evaluation

Dr. Zingman follow-up​

• $225 / 30 min (25 min face to face, 5 min documentation and cleaning)
• $425 / 60 min (50 min face to face, 10 min documentation and cleaning)
• $625 / 90 min (80 min face to face, 10 min documentation and cleaning)
• $750 / 120 min (110 min face to face, 10 min documentation and cleaning)

Osteopathic Treatment​

• $200 / 30 min (25 min face to face, 5 min documentation and cleaning)
• $350 / 60 min (50 min face to face, 10 min documentation and cleaning)
• $500 / 90 min (80 min face to face, 10 min documentation and cleaning)
• $650 / 120 min (110 min face to face, 10 min documentation and cleaning)

Physical Therapy or Muscle Activation Technique​

• $105 / 30 min (25 min face to face, 5 min documentation and cleaning)
• $180 / 60 min (50 min face to face, 10 min documentation and cleaning)
• $260 / 90 min (80 min face to face, 10 min documentation and cleaning)
• $340 / 120 min (110 min face to face, 10 min documentation and cleaning)

“I decided when we opened that I could practice medicine the way I know it should be and get the best possible result. Or I could have it be based on high volume and insurance and not do what’s needed,” Zingman said. Her first appointments with patients often run two hours long. She hired athletic trainers, physical therapists and an osteopathic doctor who often work weekly with patients to realign joints and train their bodies to stay in place."

https://www.washingtonpost.com/dc-md-va/2021/12/27/ehlers-danlos-syndrome-alissa-zingman-treatment/?fbclid=IwAR3YQ7F4SiD1mt0586QN97-q4NzjCd9humAY-ryRLeAtwvagXI9NrEzM3Pg

You've seen the recent wash post article about how doctors make too much per their opinion? Surprised they don't slam her for this..