How 1 neurosurgeon is handling insurance denials

Betsy Grunch, MD, serves as a neurosurgeon at the Gainesville, Ga.-based Longstreet Clinic.

Dr. Grunch will serve on the panels "Discectomies in the ASC — Best Practices for Optimized Spine Programs," "Where Orthopedic, Spine Patient Referrals Will Come From in Five Years" and "Cervical Spine Surgery: Most Interesting Innovations Today" at Becker's 19th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference. As part of an ongoing series, Becker's is talking to healthcare leaders who plan to speak at the conference, which will take place in Chicago from June 16-18. 

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Question: What issues are you spending most of your time on today?

Dr. Betsy Grunch: Since I'm a neurosurgeon and deal with all aspects of spine care, the biggest change outside of our clinical practice is dealing with more clarification of documentation and peer-to-peer evaluations with insurance companies regarding the treatment for our patients. To try to get those things approved has changed more recently. 

Q: What are your top challenges and how will they change over the next 12 months?

BG: The top challenge for me is finding more clinical help in the office to deal with the things I mentioned about peer-to-peer and insurance denials. Most of the time, the answer is, especially for medication peer-to-peers, I just tell my patients that I don't have the workforce to do some of those things, which is really what the insurance company wants to hear because then they don't have to pay for it. So really trying to find out how I can clinically deal with that from a workforce standpoint to give patients the care they deserve.

Q: How are you thinking about investments and growth in the next two years? 

BG: As a private practice surgeon, what I invest will benefit my practice and my patients. So moving certain procedures to the ASC setting is the safest way for both parties to ensure that we're still getting good outcomes and things like that.

Q: What are you most excited about right now?  

BG: I'm most excited about the development of robotics and how that might impact what we do in the OR setting. We don't have robotics where I'm at, but going to all these conferences and learning about how certain surgeons integrate that into their practice seems very exciting and kind of on the breaking edge of spine surgery. 

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