Information To Include In Your Appeal
- A letter of medical necessity from your treating physician. The LMN helps to explain why the proposed treatment should be approved and will detail any prior treatments that have been tried and failed.
- Medical records from the treating physician
- Your own personal narrative that explains why you need the proposed treatment
- Any additional support you can find
Prp Injection Knee Treatments Are Economical And Effective
Youll find that PRP injection knee treatments are more economical as compared to Coolief. Typically, the PRP injection cost of an initial session ranges from $400 to $1000. Depending on the healing capabilities of your body, you may need one or two follow-up sessions that may only cost you up to $300 to $400 each. Since PRP therapy can heal the causes of osteoarthritis, you may want to consider the treatment in place of Coolief that can actually result in long-term damage.
PRP therapy can help you with not just osteoarthritis, but also the various other causes of joint pain. Would you like more information about how it helps? Contact us or call us at . Our consultants will help you will all the in-depth details you need.
Have you tried PRP therapy for any health or cosmetic issues in the past? How were your experiences? Were you happy with the results? Please go ahead and share your views using the comment box below.
Why Coolief May Not Be The Perfect Solution
Aside from PRP injection knee treatments, to date, there are no effective cures for knee pain and difficulty in movement. The Coolief procedure may work to relieve the discomfort, but the principle behind it can have its downsides. In the absence of pain, youll likely continue to use the affected joint as usual. Over time, the disease may progress to a point where youll absolutely need knee replacement surgery.
With some amount of discomfort, youll not only use the joint with care but also adopt other lifestyle changes like regular exercise and a healthy diet. These precautions will strengthen the muscles surrounding the joints and promote lubricating agents to halt the further erosion of the cartilage.
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The Coolief* Patient Access Program Will Increase Your Access To Treatment Through The Submission Of Comprehensive Patient Requests For Prior Authorization Internal Patient
Request For Prior Authorization
Your licensed healthcare professional will provide clinical documentation to support a letter of medical necessity to your insurance plan requesting prior authorization for the COOLIEF* cooled radiofrequency treatment. If your plan approves, no further action is required, and the procedure may be scheduled.
This process may take 15-30 days once the request is received.
The Internal Appeals Process
If your plan denies your prior authorization request, a COOLIEF* Patient Access Program Case Manager will submit an appeal letter and your clinical records on your behalf in an effort to demonstrate medical necessity. Our team will request up to two levels of internal appeals, however your plan may only require one level. If the plan approves, no further action is required, and the procedure may be scheduled.
This process may take 30-45 days after an appeal is submitted. If a second internal appeal is available, it may take an additional 30-45 days.
Your Right To An External Appeal
If your plan denies your internal appeal, you may have the right to request an External Review with an Independent Review Organization . A COOLIEF* Patient Access Program Case Manager will facilitate this process on your behalf. The decision of the IRO is binding.
This process may take 45-60 days once the external review request is submitted.
A Minimally Invasive Option For Nerve Ablation
Although severe knee osteoarthritis with refractory pain is commonly treated surgically, this is often not an option for patients with poor health status or unwillingness to undergo major surgery.4
Fortunately, the same revolutionary COOLIEF* Cooled RF Pain Management System with documented pain relief in segments of the spine is now available to target other origins of chronic pain.
COOLIEF* Knee Cooled Radiofrequency for Genicular Neurotomy
Chronic knee osteoarthritis is one of the most common diseases of advanced age. With up to 20 million adults in the US suffering from OA of the knee¹, close to 700,000 cases progress to total knee joint replacement.² However, there exists a large demographic of chronic joint pain patients who are not candidates for invasive procedures due to BMI, age and other comorbidities. Alternative therapies such arthroscopic debridement or injections are associated with less than optimal clinical outcomes.
COOLIEF* Cooled RF:
- Clinical studies of cooled RF addressing other sources of pain have demonstrated over 20 months of pain relief and improved physical function³
- Is designed to treat complex anatomy of variable nerve courses through the creation of large volume, spherical lesions
- Potentially reduces the amount of time and fluoroscopic exposure through straightforward, familiar placement techniques
Non-Surgical. Minimally-Invasive. Non-Narcotic.
Studies show that when COOLIEF* Cooled RF is performed on other joints:
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How Does Coolief Work
On average, the COOLIEF procedure takes less than an hour. The time that a COOLIEF procedure takes varies depending on the surgeon, the patient, and the treatment area. A minimally invasive procedure, the COOLIEF procedure does not require the patient to undergo general anesthesia. During a COOLIEF procedure, the COOLIEF-trained physician uses a radiofrequency generator probe to transmit a low current of radiofrequency energy. The charged molecules create friction, which leads to ionic heating. The heat deactivates the intended nerves which prevents the brain from receiving pain receptors. In turn, the patient does not feel pain.
Q When Will I Begin To Feel Pain Relief
A You should begin to feel pain relief within one to two weeks. In some patients, the relief can be relatively long-lasting. In others, additional treatments may be required. For the specific costs associated with this procedure, and/or with any other questions please consult with your physician.
Section Resources
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Coolief Cooled Radiofrequency Thermal Treatment
Jonathan Koning, MD Contents Patient Resources New FDA Approved Treatment Options
According to new article by www.painmedicinenews.com, the FDA has cleared for marketing the COOLIEF Cooled Radiofrequency Thermal Treatment:
“The FDA has cleared for marketing the COOLIEF Cooled Radiofrequency thermal treatment for the relief of chronic moderate to severe knee pain caused by osteoarthritis . The first RF treatment to be cleared specifically to relieve OA knee pain, COOLIEF Cooled RF is a minimally invasive, thermal radiofrequency pain management system using water-cooled technology to deactivate pain-causing sensory nerves.
- 4.87/5
What Our Clients Say
I wasnt living, I was merely existing from one painful experience to another, and had very little quality of life. Fortunately I met Dr. J. Rajan.I do believe in angels and miracles and on that day I experienced both.These injections have done for me what nothing else ever has been totally successful and have totally relieved my pain.
I now have a quality of life that I have not had for a very long time. I am now not just Existing I am Living free from pain thanks to Dr Rajan and his team.
JS
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Q What Is Coolief* Cooled Radiofrequency Treatment
A Coolief Cooled RF is a minimally invasive, outpatient procedure that can safely treat chronic pain. This advanced procedure uses cooled radiofrequency energy to safely target the sensory nerves causing pain. Coolief circulates water through the device while heating nervous tissue to create a treatment area that is larger than conventional RF treatments.
Physical Function Is Improved
With the use of COOLIEF* Cooled Radiofrequency for genicular neurotomy, most patients can expect to feel pain relief within 1-2 weeks, returning to an enhanced quality of life much sooner than with surgery. It can also significantly improve long-term physical function and mobility of the knees for up to 12-24 months.
These are just 5 of the many benefits of using COOLIEF* Cooled Radiofrequency in genicular neurotomy. The use of COOLIEF* Cooled Radiofrequency treatment is primarily designed to relieve knee pain, but it can also be used to help alleviate back, shoulder and hip pain.
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The Top 7 Ways Coolief* Can Relieve Oa Knee Pain
What Is Genicular Neurotomy
Genicular Neurotomy is a radiofrequency ablation procedure that stops the genicular nerves from supplying pain signals to the brain. This is an advanced and non-surgical option for relieving knee pain.
For patients who intend to avoid a major knee replacement surgery, genicular neurotomy is the best option for you. However, this knee pain treatment can be performed before or after a knee surgery.
Knee pain is one of the most common pain disabling syndrome that can affect an individuals lifestyle. With genicular neurotomy, pain relief can last for about 6 months. Thus, helping you get back to your way of life.
The latest innovation for genicular neurotomy procedures is with the use of COOLIEF* Cooled Radiofrequency.
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Get A Sample Appeal Letter
This letter is only an example.
Please edit this letter to suit your needs and replace bolded sections with the appropriate information. Remove this portion before submitting to your insurance company.
If youre interested in an appointment, search below to find a COOLIEF*-trained specialist near you!
I’m looking for a COOLIEF*-trained specialist for my:
Are The Ads Accurate
Based on the 30-second TV commercial described above and a six-page online brochure, some of the claims seem exaggerated, misleading, or incomplete. For example:
Finally, learning that Coolief was “cleared” by the FDA might lead you to assume the FDA evaluated the evidence and concluded this procedure is safe and effective. In fact, Coolief did not require specific FDA approval because the FDA concluded it was similar enough to other “legally marketed” devices.
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Use This Guide When Talking With Your Primary Care Doctor About The Benefits Of Coolief*
Chronic pain affects 100 million Americansmore people than diabetes, heart disease, and cancer combined. It is the #1 cause of adult disability every year, and can lead to an increase in opioid use and loss of productivity. Of those 100 million, 30 million have osteoarthritis the most common form of arthritis. It is sometimes called degenerative joint disease or wear and tear arthritis. It most frequently occurs in the hands, hips, and knees.
The Tens Electrical Frequencies
A TENS device communicates with the nerves using electric fields in two sets of frequencies.
Muscle contraction in an EMS device occurs between 10 Hz and 50 Hz. The TENS units uses frequencies below and above the muscle contraction range. It uses less than 10 Hz and greater than 50 Hz frequency electric waves.
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How Can Coolief* Cooled Radiofrequency Help In Genicular Neurotomy
COOLIEF* Cooled Radiofrequency is a non-opioid procedure that can be used for genicular neurotomy. It can treat moderate to severe knee osteoarthritis and other knee pain. Thus, COOLIEF* Cooled Radiofrequency provides pain relief to patients who are not ready for a knee surgery and those who want to avoid the use of opioid for pain relief.
While traditional genicular neurotomy provides relief that lasts for about 6 months, the use of COOLIEF* Cooled Radiofrequency provides knee pain relief that lasts for up to 24 months.
The Fda Has Recently Approved Cooled Radio Frequency Ablation
The Food and Drug Administration has recently approved a new treatment modality for knee pain, namely the Cooled Radio Frequency Ablation. Doctors have developed this option mainly for patients who cannot opt for knee replacement surgery. Many patients have severe osteoarthritic pain but cannot get surgery because of various other health issues. This procedure is effective in helping such patients. The treatment works similar to corticosteroid injections that numb the pain so patients can move around more easily.
Although the procedure gives effective results for 6 to 12 months, this interval can also depend on individual patients healing abilities. Coolief targets the pain-causing nerves in the knee to numb them. The sooner the nerves regenerate, the shorter will be the pain-free time interval.
Dr. Amin Sandeep is a doctor who performs Coolief at the Rush University Medical Center in Chicago. He reveals, What were changing is the wiring of the knee so were taking away the pain signal and interrupting it.
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Alternatives To Pain Medication
While some patients with knee pain respond to physical therapy, its generally not practical for most, since this requires working the joint through pain to generate the desired results. Non-opioid treatments such as cortisone shots can be effective at reducing inflammation and pain, but overuse of this method has its own degenerative effects on the tissue supporting your knee.
For those who might benefit from lifestyle changes such as weight loss, they again face the battle of working through pain to increase their activity level. Whats needed to cope with knee pain before surgery is justified is a drug-free treatment with few side effects. As it happens, radiofrequency energy can be harnessed to accomplish this.
What Separates Coolief From Other Radiofrequency And Noninvasive Treatments
The only FDA approved thermal radiofrequency treatment for knee pain in 2017, COOLIEF uses water-cooled technology. This water cooled technology allows COOLIEF-trained physicians to deactivate sensory nerves that physicians previously found difficult to treat due to their inability to safely reach them. Studies of COOLIEF showed that COOLIEF reduces or eliminates pain altogether for up to two years. The use of COOLIEF allows patients to relieve their pain without the need for opioids. Not only does COOLIEF offer patients pain relief without the use of opioids, but COOLIEF actually gives patients more pain relief and for much longer.
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Is Coolief* Cooled Radiofrequency The Right Option For Me
You may not be ready for surgery yet, and opioids have side effects that you might not want. Thats why COOLIEF* can bring non-surgical relief to those suffering from chronic pain, without the use of opioids.1-4
COOLIEF* is a minimally invasive treatment option targeting nerves that transmit pain signals and the first and only radiofrequency treatment FDA-cleared for the relief of osteoarthritis knee pain.5
1. Pain relief for up to 12 months
In clinical studies, most patients receiving COOLIEF* reported that their pain was significantly reduced.
Surgery:An invasive and expensive path to pain relief
Medication:An old way of thinking about pain relief
Symptoms Of Knee Osteoarthritis
More than 30 million people in the United States have osteoarthritis the knee being one of the most commonly affected areas.
Knee osteoarthritis has symptoms like:
- Pain that gets worse with activity, but improves with rest
- Swelling
- A warm sensation in the joint
- Knee stiffness
- Limited knee movement
- Cracking or creaking sounds when moved
Knee pain severity differs from person-to-person. Though some can carry on with their everyday tasks, others need medical intervention to improve their quality of life.
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The Short Story On Red Light Therapy Dosing
Red light therapy dosing is complicated.
I have built some tools to make it easy for you.
Even with the tools, you still need to understand some concepts.
Some people just want the thing to work without a learning curve.
This section is for you.
For arthritis knee pain, get a red light device with light in the 830 nm or higher range .
Some devices put out energy in the red as well as the infrared range.
Get an LED light. Do not get fluorescent.
Do not get a light for growing plants. These have wavelengths of energy that will not help you.
If you get a light like this, then you need to double your session times.
This is because you want a full dose of infrared energy. The dose is based on the lights power. In a dual red/infrared light, half the energy is devoted to infrared. The other half is going into your skin, not your body.
Put the light 6 inches from your knee for 25 minutes every day.
Thats it. Just do that every day.
These are the simple instructions.
Im not tweaking anything.
I do not know your lights stated power.
I do not know the lights real power .
Its my opinion that a 25 minute session in front of the average infrared light will get you a sufficient dose of energy to make a difference.
Give the process at least 6 weeks before you decide if it is helping.
Who Should Consider Coolief
OrthoNebraska uses COOLIEF to treat patients with chronic pain who wish to avoid surgery. If you have neck, low back, sacroiliac joint, or knee pain, or if youve been diagnosed with arthritis or osteoarthritis, you may be a candidate for COOLIEF. It may be recommended after attempts at medication management do not provide the pain relief sought. It is very rare that someone would have another health condition that would prevent this treatment option.
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Transcutaneous Electrical Nerve Stimulation Pain Relief
A Transcutaneous Electrical Nerve Stimulation device sends electricity into the body through the skin.
On one end is the controller. A wire attaches the device to two electrode pads that you place on your body near the pain site.
The device sends electricity to the electrodes and then into your body.
The electric fields resonate with the bodys nerves to change how the nerves communicate.
The result is a reduction in pain.