Pain Management FAQs
Frequently Asked Questions
Yes, we accept most major insurance plans. We also accept self-pay. Please get in touch with our office for specific details about your coverage or if you have any questions. Insurance companies almost always require authorization to proceed with a pain management procedure or injection. Furthermore, each insurance company has a set of rules and guidelines that must be completed before allowing the procedure to be performed.
Medicare Part B is a federal program that covers outpatient medical services. This can include everything from doctor visits and lab tests to preventative care. Once you meet your annual deductible, Medicare Part B covers 80% of the approved amount for services, and you pay the remaining 20%. Secondary insurance is private insurance designed to cover the remaining 20% Medicare Part B doesn’t pay. Meanwhile, a Medicare replacement plan is an alternative form of Medicare covered by private insurance. It can cover 100% of Medicare’s services and additional benefits such as vision, dental, and prescription drugs. But insurance still may require deductibles, office visits, co-pays to be met and paid.
A co-pay is the fixed amount you pay your doctor at the time of service. For instance, your co-pay upon arrival might be $50 for a doctor’s visit and $15 for a prescription. A deductible represents the money you must pay out of pocket before your insurance starts contributing. For instance, your doctor’s bill might be $5,000, and your deductible is $2,500. Therefore, you must satisfy that deductible before the insurance pays the other half. Max out-of-pocket is the maximum amount you must pay for covered services in a plan year before your insurance begins paying 100% of covered services for the rest of the year. Lastly, preauthorization means obtaining approval from your insurance company before receiving certain medical services and treatment.
Co-insurance is when patients and their medical insurance company split the costs of covered medical services after the deductible has been met. Unlike a co-payment, which is a fixed amount, co-insurance is typically a percentage. For example, if your co-insurance is 20%, you are responsible for paying 20% of the total cost of a medical service, while your insurance covers the remaining 80%. This amount is paid until you reach your out-of-pocket maximum, after which the insurance typically covers 100% of covered expenses.
We require a referral to confirm that we, as your provider, are on your insurance. As insurance can be challenging, we do not want you to show up on the day of your appointment without confirming your insurance beforehand. Ultimately, this is to prevent any inconvenience to you as the patient.
This innovative medical approach relies on minimally invasive techniques to diagnose and treat chronic pain rather than resort to complex and unnecessary surgeries. More importantly, interventional pain management specialists focus on identifying and resolving the source of pain. By targeting the root cause, often with procedures that reduce or block pain signals, symptoms can be reduced or eliminated.
Pain becomes chronic if you continuously have pain for at least three to six months and may be resistant to traditional treatments such as medication, physical therapy, chiropractic therapy, and good old-fashioned rest. Unlike acute or minor injuries, chronic pain tends to linger or come and go and is often the result of an underlying injury or illness.
Neuropathy, commonly referred to as peripheral neuropathy, is a condition that affects the peripheral nerves, leading to what you may describe to your primary care physician as pain, tingling, numbness, and weakness—typically in the hands and feet. Neuropathy can have a variety of causes, ranging from diabetes to injury, infections, and exposure to toxins. When the nerves are damaged in this way, they fail to function correctly, often sending pain signals even when you cannot point to a specific injury or stimulus as the cause.
Patients must be seen by our providers, with history and physicals obtained, before injections can be performed. Many of the things we look for before injections are the history and present illness/chief complaint, vital signs, list of current medication, past medical history, past surgical history, social history, drug allergies, physical exam, and past assessments. Imaging must be reviewed, and a treatment plan must be obtained.
We must assess if you meet the criteria to proceed with any interventional procedures. You must have attempted conservative treatment, such as physical therapy, before your procedure. Your medication list needs to be reviewed as well. Not all procedures can be done while the patient is on blood thinners. Some injections include steroids. Steroids will increase your glucose levels. Therefore, your glucose must be well controlled.
Ultimately, we must assess you carefully and must use our history and physical new patient consultation note to send to your insurance provider along with your imaging to ask for permission/authorization to proceed with a procedure. Also, your insurance will almost ALWAYS require authorization to proceed with a procedure or injection. Each insurance company has a set of rules and guidelines that must be completed before allowing the procedure to be
Treatment length and number of treatments can only be determined after a thorough examination and consultation about your unique pain needs. Once we have evaluated your situation and uncovered the source of your pain, we will craft a tailored plan. Sometimes insurance will require a specific number of treatments for pain procedures.
Yes, it is possible to continue experiencing many of the same pain symptoms you’ve been dealing with while undergoing treatment. This is especially true at the beginning. Over time, many patients find that continued pain management treatments gradually begin to control or reduce the pain. You must communicate clearly and consistently with your doctor about your symptoms and progress.
Stopping, reducing, or avoiding medications before or during your treatment process depends largely on the specific type of treatment you are receiving and what medications you are currently on. Certain medications may need to be adjusted during treatments, including blood thinners, steroid injections, and NSAIDs. During our evaluation, we will ask you for a specific list of medications you are currently on and advise you accordingly before moving forward with your tailored treatment plan.
The success of a pain management treatment program depends on various factors. This includes the source of the pain, the type of treatment, and individual patient characteristics. While some patients may experience significant relief, others may find only partial improvement. The goal of pain management is often to reduce pain to a manageable level and enhance quality of life.
If it is determined that we need you off of this blood thinner before proceeding with your injection, then we will ask the prescribing doctor for permission for you to be off of the medication. You are not to stop the blood thinner without written permission from the doctor who writes for your blood thinner. You must not stop it until we have determined the day of your injection to ensure the appropriate amount of time that you need to be off of your medication with the proper documentation.
Rhizotomy is a minimally invasive procedure to remove sensation from a painful nerve by demyelinating or “killing the nerve fibers” responsible for sending pain signals to the brain. This is also known as ablations or radiofrequency ablations (RFA). You must have failed conservative treatment and been assessed as a candidate for this procedure. You will need two diagnostic blocks approximately two weeks apart before proceeding with the RFA.
The typical process for this procedure would include the new patient consultation, the first set of diagnostic injections, a follow-up visit to ensure you achieved the appropriate amount of pain relief, and an improvement of your activities of daily living/repeat exam.
Another set of diagnostic injections will be needed to confirm the first set was not a placebo effect, then another visit to ensure you achieved the appropriate amount of pain relief and an improvement of your activities of daily living/repeat exam. We will then set you up for your ablations.
Procedures are conducted in Fort Worth, TX, at Daytime Outpatient Surgery Center (6311 Southwest Blvd), in Granbury, TX, at Baylor Surgicare (1717 Paluxy Rd), or in our procedure room at our Granbury office (100 Gateway Hills Lane, Suite C, Granbury, TX 76049). Some injections that only require ultrasound may also be done in our office as well. Dr. Keneson is also credentialed at Baylor Surgical Hospital in Fort Worth, TX.
You will need two diagnostic blocks approximately two weeks apart prior to proceeding with the RFA.
PAIN MANAGEMENT
Effective Treatment for Your Discomfort
Various treatments are available to help manage your symptoms and improve your quality of life. From medications and physical therapy to advanced treatments like spinal cord stimulation, pain doctors use a range of strategies to help you reclaim your life. If you are suffering from chronic pain, early intervention is critical for effective treatment and long-term relief. Consult with the experts at Valor Interventional Pain to determine the best treatment plan for your specific needs.