Medicare coverage for the TOPS procedure is generally more straightforward than commercial insurance. Surgeons explain that Medicare Advantage patients may still face issues with insurance, but appeals can often help resolve denials.
Commercial insurance coverage for the TOPS procedure is improving, but approvals still vary by payer and plan. Surgeons discuss current challenges, appeal pathways, peer-to-peer reviews, and how support resources can help patients navigate the process.
Surgeons featured in this video include:
- Steve Robbins, MD, Wisconsin Bone and Joint. Milwaukee, WI
https://www.wiscboneandjoint.com/physician/stephen-robbins-md/
- Vikas Patel, MD, University of Colorado, Aurora, CO
https://www.cumedicine.us/providers/orthopedics/Vikas-Patel#/
- Joshua Marcus, MD, Elite Brain & Spine, Danbury, CT
https://elitebrainspine.com/joshua-marcus/
- Jonathan Oren, MD, Lenox Hill Hospital, New York, NY
https://www.northwell.edu/find-care/find-a-doctor/dr-jonathan-haim-oren-md-11373330
