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Unexpected Unreasonable Claims Costs in Intraoperative Neurologic Monitoring (IONM)

Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health & Joy McGee-Cory - Senior Vice President, Advanced Plan for Health

Several of our Health Plan clients and their members have experienced unexpected and very unpleasant surprises following certain complex surgical procedures – usually spine-related. So we wanted to get a cautionary word out a bit more broadly on this topic to our clients and others who may be facing similar situations. The surprises are coming in the way of bills for intraoperative neurologic monitoring (IONM).

In one case, the billing technician was not a physician, and the member’s bill for monitoring services was an unreasonable, non-negotiable $120,000.

Tags: Health Plan, Surgical Procedures, Healthcare Risks, Intraoperative Neurologic Monitoring, IONM, Out-Of-Network, Top Procedures, Medicare, Utilization

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