As Health Insurance Denials Soar, Patients and Physicians


TRUMBULL, Conn., May 27, 2022 (GLOBE NEWSWIRE) — Thousands and thousands of Americans have faced the devastating reality of getting to fight for the healthcare they deserve, even in the event that they have medical insurance. ZetrOZ Systems, makers of the sam® wearable soft-tissue healing pain relief ultrasound device, encourages patients to coach themselves on their care and insurance policies in order that they can challenge the establishment if there may be an initial denial.

Greater than 11% of medical claims are initially denied, based on a 2021 study of 102 million transactions at 1,500 hospitals. The skyrocketing rate of denials – up greater than 20% since 2016 – for medically appropriate care has change into an increasingly growing problem for patients and doctors, especially in the case of soft tissue injury healing. “Unfortunately, medical policies are driven by insurance company profits and fear of change,” said George K. Lewis, Ph.D. and CEO of ZetrOZ Systems. “Thus, patients are sometimes denied advanced latest care after they have to access their healthcare advantages for soft tissue injuries.”

Patients and providers with the most effective intentions may not follow the right steps to get their procedures or prescriptions covered, Lewis said. Advocating for clinically effective procedures to be covered starts with communication between three parties — the patient, the healthcare provider, and the insurance firms. If a procedure or medication will not be covered by medical insurance, most patients and their healthcare providers simply quit. But it surely is feasible to check with the insurance company and alter those decisions.

“The primary ‘no’ by an insurance policy may be become a ‘yes’ should you are informed and chronic,” Lewis said. “At ZetrOZ, we encourage patients and providers to not simply quit with the primary denial of an insurance claim for therapies like Sustained Acoustic Medicine (sam®). Your insurance should at all times cover treatments which might be proven to be each medically effective and cost-effective.”

ZetrOZ’s proprietary sam® technology was funded by federal government grants, built on 46 patents and supported by greater than 40 peer-reviewed medical studies and successful treatment of tens of millions of patients nationwide. Recent level 1 studies, the best level of clinical evidence, demonstrates the clinical and cost-effectiveness of sam® for treating soft-tissue musculoskeletal injuries. sam® has a demonstrated cost savings on the healthcare system price tens of millions of dollars annually in america.

Despite that success, nevertheless, sam® is commonly not covered as a first-line treatment by insurance policy. This stems from patients,  providers and insurers having fragmented information on the fee and quality of care, Lewis said, and results in denials of medical insurance claims which might actually reduce healthcare expenditure. 

Essentially the most effective step for a patient to avoid the primary denial of medical insurance advantages coverage is to have a conversation with their healthcare provider and their insurance representative inside the practice. After researching treatment options, you’ve gotten a greater probability of physicians ordering the procedure or prescription accurately with a purpose to meet the insurance claim adjusters’ criteria. 

Although this process will not be at all times straightforward, the choice can still be appealed if a denial letter of coverage is received out of your healthcare advantages. It could be a paperwork issue, an incorrectly entered billing code, a tax ID placed into the unsuitable box, or coding the procedure or prescription in one other way that might help with getting the appeal approved.

The truth is that tens of millions of Americans are impacted by the coverage gap and spend tons of, and even hundreds of dollars out-of-pocket on health care costs. ZetrOZ believes that when a patient is in pain, nothing should stand in the way in which of receiving the care they need. ZetrOZ helps patients achieve optimal soft-tissue healing and stop future surgeries and long-term disability by helping people heal faster.

In the event you are fighting receiving treatment or an answer to healing an injury or pain, speak to your physician and learn more about ZetrOZ |


About ZetrOZ Systems
ZetrOZ Systems is an FDA cGMP and ISO 13585 medical technology company headquartered within the southern coastal region of Connecticut. The organization also has manufacturing facilities across america. ZetrOZ Systems produces UltrOZ®, sam®Sport and sam®Pro 2.0 to offer secure and effective treatment options for prevalent conditions comparable to arthritis. Learn more at and

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Buse Kayar

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