Every stakeholder in the healthcare community benefits from the development of new medical technologies. Physicians are able to offer more effective treatment options to their patients, who themselves derive improved health outcomes from these more-advanced procedures. In addition, device companies get the opportunity to reap the financial rewards of the efforts that went into bringing their technology to market.

Since very few patients have the capacity to pay directly for their medical care, reimbursement of medical procedures by a government or private insurer is a critical element of the healthcare ecosystem. As a result, widespread and equitable patient access to transformative treatments like focused ultrasound requires that these procedures are covered and paid for by both government and private insurers.

Despite its importance, the process of medical reimbursement is not as straightforward as simply sending a bill and receiving payment. As patients and physicians alike have experienced, the process of getting reimbursed for a medical procedure can be a complicated system that involves a labyrinth of policies and processes.

Healthcare insurance is a regulated industry that collects and analyzes extensive amounts of data related to patient outcomes and healthcare costs. As a result, insurers are selective in the procedures they reimburse, with many requiring prior authorization in order to qualify for coverage. This means that certain treatments may not be accessible to patients. In this case, they will have to pay for it out-of-pocket.

The good news is that, despite the complexities of reimbursement, the use of focused ultrasound to treat a wide range of diseases is available in many countries, as shown in the chart below. Because insurers often require preauthorization for procedures and because coverage is regional in some countries, we strongly recommend that patients confirm insurance coverage with their insurer prior to undergoing treatment.

Insurance Coverage by Region SOTF 2021

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