The ability to bill and collect from insurance companies isnt a moat. Also remarkable is that Zynex stock was supported by an active share buyback program at the time. Empi was also under investigation, accused of selling unjustifiably large quantities of TENS electrodes to TRICARE beneficiaries with a particularly steep increase in the number of beneficiaries receiving unnecessary quantities in 2014-2015. Its parent company DJO decided to exit the Empi business in 2015 due to a challenging regulatory and reimbursement environment. DJO paid $7.2M to settle the issue in 2018. However, we believe Zynex is dependent on an abusive pricing strategy - reselling regular consumer batteries and electrodes at ~90% margins. Even if we are wrong, and Zynex billing practices are industry standard and sustainable, competition would enter the TENS market given the ~90% gross margins on supplies, cutting profitability. The policy stipulates "usual maximum utilization" is one or two units of a monthly supply pack which includes electrodes, batteries, and conductive gel. 41]. The device is made to be portable and can be used at home, work etc. A copy of a form that your doctor needs to fill before faxing over directly to the Zynex headquarters is downloadable from the website.Note, however, that after prescribing this device for you, it is not mandatory to use it only in the hospital under supervision. to the Nasdaq Capital Market. Is it safe? Days sales outstanding rose to highest level in over 4 years. They are generally safe for most people, but here are some possible side effects.
Amazon.com: Zynex Electrodes 25]. Copyright 2020 | All rights reserved by MediChannel.Org Australia. This does depend on what your specific problem is. In 2020 Sandgaard, whose wealth is tied up in his 43% stake in the company, bought a 3rd-tier English football club that was burning through 1m per month. Nestle Nutren Optimum vs Nutren Diabetes How You Should Choos? Consensus revenue and EBITDA estimates for 2022 are $181m (+38% Y/Y) and $38m (+65% Y/Y), respectively - the street is modeling growth, yet Zynex has stopped adding sales reps and likely lost its largest source of revenue.
Amazon.com: Zynex Medical Electrodes Pads 1-16 of 164 results for "zynex medical electrodes pads" Results Best Seller AUVON TENS Unit Pads Electrode Patches with Upgraded Self-Stick Performance and Non-Irritating Design for Electrotherapy 20 Count (Pack of 1) 40,044 2K+ bought in past week $999 ($0.50/Count) List: $12.21 Pain Relief Devices: TENS 3000 vs. TENS 7000. Several elements of the EMSI case are relevant to Zynex shareholders: We don't know why UHC initially only acted against EMSI and not Zynex even though it was sending patients 8x more electrodes. Modern TENS technology, in use since the 1970s, operates on the same basic principle of applying electricity to areas of pain via percutaneous electrodes. Long press it until the desired mode is achieved. We thought payors, particularly commercial insurers, would have a better handle on waste and abuse, especially involving products as unproven and primitive as transcutaneous electrical nerve stimulation (TENS) units which are technologically on par with transistor radios. Our prior work on Zynex, which included interviewing former employees and reviewing the reimbursement policies of numerous commercial insurers, led us to suspect UHC was reimbursing Zynex abnormally. How does Zynex arbitrage its generic supplies manufacturers and private and public payers? Check with your insurance CO to see if they will even cover a rental. ), which has investigated and found wrongdoing at other TENS device companies, RS Medical and Empi. Zynex shares are up ~100x since late 2016 as retail investors buy into a story of rapid revenue and earnings growth. We identify UnitedHealthcare as Zynexs largest payor and estimate it was paying ~7x more per order relative to other commercial insurers, artificially sustaining the weak underlying business. We notified Zynex of our concern that its billing practices are abusive as the company is overcharging healthcare payers for device supplies. What is Neuromuscular Electrical Stimulation (NMES)? I acquired a Zynex medical NexWave unit while working as a ******* Care practitioner in 2017.
Electrical Stimulation for Pain - Medical Clinical Policy Also, the fact that no other companies have aggressively stepped in to fill the void (besides Zynex) makes the idea of an unfavorable TENS market even more believable. Wed be very interested to see exactly how Zynex manages to collect $1,200 on its supplies, because the numbers dont seem to add up. Top subscription boxes right to your door, 1996-2023, Amazon.com, Inc. or its affiliates. Sandgaard claims the upswing was the result of increased market share after the exit of two large competitors. The workers' compensation market might be the last area where the TENS business is feasible, due to an arcane and poorly controlled reimbursement and coding framework. One 9 V alkaline battery is used. Amazon.com: Zynex Electrodes Shop Memorial Day sale 1-16 of 248 results for "zynex electrodes" Results TENS Unit Pads, 40PCS Round Electrodes Pads, 1.25" Reusable Carbon Electrotherapy Pads for EMS Muscle Stimulator, with 2.0 mm Pigtail Connectors 40 Count (Pack of 1) 684 $1599 ($0.40/Count)
Manage Your Zynex Medical Products & Supplies | Zynex Medical ALL PRODUCTS INSTRUCTIONAL VIDEOS REQUEST A SALES REP But even assuming Zynex unbundles batteries and electrodes codes, we cant get to $1,200 for supplies or $1,500 total in our hypothetical scenario. Seeking Alpha's Disclosure: Past performance is no guarantee of future results. After a doctor prescribes NexWave, Zynex verifies Medicare/insurance. This can gently relax stiff calfs or thighs in about 20 min. Appreciate all feedback. Obviously it doesn't hurt to have the uncapped potential for making a great chunk of dough. The TENS category includes the codes below (a few other codes are less commonly used so well ignore them). MediChannel 418 subscribers 2.1K views 1 year ago AUSTRALIA Show more Whats more, they are often portable and can be used at home, work etc. Source: Sell-side analysts and our estimates. Zynex Nexwave is one of their products from the line of electrotherapy products. Investors saw a rapidly expanding, profitable company with no significant competition.
PDF NexWave - Zynex Medical https://themedichannel.com/neurotrac-tens-review/XFT 320A TENS Machine With Acupuncture Pen Review - https://themedichannel.com/xft-320a-tens-machine-with-acupuncture-pen-review/Alpha-Stim and TENS in Treating Pain, Anxiety, Depression and Insomnia - https://themedichannel.com/alpha-stim-and-tens/What is Zynex NexWave?Zynex Medical Inc. is part of three subsidiaries of the company founded in 1996 by Thomas Sandgaard.It is a medical manufacturer of electrotherapy products for pain relief and management.Zynex Nexwave is one of their products from the line of electrotherapy products. We think the end is in sight. Specifically, we calculate that, on each device, Zynex is collecting an average of $1,200 for non-proprietary batteries and electrodes, over the average 6 to 9-month life of a device. The companys pipeline consists of a blood volume monitor called CM-1500, for which an application for approval was filed in 2015. The best it can explain by comparing it with TENS. Recall 80% of revenues now comes from supplies, so roughly $300 is collected for the device and $1,200 from supplies over the course of six to nine months, on average. UHC has shown a willingness to attempt to recoup payments from a TENS manufacturer billing improperly, Not only can UHC litigate for immediate repayment, it can also offset future claims against the amount owed. This is great and now one of the leads wont work. This give it a try, is the most effective and it is super sticky. Need Help? However, unlike the consumer market for razor blades, the payer market for TENS supplies isnt free. Please contact Patient Support at (720) 912-3415 or patientsupport@zynex.com We think Sandgaard was also referring to patients insured by UnitedHealthcare which we believe has been Zynex's largest single source of high margin revenue since the turnaround in 2017. With the fundamentals and technicals aligned, we think now is a great time to be short Zynex. You may also be interested in the following articles.Can NeuroTrac TENS Device Relieve Pains? E0730 is a procedure code for TENS modality only and E0745 is for NMES only. The batteries and electrodes sold by Zynex are not proprietary to NexWave. Zynex primarily markets NexWave, a transcutaneous electrical nerve stimulation (TENS) device indicated for the management of chronic intractable pain, post-traumatic and post-surgical pain. Zynex NexWave | Prescription Pain Management Tens Unit Products NexWave TM NexWave TM IFC, TENS & NMES in one device The NexWave incorporates IFC, TENS & NMES in one easy to use device. We recommend investors exit long positions and/or initiate shorts. An increased share of workers' comp patients and the new opportunity to dump massive quantities of electrodes on UHC patients led to major shifts in the company's financials: supplies rose to 79% of revenue in 2017 after averaging 39% between 2009 and 2016 (Zynex breaks out revenue for devices and supplies). This is a great tens for all types of muscle pain. Baseline Fingertip Pulse Oximeter, Standard, IontoPatch STAT, patch/Vial, 80mA-min, pack of 6, CanDo Treatment Table w/ Adjustable Back & Shelf, 400 LB Capacity, 72"L x 27"W x 31"H, Armedica Treatment Table - Motorized Hi-Lo, 5 Section, Non-Elev. To place on your head or transcerebrally. That's very much a negotiating item and by being able to negotiate well and make sure that the patients get the supplies that they actually need.". Some patients are having intermittent difficulties reaching us by phone due to a phone system update. I am not receiving compensation for it. Transcutaneous Electrical Nerve Stimulation. We're aware of this issue and are working on it urgently. This allows us to use it for 2 different body areas, or by 2 people simultaneously. The unit has repeatedly been delivering far higher shocks than according to program in tens mode, a powerful shock about every ten mins completely out of line with what shocking stimulation was . UHC's change of policy was overdue. In addition, UHC reduced the allowable quantity of electrodes per patient from 8 pairs to 4 pairs per month (2 supply packs). What is Zynex NexWave? This allows for 10 hours of continued use before recharging. for any questions regarding your existing account. What are the Side Effects of IFC, TENS, NMES? This is rechargeable and the battery has already lasted for 4 days with no recharge. In addition to TENS, the device also offers Interferential Current (IFC) and Neuromuscular Electrical Stimulation (NMES) modalities which essentially deliver the same electricity at different power levels and formats. Your search for "lead wires for Zynex medical - NexWave TENS Unit" returned the following results. In this Zynex NexWave TENS Unit Review, we will explain how the device work, and most importantly does the NexWave TENS help with pain management. I wrote this article myself, and it expresses my own opinions.
Complaints for Zynex Medical, Inc. - Better Business Bureau So, the penalty for Zynex could go beyond reduced future reimbursements and include liability for past profits. Massage Rapy Concepts Zynex Nexwave Ten Unit. Exhibit 7 - UHC patient claim post new policy: Electrodes not covered. archaic TENS unit yet revenue per order nearly tripled . Contact our team at (800) 845-1771, M-F, 8am-4pm MT, or at store@zynex.com, Access a condensed price list here: Price List. We alerted the Office of Inspector General (OIG), which has investigated and found wrongdoing at other TENS device companies, RS Medical and Empi. It is a device that incorporates IFC, TENS, NMES as unique all in one unit.
ZYNEX MEDICAL NEXWAVE USER MANUAL Pdf Download | ManualsLib Was dispensed a zynex medical nexwave tens/ifc unit (b) (4) for treatment of back pain. Two claims were approved for $115.62 without being reviewed to meet regulatory compliance timelines. More likely is that insurance companies dont realize theyre reimbursing for everyday 9-volt alkaline batteries rather than batteries proprietary to NexWave. Zynex also sells InWave for incontinence and NeuroMove for stroke rehabilitation, but sales of both are insignificant. Depending on where a patient lives can skew E0730 rates higher. Zynex was until recently (or may still be) billing for 8x this amount! While Zynex may not be accounting for the policy in its financials, we think it's reducing its salesforce and adjusting investor communications in response to the change at UHC and for what we think is a workers' compensation industry stiffening its reimbursement protocol. Trader/Investor with credit and equity background. How does it work? The increased messaging around this failed device suggests a dim outlook for the TENS market. You are not to use Nexwave under the following conditions or in the following areas. Those popular questions and more are what we will be answering in this review article. However, we believe Zynex should trade at a discount to peers, given the risk in its egregious pricing model. It's surprising that it took so long since UHC acted against a Zynex competitor for billing in the same manner, although less egregiously. Medicare wont allow claims using the A4630 and A4556 codes since A4595 already includes batteries and electrodes. For NMES treatment, press the NMES button. Exhibit 8 - Severe reduction in UHC reimbursement per NexWave order. For reasons discussed regulator and payer scrutiny, potential competition - its unlikely Zynexs pricing anomaly can persist for much longer and we dont think the stocks valuation is properly accounting for this risk as its currently trading at 10x EV/Sales and 40x EPS, multiples far above the average levels of medical equipment peer group companies as shown below: If Zynex were valued at average multiples, the implied downside in the stock would be in the 30-50% range. For instance, rates for rural areas are higher than non-rural areas, which may account for the difference in our device total of $210 compared to Zynexs implied total of $300. We dug through Medicare and commercial insurance billing information, and we cant figure out how Zynex collects so much on its supplies without using an aggressive claims strategy on Medicare and/or commercial insurers. Revenue per order increased 160% Y/Y in 2017 - while device revenue per order decreased. It incorporates 3 functions (IFC, NMES and TENS) in one. Here, UHC reviewed the claim and determined that 6 units of the supply pack, instead of 1 or 2, was a misrepresentation of provided services. This has an auto power-off function for saving the batteries ' power. It comes with 9 pre-programmed modes for the best experience. I am not receiving compensation for it (other than from Seeking Alpha). For supplies, Zynex should be using code A4595 which includes one month of supplies for a 2-lead TENS unit. To stem losses Zynex will be forced to cut staff significantly and reduce non-profitable orders from Medicare and most commercial health insurers. But the likely outcome is that both claims will be denied upon review and Zynex will be left with $38.54 for two units of A4595. Net income for the year was $7.4M or $0.23 per share. In 2004, the company became public by reverse merging into OTC listed Fox River Holdings. Below is a screenshot of part of our complaint to the OIG. NexWave received FDA approval in 2011. In September 2018, after conducting an audit of EMSI claims, UHC demanded EMSI stop billing for individual pairs of electrodes and to instead use the bundled supply pack code. They deliver their impulses through electrodes. In 2004, the company became public by reverse merging into OTC listed Fox River Holdings.
Zynex Tens Unit for sale| 21 ads for used Zynex Tens Units In theory, TENS stimulates sensory . We think the large receivables and DSO increases are at least partly due to lower collections from UHC, and that Zynex hasn't yet changed its revenue assumptions to account for the policy. Evidence supporting TENS efficacy is mixed and inconclusive mainly due to a lack of randomized controlled trials. Note, however, that after prescribing this device for you, it is not mandatory to use it only in the hospital under supervision. The first two codes are for the device itself, the bottom three for supplies:Source: CMS. DJO parent Empi stated otherwise when it announced closure of Empi in 2015: Empi business has created a major revenue and EBITDA headwind for the entire company for the last 4 years. We dont think its a coincidence that both RS Medical and Empi left just a few years after Medicares Competitive Bidding Program (CBP) was instituted in 2011. When I had an accident that resulted in the paralysis of one side of my body, I thought it was the end of my world. Given what we believe is an overly aggressive and/or potentially abusive pricing model based on overcharging insurance companies for generic products, we think Zynex shares are uninvestible and vulnerable to a significant repricing. It mimics the stimulating action of the central nervous system. How to Set NexWave for Optimul Stimulation? Zynex stock went from $0.10 in 2016 to nearly $30 in 2020. The use of low frequency to stimulate nerves is often associated with discomfort and pain due to the difference in the skin and the electrical stimulation. Zynex Medical Replacement Lead Wires Our Products >> Zynex Medical 56" T-Shaped Lead Wire w/Red Pin Ends Grey Click To Enlarge Zynex Medical 56" T-Shaped Lead Wire w/Red/Red Pin Ends, 1-each Works with the following units: IF-8000 IF-8100 Ewave Nexwave Truwave Plus Zynex Medical 56" T-Shaped Lead Wire w/Red Pin Ends Grey We back into potential reimbursed amounts and methods using Medicare rates and company data. Then Cefaly Anti-migraine Device might be a better option. We became aware of the situation through a lawsuit filed by the competitor. Any views or opinions expressed above may not reflect those of Seeking Alpha as a whole. Now lets turn into the device we review in this article, which is based on the above 3 technologies. thank you Glucerna Or Nutren Diabetes What Is Best For Diabetics? Replace battery when the battery icon appears on the display. We estimate the average reimbursement per UHC order was ~5x the ex-UHC average, skewing the overall average higher and making a big contribution to margins. To ensure this doesnt happen in the future, please enable Javascript and cookies in your browser. Its possible that private payer rates are higher than public rates, although in many cases, commercial insurers base their reimbursement rates off of Medicare. To hasten this process, we are actively alerting insurers, regulatory bodies, and publications of our concerns. A copy of a form that your doctor needs to fill before faxing over directly to the Zynex headquarters is downloadable from the website.
Amazon.com: Zynex What is Transcutaneous Electric Nerve Stimulation (TENS)? Zynex nexwave tens. Not only will Zynex lose revenue - it's margins will be materially impacted. Price: 200 $ This is much safer, it will for excellent value and has a compact design. This is great for loosening up tight muscles and for muscle pain. How to Take Zynex Treatment? Have pacemakers, defibrillators implanted in your body. Please. There are also 4 channels, so you can have double the leads. Overall, it's decent. This would equate to prices in the $3-6 range or downside of 50-80%. Is this happening to you frequently? Precedent occurred in 2009 when Zynex underestimated payor discounts forcing it to restate receivables and net income lower for the year prior by ~50% and 95% respectively [Pg. However, the companys revenues reveal a business model increasingly vulnerable to competition and/or regulatory scrutiny. The device line includes NexWave sales. Exhibit 2 - Zynex suddenly profitable in 2017. Including $250 for the device, Zynex was collecting nearly $5,600 for patients with UHC commercial health plans over the average 10-month prescription. Drive Tens Unit Agf-3e Dual Channel 4 Electrodes Portable Hard Case OTC (20) Total Ratings 20. IFC works like a TENS unit; its just that it yields better results and a more intense therapeutic effect. Lets start the review with one of our resident patients personal experience. In 1999, Zynex began selling its first generation electrotherapy device for pain. Rather than conserving cash or making the effort to move past a teetering business reliant on abusive medical billing by investing in new technology or M&A, Zynex is spending cash on a reckless attempt to "reward shareholders" - the largest of course being its own CEO. How Does It Work?Follow these steps for the best outcomes. Use battery-operated mode (by inserting the battery in the battery compartment at the back) or plug in the device to a power supply using AC adapter. Insert the lead wires (black and grey) in the area located on top of the device. Press the ON/OFF button For IFC treatment, press the IFC button located in front of the device.Long press it until the desired mode is achieved (look at the display screen). TENS devices are available by prescription and over-the-counter, although whether or not there are meaningful differences between the two categories is unclear. After the Centers for Medicare and Medicaid Services (CMS) instituted competitive bidding in 2015, slashing Medicare reimbursements for TENS, public reimbursement policy has remained weak. All of them utilize electrical stimuli or impulses to deliver their impact within the body. Zynex was already showing signs of nearing the limit of what insurers would tolerate, backing away from aggressive hiring guidance and reducing staff beginning in Q1 2021. Sandgaard owns around half of the outstanding shares. Traditional Chinese Medicine for Anxiety and Panic Attacks Does It Work? The rep stated that patients and providers could receive the device for a $25 copay. This is good for pulse rate and it works very well. Plus you can either purchase like units online or even Walmart for way less dollars an then you own it. Proven alternative for safe, effective home traction See product NMES E-Wave Easy-to-use NeuroMuscular Electrical Stimulator with unique features designed for high performance and a wide variety of options See product Stroke Rehabilitation NeuroMove Request a Demo 14 Day Free Trial Buy Now HCPCS Code Range E0720-E0770 E0720-E0770 Stimulation Devices E0720 Choose your option: Health Insurance Coverage Submit a claim to your insurance company for the cost of your supplies. Remember the story of David narrated at the beginning of this article? From our understanding, the purchase price is reimbursed at the same rate as the rental. A TENS unit must be distinguished from other electrical stimulators (e.g., neuromuscular stimulators) which are used to directly stimulate muscles and/or motor nerves. Please contact patient support at (800) 495-6670 or (720) 779-0218 to order more supplies. How does it work? Its noteworthy that Zynex doesnt hold any patents for NexWave, likely because its based on technology that is several decades old. Appreciate all feedback. Event Type Injury. Sandra Scariot, Im asking for I do regarding the IFC / TENS So, you may wish to check if your insurance can cover the cost. Have a bad return or refund policy.What is Zynex Nexwave Used For? This has internal batteries that can be recharged with the included charger. Zynex was founded in 1996 by current CEO Thomas Sandgaard. Our ultimate goal is your health and happiness.
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