Establishment of a cooperative - interdisciplinary second opinion procedure or diagnostic procedure in the case of chronification with subsequent recommendation of a therapy option and - if necessary - indicated interdisciplinary multimodal pain therapy (IMST) - back SPECIAL - your plus for therapy decision - in Mecklenburg-Western Pomerania (MV).
AOK Nordost plans to conclude contracts in accordance with Section 140a SGB V on the special care of insured persons in order to establish a cooperative - interdisciplinary second opinion procedure with subsequent recommendation of a therapy option and - if necessary - indicated interdisciplinary multimodal pain therapy (IMST). Patients with pending outpatient or inpatient disc or spinal surgery are given the necessary security and confidence in their subsequent health therapy decisions through an interdisciplinary second opinion procedure or patients with chronic back pain at risk of chronicity / chronic back pain through a diagnostic procedure in the event of chronification (hereinafter: diagnostic procedure). The subject of this contract is, in addition to the implementation of an interdisciplinary second opinion procedure to confirm / exclude an upcoming intervertebral disc or spine operation, the cross-sector / specialist group and specialist disciplines treatment and care of back pain patients based on evidence-based guidelines as part of a structured and specialized care program.
Insured persons who are about to undergo intervertebral disc or spinal surgery are given the option of using an interdisciplinary second opinion procedure - provided the doctor treating the acute treatment has a corresponding prescription / referral - and, in the case of special treatment needs, participation in a subsequent outpatient interdisciplinary multimodal pain therapy.
Insured persons with chronic back pain at risk of becoming chronic have the option of using an interdisciplinary diagnostic procedure and, if there is a special need for treatment, a subsequent outpatient interdisciplinary multimodal pain therapy.
Overall responsibility for the provision of the agreed content of the contract rests with the contractor in accordance with Section 140a Paragraph 3, Clause 1, No. 1 or 2 SGB V as the contractual partner (approved - authorized doctors and psychotherapists, medical care centers / MVZ, hospitals, preventive / rehabilitation facilities , Health care providers or management companies). If necessary, this will conclude cooperation agreements with the approved service providers ("the cooperation partners" - the cooperating service providers named in Appendix 3) in the area of special care.
The approximate order volume for the Mecklenburg-Western Pomerania region is estimated at 139 cases in the context of the second opinion and 56 cases of chronification.