There are many insurance carriers such as Blue Cross and Blue Shield®, Aetna®, and United Health Care® who refuse to reimburse surgeons and surgical facilities to perform the EOTTS procedure. They claim there is “lack of evidence” to support the effectiveness of this internal, minimally invasive procedure. The reality is, of course, quite different. The EOTTS procedure is approved for use in more than 60 countries and is routinely performed by leading orthopedic and podiatric foot surgeons around the world.