MEDICARE 2019 FINAL RATES

The Centers for Medicare and Medicaid Services (CMS) just posted the new Medicare fee schedule for 2019.  There are a number of changes that will impact the phlebology physician.  Please keep in mind that any allowed amounts you receive will be different (up or down depending on geographic area)from the ‘national average’ rate listed below. […]

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PICK ME, PICK ME!

Perhaps you do not really want to be picked as we are discussing why Medicare or perhaps one of the Blues may pick you to do a preliminary or more in depth audit. There are a variety of reasons you may be audited, but the top 7 reasons that are not due to external issues […]

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MEETINGS AVAILABLE AT THE ACP

As you may or may not know, the American College of Phlebology Annual Congress’ format is a bit different this year.  Instead of having the Exhibitor area open most of the day with only a bit of time between sessions in which to visit the Exhibitors, they are now scheduling lunch from 11:00 to 1:30 […]

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BACK TO BASICS – The EOB

The EOB or ERA, EOP, 835, etc. There are many acronyms to describe the payer’s remittance when received. Understanding these is even more challenging. In this article we will try to de-mystify and provide a better understanding of the process.   First the acronyms: The most common are EOB- Explanation of Benefits, EOP- Explanation of […]

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HONDURAS VEIN WEEK MISSION TRIP

Each year in March, a group of physicians, nurses, ultrasonographers and volunteers travel to Honduras on a medical service mission sponsored by the Hackett Hemwall Foundation. The week is more than just treating hundreds of Hondurans suffering from severe venous disease; it’s a life changing experience.  The academic experience is invaluable while earning approximately 40 category 1 […]

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EXTERNAL TROUBLEMAKERS

Well, they are not exactly trouble makers but if you do not pay attention on occasion to these outside entities you can have some difficulties. In the course of contracting for our new clients and re-contracting for our older clients we run into various roadblocks or issues from the Council for Affordable Quality Healthcare (CAQH), […]

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NOVITAS DRAFT POLICY

Our friends in Novitas have again come out with a policy that makes little clinical sense. This policy DL37796 – Sclerotherapy and Endovenous Non-Thermal Treatment of Varicose Veins tries to accomplish two goals. The first is to detail the covered indications and who may provide sclerotherapy. The second is to disallow use of the three […]

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BACK TO BASICS – INSURANCE CARDS

We have received a number of calls regarding confusion on policies, plans, and products put out by the various payers. The confusion stems, in part, to the large number of plans that are being developed by the various payers. It seems like every large hospital system, commercial payer, and Medicaid replacement payers are rolling out […]

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CAN I BILL THE PATIENT FOR THAT?

This is a question commonly asked by many practices, and it is a loaded question! The answer is: It Depends.   Depends on what? There are as many rules surrounding what you can and cannot bill a patient for as there are for sending clean claims. I will try to de-mystify the most common scenarios […]

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NEW MEDICARE CARDS

Every time I go to my primary care physician, the receptionist re-validates my insurance information. Perhaps because phlebology services tend to be intensive and over a shorter period of time, very few vein practices seem to do this. However, there are a few good reasons to consider taking this extra step.   New Medicare Cards: […]

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