American Physician Financial Solutions

A Growing Trend by Cheryl Nash and AJ RiviezoSome payers are requiring a rule out of peripheral artery disease to be contained in the history and physical prior to granting an authorization. One way to add this element is through a pedal pulse examination. Another is to have your RVT (or you as the case […]

Lunch and Learn with Bariatric Surgeons by AJ Riviezzo, MBAWhen establishing your referral base of physicians, one specialty niche to consider targeting is bariatric surgeons. Patients who receive lap band and other bariatric surgeries frequently have venous insufficiency surface as an issue. Their weight issues were masking the signs and symptoms until they have lost […]

Quick Information Regarding Ablation of Other Elements by AJ Riviezo, MBAWe are frequently asked if one can perform an RF or laser ablation for a tributary, anterior accessory or perforator – and receive payment for the work. The answer is, like most everything regarding insurance, perhaps. First, the vein to be ablated must meet the […]

More Requirements by UHCby Cheryl Nash and AJ RiviezoOver the past few weeks we have obtained further clarification from Dr. Jeff Mason, Senior Medical Director for United Healthcare (UHC). One of the key questions needing clarification was “pictures of what exactly?”. UHC, per Dr. Mason, would like to receive the following from the diagnostic duplex […]

Or… How to Herd Cats by AJ Riviezzo, MBAAs the data above shows, very few men are coming in for phlebology services. The reasons are fairly evident and are not unique to phlebology. The question then becomes: “How do we capture a few more of these reticent males?” Below are some ideas for your consideration. […]

A Quick Demographic Study by AJ Riviezo, MBAA new practice was asking for some information about patient demographics. To that end, I combined the demographic data of three large phlebology practices. None of these practices specifically target Medicare members as their primary market. All of them have primarily commercial payers with some (less than 20%) […]

by Cheryl Nash Many of you may have received a letter from United Healthcare recently detailing some significant modifications to their coverage guidelines. With the main topic of discussion being documentation this month, I feel this is an opportune time to review these changes.The most dramatic change by United is the addition of digital photos […]

by Cheryl Nash We’ve all heard it and we all have to do it. Documentation: The necessary evil. For a phlebology practice, each new year seems to bring more lengthy requirements and requests for records. From Ultrasound Reports to History and Physicals; Operative reports to Letters of Medical Necessity; it seems that today’s phlebology specialist […]

Effective February 15, 2010, Blue Cross and Blue Shield of Florida will no longer pay for ultrasound guidance when performed with sclerotherapy. Their medical director seems to believe that there is no clinical reason for using ultrasound guidance. They appear to be confused between being able to treat visual veins and those deeper system perforators, […]

Our friends at CIGNA have developed a few interesting nuances over the past year. Most of these new issues create denied claims and can leave you and the patient scrambling for a resolution. Self-funded riders. We have seen a number of patients that have a self-funded CIGNA plan. These plans contain a rider that disallows […]