American Physician Financial Solutions

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 […]

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 […]

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), […]

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 […]

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 […]

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 […]

Every time I go to my primary care physician, the receptionist re-validates my insurance information as well as my insurance quote. 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 […]

The following article is taken from a presentation given at the Colorado Phlebology Conference in Telluride this past January. My apologies for the length.   Medicare along with Blues and other commercial plans are ever more vigilant in regards to fraud. Unfortunately, the word ‘fraud’ seems to encompass a very wide definition including simply bad […]

Everyone is excited for the 2018 coding changes.  Some of the hottest new technologies have been assigned codes by the AMA and these will be effective on 01/01/18.  Just in time for the New Year, APFS is providing coding clarification on these new service codes. 36465 – Non compounded foam sclerosant with ultrasound compression maneuvers […]

Each year, 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 CME […]