The majority of insurance companies including Medicare recognize the importance of surgical procedures to eliminate varicose vein disease with symptoms. Each carrier administers unique requirements that must be complied with to deem the procedures as medically necessary. That is where a misconception can happen. If medical necessity is not established, the carrier will likely presume that the procedures are being performed for cosmetic reasons. An experienced vein practice will be able to advise the patient in specific requirements and thus avoid the ´cosmetic´ label when being performed for a medical condition.
Benefits vary with each insurance plan and it is important that you understand your policy. A highly experienced vein practice will help a patient understand their benefits, and guide them in specific medical necessity and coverage policies. Avoiding an unexpected bill involves a coordinated effort of meeting medical necessity, using therapeutic options that the insurer recognizes, and acquiring approval for services before treatment is rendered. Seasoned vein practices understand nuances of insurance carriers and should be able to avoid an unforeseen financial burden.
Selecting a provider can be tough, but yes you have the ability to choose the doctor to perform your procedures. An in-network provider does not necessarily mean that your experience or outcome will meet your satisfaction, yet it may prove to be less expensive. Choose the provider that makes you most comfortable, and who can deliver the results you are searching. Realize that an out-of-network provider has the ability to reduce your out-of-pocket expenses, as they are not contracted with your carrier. In these instances, seeing the out-of-network provider may have the same out-of-pocket impact as seeing an in-network provider. It pays to do your research and become comfortable with the provider and the expenses of having treatment for your varicose veins.
In practices with limited treatment options, acquiring insurance benefits may prove difficult. The Lafayette Regional Vein & Laser Center (LRVLC) offers comprehensive treatment options, except for traditional surgical stripping. Generally speaking, if you have a vein concern and a difficult carrier, LRVLC is likely to have both the treatment options to fit your needs, and the experience to deliver your intended outcome.
Dr. Schul has been significantly recognized as the patient advocate as he has spoken and written on this topic since 2005. The climate of insurance is changing and if a practice fails to recognize this fact, nothing but insurance denials will be expected. This is why Dr. Schul and his staff are the best patient advocates in the area. It all starts with an accurate ultrasound diagnosis and from there his team reviews your benefits and establishes a plan to help those in need acquire the benefits they justly deserve. Bottom-line is that the best clinical or cosmetic outcome is nothing if attached to an unexpected financial surprise.
Blue Cross Blue Shield plans