Search
Most Popular Articles
- Discussion of the Human Body Defense System
- The story of the 12 animals zodiac in China
- How to Balance Your Body to Get Pregnant
- Eating Junk Food -- The Hidden Price
- How To Stop Your Cat Scratching - Get Rid Of Those Fleas
- Ski Boots -- Testing 1, 2, 3
- Wear it Up or Wear it Down?
- Cat Care, Cat Products and Cat Diseases
- Choosing a Cell Phone
- Artificial Satellite Types
Removing Varicose Veins for Healthy Legs Is It Covered?
 Category |
: Health |
 Times Read |
: 30 |
 Date |
: 08 May 2008 07:00 |
by: AllMed Healthcare Management
In todays age of beauty and fashion, men and women are seeking ways to eliminate the ugly varicose veins they tend to get with age, weight and heredity. While this might seem like an optional, cosmetic surgery, many people in their twenties and older frequently suffer from swollen and painful legs as a result of varicose veins. In advanced cases, patients can also experience leg ulceration, skin breakdown, superficial phlebitis and, in rare instances, bleeding.
There are a multitude of causes that contribute to a patients inclination to get varicose veins. Typically, physicians prescribe basic solutions, such as compression stockings that squeeze the leg and may alleviate many of these symptoms. But, these solutions dont work for all patients.
The stockings dont make the twisted-looking and bulging veins go away, and, oftentimes, patients find them difficult to put on, hot to wear or not suitable for their lifestyle. If, after several weeks, patients are not getting what they want from compression stockings, they are probably going to consider surgery. Why? With varicose veins, the damaged veins cannot pump blood back to the heart, which causes adverse patient symptoms. Surgery either removes the vein and its tributaries, or cauterizes the vein to prevent blood flowing through it. Yet, except in well-documented cases, most healthcare plans consider varicose vein surgery cosmetic.
In order for varicose vein surgery to be covered:
A patients physician needs to conduct a physical exam, as well as document the patients history
The patient must follow the conservative treatment plan and wear the compression stockings for several weeks
The physician must track all of the patients general health, medical history, symptoms and tried treatments to help prove the need for surgery.
If the patient rejects the conservative treatment or if further proof is needed, a physician can conduct an ultrasound to measure the speed of blood flow and observe the structure of the patients veins and determine the reflux (backflow) of blood. This test can also determine if there are other conditions affecting the leg and provide the insurance carrier the medical evidence needed to cover the surgery. Another advantage of this approach, is that it eliminates those patients with spider veins looking for payers to cover a procedure thats purely non-medical and cosmetic.
For a case study on how one organization uses an IRO for medical necessity reviews, view our Ensuring Quality / Determining Necessity case study (http://www.allmedmd.com/resources/downloads/case_cbc.htm).
About The Author
AllMed Healthcare Management Founded in 1995, AllMed (http://www.allmedmd.com, http://www.allmedmd.com/blog/index.htm) is a URAC-accredited Independent Review Organization (IRO) serving insurance payers, providers, TPAs and claims managers nationwide. Reviews are conducted by board-certified physicians in active practice. AllMeds growing customer base includes premier organizations, such as Educators Mutual Life, IMS Managed Care, Tenet Healthcare Corporation, HealthGuard, several Blue Cross Blue Shield organizations, TriWest Healthcare Alliance, Allianz and many other leading healthcare payers.
info@allmedmd.com
Random Article 1 |
Random Article 2 |
by: AllMed Healthcare Management When a patient is admitted to the hospital, the most expensive days are the first few. These are the days when the patient is the sickest and the hospital staff is running tests and doing workups trying to sort out the patients condition. After that, t |
by: Gray Rollins Candida is yeast, considered a normal part of our bowel flora, generally found in the mouth, throat, intestines and genitourinary tract. Its purpose is to fight off harmful bacteria that it encounters in the body. Its presence in the body, then, is not problematic |
Random Article 3 |
Random Article 4 |
by: Johnny Lavot Many times, when one begins a new fat loss regime; they focus on dieting (hopefully intelligent dieting, not fad diets or very low calorie diets) and hopefully an exercise regime. Most of the time, to accomplish fat loss, people seem to believe that aerobic (aka. card |
by: Dr. Jamie Fettig Some people say to themselves, junk food is not that bad. If you want to believe this than good luck. Remember how important your beliefs are and especially the ones that are faulty that you still believe. It goes back to what I said earlier. If you want to build |