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The treatment of varicose veins, in your office or in a hospital outpatient department, is subject to detailed and ever changing coverage policies. These policies, referred to by Medicare as a local carrier determination (LCD), and by private payors as a medical policy, establish medical necessity criteria that must be met before a patient’s surgical treatment will be reimbursed. Non-compliance to these published criteria can have disastrous results and can put your practice at significant financial risk.

One vein practice was audited and, as a result, received a recoupment demand for $900,000 for failure to meet coverage criteria. This is just one of many scenarios where vein practices were obligated to repay a payor for not following medical coverage policies. Establishing a best practice approach to guide compliance with these coverage policies is an essential part of any vein practice.

About

In this 32-minute program, you’ll learn:

  • What makes a vein practice an audit target?
  • The audit environment: who are the payor players and how do they impact you?
  • The definition of coverage policies/medical necessity policies and where to find them.
  • Components of varicose vein coverage policies.
  • How to document compliance in office visit, ultrasound, and varicose vein procedure notes.
  • How to prioritize your practice’s compliance efforts.
  • Best practice procedures for ongoing policy compliance.
  • Why internal and external auditing are essential to compliance efforts.
  • Tips for developing and executing a compliance plan.
  • Audits and Varicose Vein Treatment
  • Coverage Policies and Documentation Imperatives
  • Conservative Trial Highlights
  • Establishing and Applying a Coverage Policy Compliance Process

Presenter

Teri Romano, RN, MBA, CPC, CMDP 
Consultant and Speaker

Teri Romano has over twenty-five years of consulting and teaching experience in the health care field. Ms. Romano works with physician groups and hospitals combining a background in clinical systems with solid approaches to operational and organizational problem solving.

Find out about more about Teri Romano, RN, MBA, CPC, CMDP
Consultant and Speaker

$99
Varicose Vein Treatment Webinar