2017 Navigating Coverage Policies in Varicose Vein Treatment.
2017 Navigating Coverage Policies in Varicose Vein Treatment. Quantity in Basket: None

Length: 32 minutes

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.

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.