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Hi, I have been watching this thread,, I cringe at the lengths labs go to
showing incompetency of GSV,, SSV.
My concern is claiming 5-6 seconds of reflux by valsalva only. When we all
know the length of the reflux time is how long they instruct the patient to
bare down !  Sorry to me it is fraud by method. I can see proving. GSV
JUNCTION  incompetent with valsalva, and not by dist augmentation plus
incompetent with distal  augmentation 5-6 seconds the entire thigh and
calf.
Veins are a big income for centers, I work in one.  The insurance companies
have made it difficult to fix the veins that need it, but I will not
contribute to proving reflux with valsalva only,,,, just my opinion and
ethics.
Denise

On Friday, January 24, 2014, Schneider, Joseph MD <
[log in to unmask]> wrote:

>    This message was sent securely using ZixCorp.<http://www.zixcorp.com/get-started/>
>
>
> I have been watching this thread for the last 2 days.  I feel compelled to
> state that our response to the insurers needs to be that we include all of
> the insurer’s required elements, for example BC/BS Illinois requires that
> we state that the exam was done standing (never mind that I told them we do
> them all that way, I must so state in every report) and recently I even got
> dinged because I did not explicitly state that I saw no perforators.
> That’s all fine, i.e., we can and must put in observations that the insurer
> requires for decisions about authorizing treatment, but we cannot embellish
> beyond what the images and spectra actually demonstrate.  Remember that
> this forum is discoverable!
>
> Joe
>
>
>
> *From:* UVM Flownet [mailto:[log in to unmask] <javascript:_e({},
> 'cvml', [log in to unmask]);>] *On Behalf Of *Bill Schroedter
> *Sent:* Friday, January 24, 2014 9:23 AM
> *To:* [log in to unmask] <javascript:_e({}, 'cvml',
> [log in to unmask]);>
> *Subject:* Re: Non saphenous vein reflux
>
>
>
> I just have to jump up on my soapbox here. (Unless you mistake – this is
> the “other” Bill)
>
>
>
> We of course deal with the insurance issues constantly and over the years
> have altered our reports in order to streamline coverage determinations
> (especially with private insurers.) In fact, I admit, we have dumbed down
> our reports. In an effort to obtain coverage for our patients (not
> completely wrong), we are basically allowing insurers to dictate and even
> set reporting standards as opposed having the medical community set these
> standards.  This is completely wrong and I believe will eventually prove
> disastrous to medicine. We need to create the environment in which the
> insurers are forced to adapt to medical reporting standards.  We should be
> involving patients more, educating them and requiring the patient to
> contact their insurers to argue for coverage. Involve the states’ insurance
> commissioner. Our patients are the customers, not the providers whom
> insurers have a significant financial incentive to deny coverage. OK -
> before someone slaps me back into reality, let me admit - I know, I am
> living in a dream world. Not that one cannot accomplish both, but I still
> cringe when our reporting verbiage is created to allow coverage as opposed
> to accurately relaying the findings in the most clinically useful fashion.
>
>
>
> Regards, Bill
>
>
>
>
>
> William B Schroedter, BS, RVT, RPhS, FSVU
>
> Technical Director
>
> Quality Vascular Imaging, Inc
>
> Venice, Florida
>
> (941) 408-8855
>
> www.qualityvascular.com
>
> www.compressionsocks.pro
>
>
>
>
>
>
>
> *From:* UVM Flownet [mailto:[log in to unmask]] *On Behalf Of *Nancy
> Williams
> *Sent:* Friday, January 24, 2014 9:31 AM
> *To:* [log in to unmask]
> *Subject:* Re: Non saphenous vein reflux
>
>
>
> This is so true.
>
>
>
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