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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:
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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]');" target="_blank">[log in to unmask]] On Behalf Of Bill Schroedter
Sent: Friday, January 24, 2014 9:23 AM
To: [log in to unmask]');" target="_blank">[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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