Insurance Coverage

Vein Specialists of the Carolinas

Insurance Coverage

Are Vein Treatments Covered by Insurance?

If you experience any type of pain, discomfort , or swelling of your legs with normal daily activities or any aspect of one your job, that are not completely relieved by the following:
- Over the counter pain meds like Tylenol, Advil, or Aleve.
- And elevating the legs and avoiding prolonged standing or sitting.
- And wearing medical grade compression garments with 20-30 mmHg pressure for a period specified by your insurance carrier- usually 2 weeks, 6 weeks, or for most plans 3 months.

If you have a venous ulcer—YES.
If you had an ulcer that is now healed—YES.
If you have had more than one episode of phlebitis—YES.
If you have had more than one episode of minor bleeding or one episode of major bleeding from a vein—YES.
If you just don’t like the way they look with no other symptoms at all – NO.
We file insurance as a convenience to our patients. We also take cash, check, credit cards, FLEX spending, and offer financing.

Insurance Coverage, Vein Specialists of the Carolinas

Financial

Vein Specialists of the Carolinas will serve its patients in a courteous and competent manner at all times

We appreciate the rising cost of medical insurance premiums for everyone along with the rising cost of living.

We understand how expensive medical care can be.

However, perhaps you are not aware that physician reimbursements in general have decreased every year over the last twenty (20) years.

Vein Specialists of the Carolinas accepts assignment of our patient’s insurance benefits and files claims on their behalf.

Patient – Insurance Assignment of Benefits

Insurance companies will pay your medical provider at what they deem “usual and customary fees”.

These are different depending on whether the provider is “in network” or “out of network”.

We are in network for about 50 providers and participate with Medicare.

They subtract your part from that amount. Your part is:

Annual Deductible
Co-Insurance
Co-Pay

This results in your obligation to pay these amounts in full at the time of service or to finance them

PATIENT FINANCING ARRANGEMENTS

Patient deductible, co-insurance and co-pay Financing

Vein Specialists of the Carolinas makes available:

Credit card payments.
(24) month financing plan.
Interest free financing plan for up to (6) months-some limitations apply.

USEFUL DEFINITIONS OF YOUR INSURANCE POLICY

Deductible

The amount of money you must pay before the insurance company will pay. An exception to this is the Co-pay.

Co Pay

This is the amount the insurance companies require you to pay, and for us to collect, to not be guilty of insurance fraud.

Co-Insurance

This is the part you owe after all of the deductible has been met. Some plans pay 100% after the deductible. Most pay 80%. This is less if the doctor is out of network. These numbers are chosen by the person buying the insurance.

Maximum out of Pocket

This is the total amount of money you will ever have to pay in that calendar year.

Pre Existing Conditions

These have been eliminated by Obama care

Un-Covered Services

These are services that have no policy about them in the insurance contract.

Not medically Necessary

A term insurance companies use to deny payment based on their guidelines as they interpret the medical literature.

It does not mean you don’t need the treatment or service by currently accepted standards of medical care that doctors go by.

Cosmetic or Investigational

A term insurance companies go by that means you don’t meet their criteria of medical necessity.

Pre–Certification

A clause that requires that patients and providers advise the carriers prior to admitting the insured party to an inpatient status at a hospital or prior to performing any surgical procedure. Failure to do so will result in non payment for medical services.

Rules and Barriers

During this time the rules and policies adopted and imposed by Insurance Carriers regarding allowable patient treatments (when, if, and what treatments patients may have according to Insurance Guidelines) have risen to an all time level using most often “not medically necessary” as the rationale behind claim denials. In an attempt to overcome this obstacle we process written requests to your insurance carrier asking for their agreement as to the “medical necessity” of the purposed treatments prior to performing procedures.

In keeping with our desire to serve you, our patient, we additionally accept “an assignment from you of your insurance benefits” in order for us to file your insurance claim covering the cost of the medical services rendered by Vein Specialists of the Carolinas. This does not relieve you of the burden of payment should your insurance company failed to pay your claim; however, we do all that we can possibly do to effect payment.

What To Expect

Insurance Coverage

Patient Forms

What To Bring