The
“We treat people, not
just problems.”
John
L. Pfenninger, M.D.
(989) 631-4545
Visit our
website at: MPCenter.net
.
SCLEROTHERAPY BILLING PROCEDURES
The
purpose of this communication is to discuss with you the cost and payment
mechanism should you desire to have sclerotherapy (vein injections) performed.
For your first visit, we will spend
approximately 30 minutes discussing your problem and conducting an
examination. In addition, there will be
a separate charge for a test (photoplethysmogram—abbreviated "PPG")
that will be carried out to determine if there are any problems deeper in your
veins, which would prevent us from doing sclerotherapy. For this first visit, we will usually accept
what your insurance company allows as the "reasonable and customary"
fee, provided these services are covered by your insurance company. If you have a co-pay or deductible, this
would be your responsibility. If these
services are not covered by your insurance, payment is expected at the time of
service. You will receive a 20% discount
if the office consultation and PPG are paid in full at this time and you have
no insurance.
If it is
decided that you want to proceed with sclerotherapy, you will usually need to
purchase compression (special type support) stockings at your first visit. Most patients will need panty hose (but
occasionally we use below the knee, single leg hose, thigh highs, or even ACE
wraps) which will need to be worn after the injections. We will order them for you at a reduced rate
through our supplier. However, they will need to be paid for before
they are ordered. The costs are
$________ for panty hose, $________ for knee-highs, $________ for thigh-highs,
and $________ for single leg. You can
purchase compression hose elsewhere, but we prefer MediUSA, Sigvaris, or Jobst
brands.
Most
insurance companies judge the sclerotherapy injections themselves to be
"cosmetic" and do not cover cosmetic procedures. When we first began doing vein injections, we
tried to bill the insurance directly. However, there were so many claims rejected
that it became a nightmare.
Subsequently, we have decided not to participate for the injection
procedures. Thus, you will be
responsible for the cost of injections on the date of service (cash, credit
card, or check). Although we generally
offer a 20% discount for payments on the date of service, this discount does not apply to sclerotherapy
injections, since our fees are below the average rate. The fee is $372.00 for approximately 30-40
injections, which take approximately 30 minutes. You may submit your bill to your insurance
company and they may reimburse you directly in some instances. Medicaid
and Medicare are particularly difficult to deal with regarding vein injections. It is
very difficult to have them approve any payment, and they consider nearly
all sclerotherapy injections cosmetic.
Subsequently, even though we do accept Medicare and Medicaid patients,
you must understand that this is may not be a covered benefit and you will still
be responsible for payment on the date
of service. We will do what we can
to help you with documentation for reimbursement.
Please call in advance should you have any questions whatsoever regarding the billing and fees. Please read over all handouts and fill out your forms before the visit. We look forward to meeting you.
Copyright, 2011. John L. Pfenninger, M.D.
Sclero Billing/02/11