As part of their strategy to increase quality-of-care and control costs, many managed-care plans require patients to choose a primary-care physician (PCP) – usually a family practitioner, internist or pediatrician – to provide basic medical care. Often, PCPs also play the role of medical specialists gatekeeper. That is, they are responsible for determining treatment and use of specialists for various health conditions. The aim of such an approach is to cut down on unnecessary and costly visits to specialists that may include needless and expensive tests and hospitalizations. Although not all insurance plans operate like this, more and more are moving to this system.
Even if your own insurance plan doesn’t require a PCP referral prior to being seen by a specialist, it’s always a good idea for you to have a PCP to provide routine care, coordinate all of your healthcare services and advise you on improving your general health and well being.
A little known fact is that, in either case, you are NOT required to rely only on your primary care physician’s recommendation regarding which specific specialist to see for your condition. Many physicians are now employed by hospitals or healthcare networks and are, often, highly encouraged to refer patients to specialists within their own network, whether or not that specialist is the most experienced or best fit for the patient’s medical needs.
In the event that you need to see a vein specialist, take some time to do your own research, and make sure you feel comfortable with your vein specialist’s reputation, credentials, staff and location, as you will visit the office several times from time of evaluation to final post-treatment check-up. In addition, the specialist should be a participating physician within your insurance network.
Good online sources for gathering vein treatment information/area listings for specialists include:
Premier Vein & Body by Schwartz is an independently-owned and operated vein treatment center located in Leawood, KS. Owned and operated by Dr. Craig Schwartz, we have been providing vein treatment procedures for both varicose veins and spider veins in the Kansas City metro area since 2003. We participate with most major insurance providers in the area, and our staff is very knowledgeable and experienced with the coverage provided by each plan for vein treatment and will be a great resource for you as we determine insurance eligibility and benefits. Please call Premier Vein & Body by Schwartz with any questions regarding our participation with your specific insurance plan or to schedule a free vein screening. 913-451-VEIN (8346).
– Dr. Craig Schwartz