The path from deciding to outsource medical billing to selecting your medical billing company requires a well planned selection strategy. A cornerstone of this strategy is well thought out and executed reference checks.

Reference checking is certainly not the only element that must be properly executed in your medical billing company selection. It is, however, one of the more critical and it has several sub-steps that must be properly considered.

Although today's write-up is geared towards creating an effective interview guide, this is far from the only ingredient of a successful medical billing services company selection. Other critical ingredients include outlining the minimum requirements of an acceptable reference (e.g., does it need to be in your state, what specialties are acceptable, etc), deciding if you want to speak with a former client, outlining the roles of the people with whom your wish to speak (e.g., lead partner, practice administrator, day-to-day billing contact, etc), creating the interview guide, call the references, and making the final go/no-go decision.

Your interview guide will allow you and not the references to determine what topics are addressed in the reference calls. If you do not drive the calls, you may well end the process still unsure about your final decision. To kick-off the interview guide creation think about the worst things and the best things that could happen as a result of medical billing outsourcing. Keeping your mind on these best and worst cases develop questions that will help you determine where between these two extremes your potential medical billing company operates.

It is critical to ensure that your questions are specific enough that you can come away with real facts from the reference calls. You do not want to ask broad questions like "Are you happy with this company's performance?" Such questions are open to much interpretation and are driven by the individual's previous experiences.

Given this issue, your next task is to make the question more geared towards gathering objective facts. For instance, you might change the question above to say, ?How many hours per week did you spend before outsourcing on reviewing billing performance reports, reviewing EOBs, and reconciling your bank deposits with your billing system reports? How many hours per week do you spend on this now??

Once you complete the list of questions and make them specific enough to gather objective data type them out in a logical manner and leave the space required to jot down the answer right on the interview guide. Before the first call sit down and look at the questions one final time. Make sure that the answers to these questions will give you the comfort you need to make a final decision. Start making the reference calls once you are confident your interview guide is ready.

It is your job to make sure you get specific answers to all of all your questions. Think of yourself as a reporter and do not let the call end until you have all of your questions specifically answered. You will need to practice good time management to make sure this happens in the period the person is allowing for the reference call. If you do not get all of your questions answered, then ask to schedule a second call.

You may find that one of your references brings up a point you had not considered. If they do, add the relevant question to the end of your interview guide and call back any individuals with whom you have already spoken to get this additional information.

With your well planned and structured reference checks complete you will be in a position to make an informed medical billing service decision.


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Medical billing is a rapidly expanding field in the healthcare sector, and the demand for skilled medical billing specialists is on the rise. There are many companies now offering medical billing services in Texas in an effective and prompt manner. These companies assist with the tedious tasks of billing and follow-up functions, thus allowing you to concentrate more on your core business.

The process of medical billing involves preparing, submitting as well as following up on insurance claims. The procedures involved in medical billing applications and insurance claims are highly complex. Since most medical office personnel do not have much time to process claims with the insurance companies, they outsource their medical billing assignments to other locations.

Most of the medical billing companies in Texas provide medical billing services to all types of practices and organizations, including physicians’ groups, clinics, hospitals, large healthcare facilities and insurance companies. The companies appoint well trained and highly qualified billing specialists to carry out all the medical billing procedures in an efficient way. They also take care of your insurance details and medical coding processes as part of their services.

Mentioned below are some of the medical billing services provided by medical billing companies:

• Demographic and insurance information
• Insurance verification procedures
• Authorization
• Cash posting
• Charge entry
• Accounts receivable follow up and collections
• Insurance collection

You can enjoy a number of benefits by using the services of a well established medical billing company:

• Electronic processing
• HIPAA compliance
• Complete medical billing management
• Improve your cash flow and collections
• Reduce billing costs
• Reduce payer denials
• Eliminate billing headaches

Before relying on a medical billing firm in Texas, it is better to perform considerable research in terms of rates, services, and other associated factors. As many of the medical billing companies offer free trial version for service quality evaluation, it is an excellent idea to take advantage of those free trial packages.

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Over the next several articles I plan to discuss a framework for thinking through whether outsourced medical billing is the right decision for you. The decision is a critical one, so it is imperative that it be based in facts and not in urban legends and myths. Although I am focusing on medical insurance billing services, the basic concepts apply to any outsourcing decision. Today I will outline the main benefits to consider when making the decision about medical insurance billing outsourcing and the most typical concerns and risks associated with the decision to outsource medical billing. Over the following days I will discuss each element in more detail.
The fundamental principal behind outsourcing is the focus on core competencies. The idea is that you and your practice are geared towards treating patients, not fighting insurance companies and pursuing personal balances. On the other hand, medical insurance billing services focus on billing and should have the scale, focus and employees to do a better job than most medical practices or medical facilities. The primary benefits that a medical practice should see from the right medical billing service are:

1. They have more scale to purchase and deploy the technologies required to properly submit claims, battle with insurance companies and collect personal balances.
2. They are able to attract a higher caliber of billing specialists and retain these individuals.
3. They have a deeper bench of employees and this provides a layer of protection for your practice by decoupling you from the risk associated with losing a key (if not the key) billing employee.
4. They are better positioned to properly utilize the technology they have.
5. They have a broader scope than any single medical practice or facility. This allows them to see patterns across practices, specialties, states and payers that can add money to your medical practice's bottom line.

The typical concerns that physicians and practice managers have when deciding whether they want to outsource medical billing are:

1. Will billing services fight as hard for me with insurance companies as my own employees?
2. Can outsourced billing companies handle the unique elements of my practice?
3. Will I lose control and visibility into how my accounts are being worked?
4. Will an outsourced billing company alienate my patients through heavy handed collection practices?
5. Will medical insurance billing services only go after the low hanging fruit, and leave the more difficult money uncollected?

Over the upcoming articles I will go into more depth on each of the benefits and concerns outlined above. I will go ahead and give you a peek at the final chapter. The trick is finding the right insurance billing company. Once you have a company with a proven track record you will be able to see substantial improvements in your practice's revenues have a more attractive bottom line and have more time and energy for your patients, growing your practice and - heaven forbid - a life outside the office.


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Health care facilities around the country see numerous patients every day. An important part of their operation is the health care providers that they choose to employ. Some hire better doctors, nurses, and technicians. Therefore, they are frequented by more patients. Many people do not realize that an important part of a health care facility's operation is it's medical claims processing abilities.

To ensure timely payments by insurance companies, medical claims must be processed in a timely manner and submitted to the appropriate insurance companies for consideration.

Some facilities employ medical billers and coders. Other facilities employ individuals who handle both aspects of the claim process simultaneously. A medical biller and coder will generally earn more than a medical biller or coder does. That is because he or she is performing double duties and eliminating the need for the health care facility to hire two different people.

Medical coders provide the diagnostic codes and procedure codes that apply to the patient's visit. If the codes do not match, a claim may be denied. The insurance company will more than likely say that the treatment was not medically necessary. That is why it is so important for a medical coder to be precise.

A medical biller obtains the correct codes from the medical coder. He or she uses the codes to fill out a claim form. The claim is submitted to the insurance company, generally in the form of an electronic claim. It is important that the medical biller comply with the requirements of each insurance company. Many have specific guidelines that must be followed. The claim could be delayed or denied, if the claim form is not filled out properly and according to the insurance company's regulations.

Medical billing software is often used in medical claims processing. The software saves time and eliminates common mistakes. Medical billing software allows medical coders to look up diagnostic codes and procedure codes via the software rather than in a manual. The software also checks databases to ensure that the diagnostic codes and procedure codes match up, eliminating the denial of claims based on discrepancies.

Medical claims processing is a job that can be done from home. Many people have started their own home businesses in medical claims processing. It is a great way for stay at home mothers to earn an extra income and remain at home with their children. Source: Accrmedicalbillingtraining dot कॉम

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One of the more potentially volatile risk areas for health care practitioners today is the delegation of therapeutic procedures to unlicensed assistants, and billing for those procedures as though the practitioner personally provided the procedures. This practice activity is particularly prevalent and ever-growing in chiropractic!

Some practice consultants - with promises of increased income, coach chiropractors to integrate low-tech rehab and protocols into their practices. Chiropractors are advised that it is legally permissible for unlicensed assistants (e.g., chiropractic assistants) to perform the therapeutic procedures on patients that are billed (per "incident-to") as if personally performed by the chiropractor, who at the same time, is providing services to other patients who are billed for the chiropractor's services during the same time frames as the therapeutic procedures.

Does the regulatory board allow for delegation of therapeutic procedures to unlicensed staff?
Individual state health care regulatory boards establish their own state's administrative practice standards for licensees for the purpose of protecting the public from conduct that does not conform to their state's accepted standards of conduct. Such administrative regulations almost always include standards relating to the delegation of services to persons other than the licensed provider. In many states, chiropractic boards do not allow their licensees to delegate therapeutic procedures to unlicensed staff, and, as such it would be inappropriate in any and all circumstances for the licensees to engage in this conduct!

However, some boards opine that licensees (e.g., chiropractors) can delegate therapeutic procedures to qualified and properly trained unlicensed staff (e.g., chiropractic assistants) acting under a licensee's supervision consistent with the health and welfare of a patient so as to encourage the more effective use of the skills of licensees. It would appear prudent for chiropractors to gain clarification from respective regulatory agencies regarding the following:

What are the standards that must be met by chiropractors to ensure their unlicensed staff are "qualified and properly trained"?

What level of supervision (general, direct or personnel) is required of the chiropractor relative to unlicensed staff directing therapeutic procedures?

What is meant by "consistent with the health and welfare of a patient so as to encourage the more effective use of the skills of licensees"?

How should the therapeutic procedures (supervised) by unlicensed staff be documented in the patient's clinical record?

How should the therapeutic procedures be reported to payers - especially those following Medicare standards, to avoid potential allegations of misconduct?

Is reporting therapeutic procedure codes for supervised procedures consistent with CPT?

Therapeutic procedure codes (97110-97546) identify the application of clinical skills and/or services that attempt to improve function that requires the physician or therapist to have direct (one-on-one) contact with the patient. These procedure codes do not indicate "supervised" services and to report them to payers in such a manner could result in allegations of misconduct. Consequently, it is imperative for the practitioner (e.g., chiropractor) to obtain prior approval for this billing practice from ALL involved payers notwithstanding the fact that this type of practice activity has previously been found to be consistent with state regulatory standards on delegation. The purpose of seeking the payer's approval is not to enable the payer to make determinations on what practices are legal and what practices are not; rather, it is to protect the individual provider from a payer's unilateral referral of the provider billing practices to law enforcement authorities who may have a differing interpretation of the acceptable standards of delegation that the provider's state regulatory board.

Current Procedural Terminology (CPT) is a listing of (a) descriptive terms and (b) identifying codes. The foregoing is used to report medical services and procedures, as well as to provide a uniform language that accurately describes medical, surgical, and diagnostic services. The use of CPT provides an effective means of reliable nationwide communication among providers, patients, and payers.

The listing of a service or procedure and its code number in a specific section is not restricted to any specific specialty group. Any procedure or service in any section may be used to designate services rendered by any qualified physician or other qualified health care professional. CPT indicates that the terms -"Physician or Therapist" and "Provider" as identified in CPT are interchangeable to refer to someone licensed to perform health care services.

Select the name of the procedure or service that accurately identifies the service performed that is adequately documented in the medical record. Do not select a CPT code that merely approximates the service provided, and that if no such procedure or service exists then report the service using the appropriate unlisted procedure or service.

Suggestions concerning introduction of new procedures, or the coding, deleting, or revising of procedures contained in CPT should be made by contacting the CPT Editorial Research & Development.

The Final Rule for transactions and code sets as part of the Health Insurance Portability and Accountability Act (HIPAA) identifies CPT codes and modifiers as the national standard for health care plans and providers to electronically transmit: Physician services; physical and occupational therapy services; radiological procedures; clinical laboratory tests; other medical diagnostic procedures; hearing and vision services; and transportation services including ambulance.

Does the involved payer reimburse for supervised therapeutic procedures?

Payers often set their own standards for reimbursement of health care services and determine what will be paid, who will be paid, and how much will be paid. Standards may vary from payer to payer, and may differ from those standards established by the provider's own regulatory licensing board. Accordingly, it is the responsibility of all practitioners (e.g., chiropractors) to be familiar with both the payer's billing/coding and their state board's standards and seek to abide by those standards that impose the stricter requirements when seeking reimbursement! By adopting a policy of compliance with the stricter standard the provider will always ensure that he/she is protected from claims of improper billing practices.

Medicare, and other payers following Medicare standards, indicates that therapeutic procedures supervised by (unqualified) unlicensed staff are not reimbursable! Payers with such standards do not pay for provider services, at provider rates, when such services are administered by non-providers. Further, these payers do not maintain that practitioners can not delegate therapeutic procedures to unlicensed assistants but are asserting that such services are not covered and, therefore, they are not reimbursable - BILL THE PATIENT! Medicare Benefits Policy Manual, Chapter 15, Sections 220 and 230 specifies:

Therapeutic procedures are medically necessary only when they require the professional skills of a qualified practitioner, are designed to address specific needs of the patient, and are part of an active treatment plan intended to achieve a specific goal.

Medicare pays only for skilled, medically necessary services delivered by qualified individuals, including therapists or appropriately supervised therapy assistants. Supervising patients who are exercising independently is not a skilled service.

Providers can not bill and seek payment for one-on-one codes (e.g., therapeutic procedures) administered at the same time as other procedures were rendered to the patient, or to other patients.

A physician may not delegate physical therapy services (e.g., therapeutic procedures) to unlicensed persons and report them as "incident-to" services unless that person has the education and clinical experience equivalent to a physical therapist.

Incident-to a physician's professional services are defined (Benefits Policy Manual, Chapter 15, Section 60) as services or supplies furnished by auxiliary personnel as an integral, although incidental, part of the physician's personal professional services in the course of diagnosis or treatment of an injury or illness that are billed to Part B by the physician as if they personally provided them.

Some within chiropractic have differing opinions as to the appropriateness of the delegation and billing of therapeutic procedures. Illustrative of this is the following written opinion of a chiropractor to whom a colleague was referred subsequent to requesting assistance from a State Chiropractic Association regarding the issue discussed herein:

The auditor is confused, to say the least. As a doctor, you can delegate to whomever you wish to perform those [therapeutic procedure] services. You simply must be in the building at the time services are rendered to supervise [sic]. You do not have to perform the treatment yourself, nor do you have to stand over them and watch. This auditor may be confused with what some insurance companies are pushing for and have proposed, i.e., they require the doctor to do it. However, as far as I know, no insurance company has any policy in place to prohibit you from delegating to staff. As far as statute goes in Xx, if an insurance company did write that into their policy, we would have to go to the Xx with complaint. The P.T.'s would love to have those rules in place as well. Short answer is the auditor is wrong. Maybe some other state he/she is familiar with has that as a rule. Not here though.

The bottom-line is that due-care and good judgment must be exercised by chiropractors in this risk area, as missteps could result in administrative, civil and/or criminal exposure. A few years ago chiropractors, similarly instructed on use of "incident-to" to increase income, billed for their rendered services under the license of an associated medical doctor in MD/DC practices so as to avoid limited chiropractic (insurance) coverage. Several of these doctors, including a highly prominent chiropractic consultant who advised them on the use of "incident to" billing, are now serving federal prison sentences. Many chiropractors have learned the hard way that "incident-to" does not allow for the misrepresentation of the actual service provider to facilitate reimbursement for services that would otherwise be non-covered.

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Investigations relating to health care fraud activity are reportedly at an all time high, and will continue to flourish with the advent of new working groups, task forces and other fraud-fighting activity that existence depends on the development and investigation of health care fraud cases. Simply put, the investigation of health care fraud consists of proving that the provider engaged in an intentional deception or misrepresentation (of material fact) that resulted, or could have resulted, in an unauthorized payment. Some key facts related to health care fraud investigations:

Complaint Driven: Private, local, state and/or federal agencies are actively involved in the identification and investigation of health care fraud and abuse, which, for the most part, are initiated by complaints received from patients, insurers and others on a health care provider or entity.

Complaint Evaluation: The investigative process starts by the investigator evaluating the information in the complaint to determine if it represents actual misconduct, and then to identify what specific laws, rules, and/or regulations may have been violated. Critical areas to be addressed may include:

•DOCUMENTATION-was the services documented as medically necessary, and completely and accurately documented in the patient's health care record?

•REGULATORY LAWS & RULES-were the services rendered consistent with the administrative law for the State, including scope of practice, training, supervision and delegation? Additionally, were the services, or the manner in which they were rendered, in violation of prohibited conduct?

•THIRD PARTY PAYER RULES-were the services rendered consistent with the rules set by the involved third party payer, including those relevant to limitation of services rendered, and those limiting the service provider?

•CODING-were the proper ICD-9 and CPT-4 codes used to identify the condition (s) being treated and the services rendered when seeking reimbursement?

Investigative Plan: The investigator will identify potential witnesses to interview, other needed information, such as patient and insurance claim files that may possess evidence of the misconduct. The successful investigation will result in the collection identify and collect all relevant evidence that would indicate the laws, rules and/or regulations governing health care have been violated, and to identify storytellers who will be able to testify on matters relevant to the identified misconduct. The patient file is the crime scene when investigating health care fraud & abuse.

MAJOR TRENDS IN HEALTH CARE FRAUD

Problem (Multidiscipline Practices): Some multidiscipline practices of medical doctors, chiropractors, and other providers working together in one practice entity are formed by some chiropractors as a means to circumvent managed care and other third party payer limitations on reimbursement of chiropractic services. At times, when necessary, multiple corporations are created to allow the chiropractor to employ medical doctors and to maintain control over all revenues of the multidiscipline practice. The services rendered by the chiropractor in cases where there is little or no chiropractic coverage are billed to the third party payer under the license and name of the medical doctor, purportedly following "Incident-to" billing principles after the medical doctor evaluated the patient and referred them for care with the chiropractor. Is the chiropractor billing for their services rendered under the license of a medical doctor?

Problem (Mobile Labs): Some external companies, or mobile labs, market their electro-diagnostic testing services extensively to health care providers as a means to increase patient retention and increase revenues. The mobile lab provides on-site electro-diagnostic testing on the provider's patients with their equipment and by their technician. The provider pays the lab a rental fee for the equipment and technician, and agrees to provide a minimum number of patients for testing during one day. The lab bills the third party payer for only the reading of the tests, or the professional component, and the provider bills for administering the tests, or the technical component, because they rented the equipment/technician and supervised its administration. Further, the lab will provide the provider with the CPT codes and amounts that should be reported and billed for the technical portion of the test. The provider, claiming to have supervised the administration of the diagnostic test, may not have the requisite training and skill on the test. Often, the total amount billed (both professional and technical) for the tests will far exceed the RVU (Relative Value Unit) set for these tests. The client provider usually will have no actual knowledge on what the labs will bill to the third party payer. What service did the provider perform to bill for the technical portion?

Problem (Rehab): Some providers implement (active) rehabilitation care into their health care practices by having their unlicensed staff administer therapeutic procedures to patients that are defined as one-on-one with the patient by a licensed provider, and are reported in 15-minute increments. Documentation of medical necessity of therapeutic procedures may not be properly established in the patient's clinical record as part of a treatment plan. Documentation of procedures in file, even when directly provided by licensed provider, may not be properly documented to account for the time component of the service, i.e., Start & End time, which includes pre-intra-post service time. Is the provider's unlicensed staff rendering the rehab services to the patients of the practice? What does the patient's health care record show? Do they support the need and accuracy of the billings?

Problem (Billing): Various insurance companies have limitations on what health care conditions and services they will reimburse providers for. Some providers provide their patients with health care services that are not reimbursable by the involved managed care organization or third party payer, but report and bill for these services via use of ICD-9 and CPT-4 codes that are reimbursable. Some providers provide their patients with various health care services based solely on the premise that the involved managed care organization or third party payer will reimburse for those services.

Problem (Solicitation): A number of providers market "free" services, such as consults, exams and x-rays to attract new patients that may not be established as medically necessary, or will later be billed to a third party payer. A number of providers' market "free" services, such as therapeutic massage, as a means to attract new patients to the health care practice, which later may become a part of the patient's billed care. A number of providers inform marketed individuals when converting them to patients that they will not be responsible for what the insurance company does not pay. For the health care provider what is a consult? Isn't it a history? Was the promised free service, or a portion of it, later billed? Is it possible to give away a therapeutic massage without first examining the patient to establish need?

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A bill excluding Kansas physicians and other health professionals from the state's consumer protection law may become a legislative fatality.

The Senate Judiciary Committee passed Thursday on an opportunity to vote on a House bill drafted after the Kansas Supreme Court ruled deceptive acts and practices of medical professionals fell under the Kansas Consumer Protection Act.

Physicians, nurses, veterinarians, anesthesiologists, pharmacists and radiologists had reacted to the Supreme Court's decision by insisting the Legislature approve a statute nullifying it .

Opposition for the House bill had surfaced from the Kansas Trial Lawyers Association, Attorney General Paul Morrison and AARP of Kansas.

"We ran out of time," said Sen. John Vratil, R-Leawood, and chairman of the Judiciary Committee.

His committee met Thursday for the final time in the 2007 session, but the health industry exemption could be amended to other legislation before adjournment in April.

Another option, Vratil said, would be to refer the issue to an interim legislative committee. That panel's report would be due before the start of the 2008 session in January.

Jerry Slaughter, executive director of the Kansas Medical Society, said legislators need to declare the exemption clearly in state law.

Otherwise, he said, plaintiffs will file consumer protection claims in addition to medical malpractice lawsuits.

"It will raise the cost of defense and interject a new element into an already difficult situation," he said.

The Supreme Court ruling stems from the case of a Parker woman who sued an orthopedic surgeon in 1999. Two surgeries on Tracy Williamson by Dr. Jacob Amrani, formerly of Wichita, were supposed to relieve her back pain. Amrani told her the procedure was highly likely to succeed when it actually hadn't worked in a majority of cases in which he had performed the procedure. Her medical condition deteriorated after the operations.

The Supreme Court found Williamson could bring a claim under the Kansas Consumer Protection Act related to Amrani's conduct in providing treatment.

Callie Hartle, spokeswoman for the Kansas Trial Lawyers Association, said the House bill was flawed because it "would create the broadest exemption to a consumer protection act of any state in the nation with regard to the health care industry."

Passage of the bill will trigger a landslide of pleas from other professions or industries for an exemption, she said.

"We'll have a consumer protection act that is Swiss cheese," she said.

WASHINGTON -- Dietary supplement and over-the-counter medications would have a new mandatory reporting system for any illnesses, death or other problems associated with their products, based on a bill introduced Wednesday by Sen. Orrin Hatch, R-Utah, and Sen. Dick Durbin, D-Ill.

The new bill builds on the Dietary Supplement Health and Education Act that Hatch sponsored and Congress supported in 1994. Right now, the Food and Drug Administration regulates these two types of products, but there is only a voluntary system for companies to report any problems.

Under the bill, manufacturers, packers or distributors of over- the-counter drugs or dietary supplements would need to file a report to the FDA within 15 days of any reported incident of an adverse health effect specified in the bill such as death, inpatient hospitalization, birth defects and several others. They would also have to keep records for six years of any reported health problem, even if it is not under a "serious" one listed in the legislation.

"This is an important public health initiative, which at the same time safeguards access to dietary supplements and over-the-counter drugs," Hatch said.

The Utah Natural Products Association, National Nutritional Foods Association, the Center for Science in the Public Interest and the Council for Responsible Nutrition all support the bill.

Durbin said the "strange bedfellows" coming together to support the legislation -- he and Hatch do not always see eye to eye -- demonstrates the quality of the bill.

"Those who are selling dangerous products will have to face the music," Durbin said.

Sen. Tom Harkin, D-Iowa, also a co-sponsor of the bill, said that filing a report is not evidence of anything and does not automatically mean a product is unsafe but it could lead the government to discover where there might be a problem. Harkin said if this was in place problems associated with ephedra would not have happened.

"This is another example of how good legislation can come out of a serious situation," Harkin said.

The Senate Health, Education, Labor and Pensions Committee will take up the bill next week, and Hatch hopes it will be passed this year. There is no identical bill in the House yet.

Hatch did not know an exact cost of the reporting procedures and other protocol laid out in the bill but estimates say about $2 million for over-the-counter-drugs and $2 million for supplements.

Empower Technologies Inc, a provider of speciality specific electronic medical record software systems, has chosen MPMsoft, a provider of electronic billing software solutions for the healthcare industry, as its front-office patient scheduling and back-office electronic medical billing software solution.

Empower's SonoSoft is an EMR (electronic medical record), designed for phlebology and venous surgery. SonoSoft's Vein Specialist module produces reports of every procedure, including a complete initial workup, endovenous ablation procedures (laser or radiofrequency) and follow-up visits for sclerotherapy, and can automatically generate a CEAP classification.

The company said it believes the partnership with MPMsoft will give it a combined product that meets the specialised needs of vein surgery practices, providing a seamless operation between the two programs.

No financial details were disclosed.