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Frequently Asked Questions Do I need a referral to see Dr. Cox? It depends on your health plan. Many, but not all, private insurance plans require a referral from your primary care physician in order to see a specialist. You’ll have to check and see what your individual plan requires. We are familiar with most insurance plans in the Central Ohio area, and we may be able to help you sort it out if you call the office before your appointment. If you have a varicose vein problem, we can see you in the office and evaluate whether the necessary treatment is covered under your insurance plan. Many patients elect to pay for the treatment of their varicose or spider veins on a cash basis. Does health insurance pay for treatment of varicose veins? Most insurance plans will pay for treatment of varicose veins that is medically indicated, that is, varicose veins that are producing significant symptoms that interfere with daily activities, such as pain, swelling, fatigue, and “restless legs.” Many plans require a documented period of several months of conservative treatment, including moderate compression support stockings, leg elevation, and mild analgesics. We also must document the severity of the venous disease by performing a duplex ultrasound in the office, which maps out the veins and demonstrates the amount of reflux in the veins. With proper documentation, most insurance plans will pay for endovenous laser therapy and excision of varicosities, but you must check your own plan to see if varicose veins are covered. Insurance companies will not pay for cosmetic treatments, such as sclerotherapy for spider veins. Is a screening colonoscopy necessary if I don’t have any symptoms? The current recommendation is for all patients over the age of 50 to have a screening colonoscopy, or sooner if there is a family history of colon cancer. All colon cancers start out as polyps, and you could have small polyps anywhere in the colon and not know it, as they don’t cause any symptoms. By the time a polyp is large enough to cause symptoms, it has turned into an advanced cancer, which requires extensive surgery and possibly chemotherapy. Small polyps can be removed at the time of colonoscopy, thus preventing the development of colon cancer. If I have GERD, do I need an upper endoscopy? Gastroesophageal reflux disease (GERD) that has been present for several years and is severe enough to require daily medications to control symptoms should be evaluated with an upper endoscopy. Chronic inflammation in the esophagus can sometimes turn into Barrett’s esophagus, which looks like pink patches of tissue. These patches can develop changes which can turn into cancer over time. Patients with Barrett’s esophagus secondary to GERD often undergo upper endoscopy every year, to biopsy these areas and look for precancerous changes. What is a Nurse Practitioner? A Nurse Practitioner is a registered nurse (RN) who has undergone advanced education and clinical training. At present, Nurse Practitioners must obtain a Master of Science in Nursing (MSN) degree. Certification requires additional training and testing in a specialty area. Nurse Practitioners can serve as regular health care providers, performing histories and physicals, diagnosing and treating acute and chronic diseases, ordering tests and treatments, and prescribing medications. They also are deeply involved in the provision of screening, health maintenance, promotion of healthy behaviors and wellness, and patient education and counseling. Nurse practitioners collaborate with physicians and other health professional as needed. Joyce Cox MSN, CNP has attained certification in Adult Care. She is involved in direct patient care in the office, and performs a variety of minor surgical procedures. She is also an expert at sclerotherapy and microphlebectomies in the treatment of varicose and spider veins. |
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