Insurers Reject Claims
Patient treatment choices belong exclusively to the attending physician,
said Kim Sang-dong, chairman of the Korean Phlebological Society, at a press conference on Oct. 8, medigatenews.com reported.
Medical professionals in South Korea are strongly pushing back against health insurance companies denying inpatient insurance payouts for varicose vein surgeries, medigatenews.com reported. The dispute follows a June Supreme Court ruling that found inpatient necessity was not established for a patient who underwent a catheter-based endovenous procedure.
Supreme Court Ruling Sparks Denials
Insurance companies are shifting their evaluation standards based on the June Supreme Court decision, medigatenews.com reported. Insurers now refuse to pay inpatient claims simply because a patient completed admission procedures or stayed at a hospital for a certain period.
Kim Sang-dong stated that the ruling applied to a specific individual whose case failed to meet actual inpatient criteria, medigatenews.com reported. He noted that insurers are improperly applying that single judgment to broadly reject claims for all varicose vein procedures.
Broad Rejections Target Modern Treatments
Insurers are grouping laser, radiofrequency, and cyanoacrylate closure (Venaseal) procedures together under catheter-based treatments to deny coverage, medigatenews.com reported. Kim Sang-dong pointed out that these methods often involve longer recovery times, more pain, and higher risks than the percutaneous mechanochemical ablation addressed in the court case.
Kim Sang-dong also said that insurers currently recognize traditional surgical stripping only, while excluding standard catheter treatments, medigatenews.com reported. He called this practice an approach that runs contrary to global treatment guidelines.
Global Guidelines Clash With Standards
International varicose vein treatment guidelines recommend catheter-based methods like lasers and radiofrequency as primary options, Korean Phlebological Society President Kim Sung-chul said, medigatenews.com reported. He noted that while member doctors mostly use these recommended catheter treatments, insurers only pay out claims for older surgical stripping methods.
Kim Sung-chul criticized insurers for ignoring attending physicians who emphasize the necessity of inpatient care, medigatenews.com reported. He added that insurers apply inconsistent standards without any unified criteria, leading to widespread payment rejections across hospitals nationwide.
Why the Supreme Court Denied Inpatient Insurance Payouts
Why did the Supreme Court deny the inpatient insurance payout in June?
The court determined that inpatient necessity was not proven for a specific patient who underwent a catheter-based vein procedure, failing to meet the required criteria for hospitalization, medigatenews.com reported.
Which varicose vein treatments are insurers currently refusing to cover?
Insurers are denying inpatient claims for modern catheter-based procedures such as laser treatments, radiofrequency ablation, and Venaseal, while primarily approving traditional surgical stripping, medigatenews.com reported.
Where did the Korean Phlebological Society hold its press conference?
The society held its press conference during an autumn academic symposium at the Baekbeom Kim Gu Memorial Hall in Seoul on Oct. 8, medigatenews.com reported.
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