Physician Information › Reference Material

› Procedures • Practice Aids • Billing Guide

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Procedures--Quick Reference Guides for Clinical Staff ( 2.6 MB .pdf, 21 pages)

Practice Aids--Forms to Support Occlusion Therapy (2.0 MB., pdf, 17 pages)

Or  Choose a Page . . . Symptoms Checklist (Word) Patient Self-Evaluation Form (Word) After Care Instructions (PDF) Request for Pre-authorization, Collagen (Word) Request for Pre-auth., Opaque Plugs (Word) Request for Testing, Collagen (LO1) (Word) Request for Treatment, Removal of Lacrimal Plug (Word) Request for Partial Treatment and Sec. Testing (LO2) (Word) Request for Treatment (LO3) (Word) Procedural Report, Collagen (LO1) (Word) Procedural Report, Opaque Plugs (LO3) (Word) Proc. Rpt., Opaque Plugs in Upper/Lac. Test Lower(LO2) (Word) Procedural Report, Saline Irrigation (Word) Procedural Report, Removal of Plug (LO5) (Word) (approx. 100 kB each .doc)

Billing Guide--Comprehensive Medicare & Private Insurance Guidelines (2.4 MB .pdf, 20 pages)

Medicare Summaries by location:

Choose your location . . . Alabama Alaska Arizona Arkansas California: Anaheim, Santa Ana California: Los Angeles California: Marin, Napa, Solano California: Oakland, Berkeley California: San Francisco California: San Mateo California: Santa Clara California: Ventura California: Rest of State Colorado Connecticut DC, Maryland, VA Suburbs Delaware Florida: Fort Lauderdale Florida: Miami Florida: Rest of State Georgia: Atlanta Georgia: Rest of State Hawaii and Guam Idaho Illinois: Chicago Illinois: Suburban Chicago Illinois: E. St. Louis Illinois: Rest of state Indiana Iowa Kansas Kentucky Louisiana: New Orleans Louisiana: Rest of State Maine: Southern Maine: Rest of State Maryland: Baltimore + Surrounding Counties Maryland: Rest of State Massachusetts: Metro Boston Massachusetts: Rest of State Michigan: Detroit Michigan: Rest of State Minnesota Mississippi Missouri: Metro Kansas City Missouri: Metro Saint Louis Missouri: Rest of State Montana Nebraska Nevada New Hampshire New Jersey: Northern New Jersey: Rest of State New Mexico New York: Manhattan New York: Queens New York: Long Island, So. NYC Suburbs New York: Poughkeepsie, No. NYC Suburbs New York: Rest of State North Carolina North Dakota Ohio Oklahoma Oregon: Portland Oregon: Rest of State Pennsylvania: Metro Philadelphia Pennsylvania: Rest of State Rhode Island South Carolina South Daktoa Tennessee Texas: Austin Texas: Beaumont Texas: Brazonia Texas: Dallas Texas: Fort Worth Texas: Galveston Texas: Houston Texas: Rest of State Utah Vermont Virginia Washington: Seattle and King County Washington: Rest of State West Virginia Wisconsin Wyoming Puerto Rico Virgin Islands (approx. 125 kB each .pdf )