At Region Vein, we take the “Inside-Out” Approach® to Venous Treatment.

Initial Consultation/Evaluation

During the initial consultation appointment, it is very important to us that you have time to review the initial ultrasound scan with your provider. Your history, symptoms, the scan, and initial exam play a large role in determining the next steps for evaluation.

Many patients often have large caliber varicose veins that are interacting with these readily visible surface veins. If large “refluxing” veins are found, the next step for evaluation will be an ultrasound “map”, which is a more in-depth ultrasound scan with our technologist. This map helps confirm our treatment strategy to address these refluxing veins. Your provider and his team will also give you an overview of the overall treatment process including endovenous ablation and sclerotherapy.

If your condition is found to be isolated to the surface veins, a mapping visit is not usually required and an additional discussion regarding treatment options (including surface sclerotherapy and possibly surface laser) will occur during your consultation.

Common Questions at the Initial Evaluation:

  1. Will insurance cover these procedures? As you are aware, our staff will check on your policy deductible and whether treatments are covered. Typically, most insurers cover the larger, varicose vein treatments and typically do not cover surface vein treatments. If services are not covered, you will receive a cost estimate.
  2. Why does my insurance require me to wear these stockings? Use of compression stockings with regular exercise, leg elevation, weight control, and even use of anti-inflammatories, may help with leg discomfort related to venous disease. There is no scientific evidence currently that the use of compression stockings reverses existing vein disease. Since most insurers do require a trial of compression stockings before considering treatment, we will do our best to find you a comfortable, usable option.


Documenting the veins with large caliber reflux is key to treatment for patients that require mapping. This is our “Inside-Out” Approach — treating these larger segments first. This is important to long-term success and symptom control.

For large saphenous segments that are the source of reflux, we will treat these veins using endovenous ablation treatment or Varithena®. After these sessions are completed, the leftover branches are addressed using a series of ultrasound-guided sclerotherapy sessions. Depending upon your situation, surface vein sclerotherapy may also be used.

For patients with only surface veins as their main concern, the “Inside-Out” Approach is also used. We identify the roots, also known as reticular veins, which are crucial to the long-term treatment of spider and surface veins.

Financial Consultation:

Our billing experts will go over the process for submitting an insurance claim with you. Authorization from insurance companies for your treatment can take 3-days to 6-weeks depending on your insurance carrier.

Certain insurance plans may also require conservative measures, which in this case typically means a trial period of compression therapy with support stockings prior to other forms of vein treatment.

Click here to read more about insurance coverage.