Welcome to Michigan Vascular Access, PC. If you are a dialysis patient, or if you are trying to insure the best possible care for a family member or friend needing dialysis, we hope you will find the best professional relationship you have ever had. Michigan Vascular Access, PC, is designed to provide life-long management of dialysis access, and to be valuable to you as long as you are on dialysis.
Generally, the recommendation to come to Michigan Vascular Access, PC, will come from the patient’s nephrologist (kidney doctor) or dialysis unit. Sometimes patients will hear of us from other patients. Contact the office by phone (1-248-355-1100), secure fax (1-248-355-2361), or preregister online by going to https://health.healow.com/DrWebb to get the process started.
The Affordable Care Act (ACA), and the Health Insurance Portability and Accountability Act (HIPAA) have changed the way we are allowed to communicate with patients in order to protect your privacy. In particular, we are now required to collect e-mail addresses, and to enroll patients in an on-line “Patient portal” as part of the “Meaningful Use” requirements of the ACA. This “Patient portal” allows HIPAA compliant communication between the practice and patient to protect your privacy. After the initial contact with the office to make an appointment, we will give you access to the secure online patient portal and ask you to fill out one of two questionnaires depending on whether you are a new patient to our practice, or a patient returning with problems. Additional information can be found at our website “drmarcwebb.com”.
We ask that you come with all insurance information and current insurance cards, identification, contact information including a reliable phone contact number and e-mail address, social security number, a list of medications, allergies and any other medical information you may have about recent hospitalizations on and procedures. Contact information for your cardiologist and primary medical practitioner, or other important physicians involved in your care is helpful (see “Appointment Checklist“). Someone from the office may call to review your medical history with you over the phone. This designed to save time and make your actual visit to the office more efficient.
Please be aware that your insurance plan may require pre-authorization for your visit or procedure from the plan, or from your primary care provider (PCP). Failure to obtain pre-authorization is a common cause of denial of payment (a hassle for us), or last minute cancellation of your procedure in the hospital (a hassle for everyone). If necessary, have your nephrologist discuss the referral with the insurance plan or PCP. This is a common reason for delay of surgery.
Knowing that the hospital anesthesia department may want information on your cardiac status, it is wise to have information on any cardiac testing you have had, and to prepare to see your cardiologist again if necessary – this is also a common reason for delay of surgery.
We may ask you to review specific information from our website depending on whether you are a new or established patient, and depending on the nature of your problem – please see below.
BUT DO NOT DELAY YOUR APPOINTMENT – time is not on the side of those who delay.
Specific situations
New patients not yet on hemodialysis (including patients on CAPD and failing transplants) and new patients on dialysis via a catheter but without previous dialysis access operations
Go to the “Appointment Forms” tab of the drmarcwebb.com website. Review the “Appointment check list“, “Authorization and disclosure of information” form (so that we can get information from your other doctors, hospitals, etc), “Notice of Privacy Practices (HIPAA) and information release form” (to authorize us to release information to your other doctors, hospitals, family and dialysis unit), “What to expect“, “Location“, and “Preservation of the veins for AV access“.
Consider reviewing useful background information on the website in the “About MVA” section, the “Services” section, and the “Resources” section, along with the FAQs. In particular, read “What is a fistula? ” in the FAQs, along with “Can everyone have a fistula?”, “What is a graft?”, “The role of ultrasound in the creation of fistulas”, “Creating forearm fistulas above the wrist”, “A strategy to utilize our hidden vascular assets”, “Transposing the basilic vein” and “Maturation of fistulas once created”.
Patients not yet on dialysis should have their last dated GFR or creatinine clearance. CAPD and failing transplant patients should have information on their current renal replacement adequacy, and a projection for when they might require hemodialysis. No procedure will be performed on the day of the initial evaluation other than the ultrasound examination.
New or established patients with failed, or problematic dialysis access, with or without a catheter
Go to the “Appointment Forms” section. In addition to the items listed in the section above, i.e. “Appointment check list“, “Authorization and disclosure of information” form (so that we can get information from your other doctors, hospitals, etc), “Notice of Privacy Practices (HIPPA) and information release form” (to authorize us to release information to your other doctors, hospitals, family and dialysis unit), “What to expect“, and “Location” forms, please review the “Warning signs” information form with your dialysis unit to clarify the functioning and measurable problems with the access (venous pressures, clearances, and flows where available) and be prepared to provide information about what is going wrong with your access.
Patients with failed accesses should have whatever information exists on their previous access, including all procedures done elsewhere to create, modify, maintain or rescue the access.
Consider reviewing useful background information on the website in the “About MVA” section, the “Services” section, and the “Resources” section, along with the FAQs. In particular read “The myth of permanent access and when to arrange for a shuntogram” in the FAQs section, along with “Maturation of fistulas once created”, “Endovascular maintenance of dialysis access”, “Endovascular topics : Thrombolysis of AV grafts”, and “The use of stents in hemodialysis access”
Occasionally, the patient care coordinator may ask you to come to the office NPO (nothing to eat after midnight) if an urgent procedure is indicated. In this case, clear liquids are permitted and encouraged up to 8am (clear juices, water, tea or coffee without milk products, no carbonated beverages or alcohol).
Established patients with a recurrent problem previously treated
If your problem is a recurrent one, review the “Warning signs” list with your dialysis unit to clarify the function and measurable problems with the access (venous pressures, clearances, and flows where available), and call to review the situation with one of our patient coordinators. An office visit may not be necessary if a known problem recurs, and you may be scheduled for an intervention directly. Be ready to update your medication list, allergies, contact information and current insurance.
