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From:
Maria Paciullo <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 1 Aug 2012 00:13:46 -0400
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Who are our legal advocates negotiating with the insurance companies??!!!!

The most important thing here is that it appears that a couple of people with all good intentions negotiated with Aetna and now some very wise people are saying that no, these rates are not at all representative of the value of our work.
If we are going to the table without the representation of attorneys trained and experienced in negotiating healthcare provider rates, by definition, we are failing miserably.  When representing others, there is a responsibility to do it the right way.  The right way is with good legal representation, and if proper representation is not employed, the committee will be failing its duty to the people it is supposed to be serving.
I hope that instead of being defensive and telling people who are speaking up that they "don't make sense" or don't have good "logic" or worse, telling individuals that they can "call Aetna and negotiate for themselves", they will immediately take this opportunity to ask for help rather than leave it as their legacy that they messed up on insurance representation.
Being a great IBCLC does not make a person a skilled negotiator.  I have no doubt that Aetna's people have been very "nice" and interested in learning, etc.  That is called reasoned bargaining.  We need to be doing the same with skilled representation.  There is no shame in hiring people to do what one is not trained to do.  It is the only smart and reasonable thing to do.
As LC reimbursement becomes a necessity for insurance companies to provide down the road, we are in THE POWER SEAT when it comes to negotiating.  We have some very important facts being made regarding how much it costs to run a private practice and to practically schedule visits at someone's home and get there (in some parts of the country, 2 miles means 2 minutes, in other parts of the country it means an hour each way, adding 2 hours to our time, and smart people will not work for rates that don't take into consideration how much of our day it is taking up).
Why are we being met with snide and bullying remarks of denial instead of an explanation of why attorneys are not representing us?  Let's put a stop to this and get real representation that addresses our concerns.  

As an aside, there was a post about speech therapists.  why are we being compared to speech therapists?  Anyway, speech therapists make 110 for a 30 min. consult and can book them back-to-back and don't have to worry about timing with an infant being ready to feed.
When working for a company that covers services within a school, a speech therapist makes 60 for a 30 minute session plus 15 minutes set up/clean up, but that is only a small fraction of what the company makes!  And the speech therapist then has worker's comp, medical insurance, disability insurance, vacation, no need for supplies or marketing, etc. etc.  Speech professionals are represented by ASHA, and their organization has a very strong advocacy section that hires lawyers to negotiate their fees.  This is what every organization does.  What is wrong with us?  I take it that it is just a mistake and the people spearheading this were trying their best but……please listen to your constituents rather than turning it into a debate of "logic" because it creates ill will and I think that the Susan Burgers and others who have posted are the ones who will clearly win out on logic.  

oh, re physicians--BUT I don't think it makes any sense to debate in this forum how much we should be paid AND I cannot understand why we actually have the people who should be representing us and supporting us arguing against us!!!  The debating should be done by our lawyers at the table.
But as for the point re physicians--we are uniquely qualified, even more qualified than physicians, so no, we are not physicians, but the point is that becoming a really good IBCLC takes more training than physicians' training--we are actually qualified to be making more than physicians make for lactation help per every ten minutes charged.
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