Judy G writes:
Your above statement is a misunderstanding of the provider policy, Aetna
said, "Provider must be able to initiate a therapy within three (3) hours of
the referral call for urgent services and within twenty-four (24) hours of
the referral call for routine services."
I have spoken to Aetna about this and was told that this means, it would
be best to have access to your phone messages and return the client's call
within the 3 hour window to arrange an appointment - this is what is meant
by "initiate therapy".
~~~
Judy,
Thanks for your clarifications. You are right, I was misinterpreting
things. The actual truth is even harder to comply with, in the sense that if I
am on a home visit that takes 2-3 hours, (which is the norm for me and most
of my colleagues), I am often out of the apartment for 4 hour blocks of
time. So I would not be able to commit to complying to this kind of regulation.
As we both agreed, the era of being able to provide the kind of care that
I have always provided, seems like it may be coming to an end. If there are
IBCLCs in my area who want to form some kind of consortium where we share
the billing, reimbursement, and logistical scheduling issues, we may be
able to make this work.
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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