Congratulations. I think this is a fabulous step.

Out of curiosity do you have any idea what the *reasonable and allowable* reimbursement rate will be? 

Historically DSHS reimbursement in my area has been so pitifully small that although we are permitted to bill and be reimbursed for our services, the reimbursement doesn't come anywhere near our cost for providing the services. Particularly when we use an interpreter, (which we pay for),?we end up paying money to serve the client, even with reimbursement.

I know this happens with many healthcare services, insurance may be billed for example $150.00 yet the reasonable and allowable reimbursement is $20.00. 

I would love to hear how/if this is addressed in your new agreement.

Michelle H. Kinne ICCE CD(DONA) CLE
www.DoulaDiva.org

I am Sent: Thursday, October 25, 2007 9:13 AM
To: [log in to unmask]
Subject: Medicaid not paying for outpt LC services

Hi all,

I attended a meeting with the Oklahoma Health Care Authority (Medicaid)
last week and they informed us that the Governor of Oklahoma had signed
a bill allowing IBCLCs to bill and be paid for Outpatient LC services.
The plan goes into effect Dec 1, 2007.? You can either work for a
hospital, dr. office or other places that can do the billing for you or
can be a private practice IBCLC and bill yourself.? We are not licensed
in Oklahoma but hope to start working on that.? We are beyond excited
with this major step for Oklahoma.? The one thing OK Medicaid states is
it must be an IBCLC that provides the care.? The patient can self
referral, nurse referral or doctor referral.? I am at present applying
for hospital admits privileges so when I see an outpatient and they are
not a Dr. referral then I can admit and I will be the one doing the
paper work for the hospital to bill.

=20

Happy Happy Happy=20

Crystal Stearns RNC, MS, IBCLC

Mercy Memorial Health Center

Ardmore, OK 73401









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