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Tue, 7 Jul 2009 13:54:23 EDT |
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Jane writes:
Until what LC's do is coded so reimbursement can be paid by third party
payers which would be tied to highly respected credentials, accurate
documentation standards and scientific rationale for our recommendations, nothing
will improve.
~~ In the US, the insurance system is so broken, we are in a really tough
spot even if IBCLCs gain respect/appropriate referrals/coding. Many
professionals who are allied healthcare people, like PTs, OTs, prosthetists and
ocularists ( professionals who make artificial legs and eyes, respectively)
are working and documenting for hours a day and still being denied payment
left and right by insurance companies who code and re-code and deny and
delay. Cash flow for most small practitioner's businesses is putting many in
danger of collapse or being eaten by big Wal-Mart like businesses.
It's a sad state of affairs. Being as "independent" as we are at this
point at least has the advantage that any mom can call an IBCLC and make an
appointment without waiting to see an MD who will refer or if the insurance
company recognizes and compensates for the service, ( but may turn around and
deny payment anyway). My husband has clients who wait for a leg for a
month, while paperwork gets sorted through, and then he may find out they never
get authorization, or they are told to provide the service, measure and fit
and deliver the prosthesis, and then find out they will get no
reimbursement. It's scandalous, and how many mothers would find their baby's normal
feeding skills so badly affected while waiting for weeks or months to get
approval to see and/or work with an IBCLC.
Peace,
Judy
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