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Date: | Tue, 31 Jul 2012 10:55:56 -0400 |
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Judy G writes:
The IBCLCs will be providing "preventive counseling" and a physician
assessment of an infant feeding problem would not have anything to do with this
billing. I must assume that prosthesis is
"ordered" by a physician and there must be some common diagnosis for each
of
them. Preventive health care is not going to be ordered by the physician.
~~~ See now perhaps we are getting somewhere. I read "preventative
counseling" as a pro-active session designed to provide information and some basic
problem-solving strategies. That does sound like something that would take
less time and require simpler documentation. What I do, and what many
IBCLCs do is more like "crisis intervention" and feels a lot like trying to stop
a train that has gone in completely the wrong direction or derailed
completely, for dyads for whom many things have not been prevented from going
off track, even sometimes have gone horribly wrong. Many dyads are
"crashing or have crashed" . This is very time-consuming and ultra-detailed
consulting. I don't know any other health professional who goes to the home of
the affected family and spends that kind of time and energy, which is then
also followed by intense and regular phone and/or email contact after the
consultation ( the vast majority of which asks for no further fee despite many
extra hours). The phrase "preventative counseling" seems to have little to
do with how most private practice IBCLCs work. If it is true, I do find it
disconcerting that a physician can bill for a 15 minute lactation visit in
office and get paid more than a 2 hour home visit by someone who is
providing a vastly different level of detailed analysis, individual relevance in
one's own home, the ability t0 take time to see the effect/outcome of many
of the suggestions and strategies and much deeper and broader follow-up
care. Both of these may be important links in the family's service chain,
but they are not at all the same.
Peace,
Judy
Judy LeVan Fram, PT, IBCLC, LLLL
Brooklyn, NY, USA
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