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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