Financial and Business Issues: Documentation and Coding for Improved Reimbursement We know that the professions of speech-language pathology and audiology have been challenged with reimbursement issues over the past few years. The Balanced Budget Act of 1997 (BBA) significantly changed reimbursement for many health care settings, including skilled nursing facilities, home care, and rehabilitation facilities. In addition, private health ... Article
Article  |   June 01, 2004
Financial and Business Issues: Documentation and Coding for Improved Reimbursement
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  • Peter R. JohnsonColumn Editor
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Practice Management / Professional Issues & Training / Financial and Business Issues
Article   |   June 01, 2004
Financial and Business Issues: Documentation and Coding for Improved Reimbursement
SIG 11 Perspectives on Administration and Supervision, June 2004, Vol. 14, 7-9. doi:10.1044/aas14.2.7
SIG 11 Perspectives on Administration and Supervision, June 2004, Vol. 14, 7-9. doi:10.1044/aas14.2.7
We know that the professions of speech-language pathology and audiology have been challenged with reimbursement issues over the past few years. The Balanced Budget Act of 1997 (BBA) significantly changed reimbursement for many health care settings, including skilled nursing facilities, home care, and rehabilitation facilities. In addition, private health insurance and managed care have ratcheted down coverage for our services. State governments and the insurance industry adamantly oppose mandating coverage for speech, language, hearing, and swallowing disorders. Employers appear to be reluctant to offer our services to employees as part of the employee benefit package.
Given the above scenarios it is certainly understandable if the speech-language pathologist or audiologist would feel pessimistic about achieving any meaningful change in the reimbursement picture. However, there is some good news: Legislative, employer, consumer, and insurance advocacy is underway to improve reimbursement. Insurance advocacy focuses on the establishment of more consistent review policies among the fiscal intermediaries. Employer advocacy seeks to approach the decision-makers in the workplace to offer speech, language, hearing, and swallowing coverage for their employees. Consumer advocacy seeks to educate the general consumer regarding the value of our services and to solicit consumers willing to testify to our value to the public, employers and legislature. Legislative advocacy seeks to obtain coverage for our services through the legislative process. All of the above advocacy approaches are needed to improve the reimbursement picture for our services (ASHA, 2001).
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