As many of you who have attended the workshops know, Pamela Crouch, M.A., CCC-SLP is my partner in the Speech Team, and my best friend. Her faith in our profession and in the care we provide to patients in crisis are real and enduring. I hope her poem gives you strength in your life and profession as she has given to me.
Articles in Category: Speech Evaluation
As we have entered into the Medicare reform rollout period, which began last October 1, 2011, our lives are now characterized by increased stress due to company requested higher productivity levels, which in many cases will become a red flag to investigative teams seeking out fraud. Medical records of patients are now being copied for the RAC teams, and other investigative teams, and fines are being leveled because “perfection” is the rule of the law. Even we here at the Speech Team are altering our tests to include the patient’s name and date of evaluation on every single test page since RAC team reviewers require “absolute coherency” in every chart. The point being that a patient’s medical chart must read like a novel by non-medical accountants! No more “off or low energy days” for any of us, even though we are human beings.
It is interesting to note what is expected of the Speech Language Pathologist in Medicare law as regards the appropriate evaluation of the dysphagia patient. To quote the law: “If you conduct videofluoroscopic assessment (modified barium swallow), document that the exact diagnosis of the swallowing disorder cannot be substantiated through oral exam and there is a question whether aspiration is occurring. The videofluoroscopy assessment should be conducted and interpreted by a radiologist (often with assistance and input from the physician and/or individual disciplines). The assessment and final analysis and interpretation should document a definitive diagnosis, identification of the swallowing phase(s) affected, and recommend the treatment plan. “ (Medicare Intermediary Manual, Part 3 – Claims Process, Transmittal No. 1528, section 450. Subsection D, paragraph 2).