July 22, 2003 Feature

National Reimbursement Network Created to Advocate With Payers

ASHA has created a new national network to advocate on reimbursement issues on behalf of clinicians around the country. The STARs—State Advocates for Reimbursement—include audiologists and speech-language pathologists appointed by state association presidents. At its first meeting on May 14 in Omaha, NE, the group participated in an all-day "reimbursement boot camp" led by ASHA staff.

The STARs shone brightly despite torrential rain and wailing sirens warning of an approaching tornado. Participants represented 35 states and the District of Columbia.

"The interaction of participants from so many states demonstrates the need for a reimbursement network," said Linda Pippert, a STAR member from California. "We may feel powerless in our individual practices or in our states, but as we came together, we saw the strength in numbers and a sense of unity in cause.

"We’re hoping that all states select a STAR member so that we can truly join forces to make gains in reimbursement."

Network members will advocate locally with legislators, state insurance commissions, health plans, unions, and employers on matters related to private health plan reimbursement. They will share their advocacy skills and help create coverage and reimbursement strategies with state associations, and will provide a vital link between state associations and ASHA.

Last November, the ASHA Legislative Council approved establishment of the network as part of the 2003 Focused Initiative on Health Care Reimbursement. Visit ASHA's State-Based Reimbursement Network page to locate your STAR member.

Fun at Boot Camp

It was time for mental calisthenics in Omaha, as boot campers engaged in mental drills to sharpen their reimbursement skills. The exercises helped them to identify private health plan reimbursement issues, define the network’s purpose, and set goals. Among the issues identified by the group were coverage exclusions based on diagnosis codes, difficulty establishing "medical necessity," poor documentation by providers, low reimbursement rates, and inconsistent coverage across plans.

The STARs set three goals: to share information with other states and ASHA; to identify important issues and set priorities among them; and to educate legislators, consumers, health plans, and professionals about the value of speech-language pathology and audiology services.

The group wrapped up its work by learning about the reimbursement "players" and the art of effective persuasion.

Maureen Thompson, is ASHA’s director of private health plans advocacy.

cite as: Thompson, M. (2003, July 22). National Reimbursement Network Created to Advocate With Payers. The ASHA Leader.

  

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