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[quote=Anonymous][quote=Anonymous]It's not 1 word. Assessment is a very different type of service. How is it that you're in this line of business and you don't know it? [/quote]

I know what an assessment is thanks, I have done them for 20+ years. I didn’t spend 60 hours doing an assessment, it was 15-maybe 30-minutes of about 60 hours across several months. Any notes that contained the word “assessment” insurance demanded I pay back. It didn’t matter to them that 59 1/2 hours were spent doing other things that were also clearly documented. So yes it did come down to just the word “assessment”.

Anyone with any sense knows it’s impossible to spend 60 hours on that single assessment. Plus I’m seeing this child 25-30 hours a week and they’re a quick learner, so it’s also ridiculous to assume an assessment only needs updated once every 6 months. That’s like 700 service hours before I would be “authorized” to assess- how am I supposed to know if a child’s learning anything or create new goals if I don’t regularly evaluate progress?

So I do my job and then you punish me because rate of learning exceeded the standard rate of assessment? Say what?! Also, why is there even a standard rate of assessment? Why isn’t assessment time just determined yearly and able to be billed in 15 minute increments? Why does it matter if I split 3 hours of assessment time across 6 months or do it all at once? Why choose the latter when it’s not even best practice for some children?

The system shouldn’t punish someone for going above and beyond their expectation, but more importantly insurance expectations shouldn’t be so low to begin with that my standard practice is “too good” for the system. They should start by hiring people that understand the job skills when determining service hours and reviewing claims. Doing it their current way creates a system that highly qualified providers just don’t want to deal with and lowers the standards for good providers.

Sorry for the rant but I hope someone from insurance is reading this because they need to understand some of these problems.[/quote]

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