Katie Gore joins Peter Reitzes to discuss stuttering and insurance reimbursement. Ms. Gore is asked about general health care terms such as co-pays, “case studies” and victories from her private practice in advocating for clients with their insurance companies, peer-to-peer meetings with insurance companies, how people who stutter and parents may consider advocating for themselves, how speech-language pathologists may consider advocating for clients, pre-authorization with insurance companies, the importance of contacting insurance companies with questions before beginning treatment, using pre-tax income to pay for treatment (such as flexible spending accounts), gap exceptions, diagnostic criteria and codes and so much more.
StutterTalk reports with great pride that Katie Gore has advocated so hard for clients that she has actually, on occasion, been informed by insurance companies that she has “maxed out” in the number of letters she is aloud to submit on a client’s behalf. Even so, when this occurs, Katie continues to advocate for her clients by assisting them in writing letters to their insurance companies.
Special thanks to the great Craig Coleman for recommending Katie Gore for today’s topic.
Katie Gore, MA, CCC-SLP is a speech-language pathologist, Director of Speech IRL and co-leader of the City of Chicago’s chapter of the National Stuttering Association. Ms. Gore made a splash last summer with her postThe Australian Budget Lidcombe Proposal Debate: A Primer in Memes.
One of the most challenging questions to satisfactorily answer in stuttering treatment and in the community is what causes stuttering? Today on StutterTalk we launch a series featuring a range of perspectives and experiences on this important topic. Our first guest for this series is Dr. Mark Onslow.
Dr. Onslow discusses his view that stuttering “appears to be a problem with neural processing of speech involving genetics” (link) and is asked to discuss brain imaging research on the cause of stuttering that is currently being conducted at the University of Sydney. Dr. Onslow is asked how his treatment and research experience may influence how he views causation and much more.
Mark Onslow is the Foundation Director of the Australian Stuttering Research Centre (ASRC) at The University of Sydney. From 2004-2008, Dr. Onslow was a Principal Research Fellow of the National Health and Medical Research Council of Australia, being the only speech pathologist to have received this distinction. Dr. Onslow’s accomplishments include authoring over 250 publications related to stuttering. Dr. Onslow is one of the lead developers of the Lidcombe Program, a widely used and researched preschool stuttering treatment (see full bio here).
Bob “the expert” Quesal joins Peter Reitzes to reflect on almost four decades of working in speech-language pathology. During the first half of today’s episode, Dr. Quesal is asked about some assorted topics which include the announcement that Speech Pathology Australia’s recent proposal to the Australian Treasury was rejected. Bob is then asked if our understanding of stuttering has improved during recent decades and about aggressive promotion of stuttering sites and products on social media. On the second half today’s episode, Bob is asked to discuss his reflections on a career in stuttering and speech-language pathology. Bob discusses ASHA and stuttering, the view that “everybody must acknowledge that there’s more to it [stuttering] than fluency,” the need for stuttering organizations to “continue to step up and provide educational opportunities” and that professionals “need to take advantage of those opportunities,” the importance of fluency specialists being vigilant in responding to potentially irresponsible internet claims and warnings about “political research.”
Robert Quesal, Ph.D., CCC-SLP is a person who stutters, a professor emeritus of Communication Sciences and Disorders at Western Illinois University, a fellow of the American Speech-Language Hearing Association (ASHA) and a retired board certified specialist in fluency disorders.
For background to the Speech Pathology Australia proposal, see this episode and show notes for related links.
Janet Beilby and Kathy Viljoen join Peter Reitzes to discuss a recent proposal by Speech Pathology Australia (SPA) which has many professionals and people who stutter concerned. In an ASHA blog post, Craig Coleman explains this serious issue:
“Recently, Speech Pathology Australia (the national speech-language pathology association of Australia) submitted a proposal to the Australian Government Department of Treasury that would require Medicare rebates be made available for children who stutter, but only if they are treated using the Lidcombe Program.”
StutterTalk covered this issue at length on Episode 502. For a brief and creative background on this issue, check out Katie Gore’s amazing summary The Australian Budget Lidcombe Proposal Debate: A Primer in Memes. Today, Dr. Beilby and Ms. Viljoen discuss much, including their experiences with a number of preschool stuttering treatments which have benefited children and families. They also share that Lidcombe treatment does not “work” for all preschoolers who stutter and that the current Speech Pathology Australia proposal may have the effect of discouraging other treatments which may be beneficial and appropriate. Mr. Reitzes asks Dr. Beilby and Ms. Viljoen about a submission made to Australia’s Community Affairs References Committee of the Senate, on University of Sydney letterhead, which concludes in part, that the Australian government should consider the informed choice of parents regarding speech-language pathology services. Ms. Viljoin shared, “I would like to see the SPA proposal be amended to extend coverage to children presenting with the disorder of stuttering rather to a specific treatment per se.” When asked how she might respond to a person who states, “It is only ethical to use Lidcombe treatment with preschoolers who stutter,” Ms. Viljoen responded, “I would ask them if they have had a child who stutters, if they think it is ethical for a program to offer the client to fit the program as opposed to the treatment approach to fit the client.”
Janet Beilby, Ph.D., is Senior Lecturer and Clinical Educator at Curtin University in Western Australia and has been a lecturer, researcher and clinician in the field of stuttering for over 30 years. Dr. Beilby has treated thousands of clients, trained hundreds of students and been awarded over half a million dollars in research funds investigating varying aspects of stuttering disorders.
Kathy Viljoen is the mother of children who stuttered and a Clinical Educator at Curtin University in Western Australia specializing in the management of stuttering. Ms. Viljoen supervises both undergraduate and Masters students at Curtin University in their stuttering placements. The Curtin Stuttering Treatment Clinic is the largest treatment facility for individuals who stutter in Western Australia.
Related Links:
Kathy Viljoen’s letter to Speech Pathology Australia – link
Janet Beilby’s letter to Speech Pathology Australia – link
Speech Pathology Australia’s proposal/budget submission to the Australian Government for 2015-2016 – link
The Stuttering Foundation’s Response/Statement titled Another Blunder from Down Under – link
Craig Coleman’s post/petition – A Dangerous Precedent from Australia: What It Means and What Happens Next – link
Speech Pathology Australia’s Response/Statement – link
Craig Coleman’s ASHA blog post, A Controversial Proposal on Stuttering Treatment from Speech Pathology of Australia: What It Means and What Happens Next – link
ASHA blog post by Ann Packman, Mark Onslow and Deborah Theodoros – link
International Fluency Association Press Release – link
Lidcombe the only effective treatment in Australia? – link
Submission to the Community Affairs References Committee of the Senate – “An inquiry into the prevalence of different types of speech, language and communication disorders and speech pathology services in Australia” – link
A very important question to Onslow and Packman – link
Deborah Theodoros has been misinformed about the efficacy of Lidcombe – link
The Australian Budget Lidcombe Proposal Debate: A Primer in Memes – link
Jane Fraser, Elaine Kelman, Craig Coleman, and Bob Quesal join Peter Reitzes to discuss a recent proposal by Speech Pathology Australia (SPA) which has many professionals and people who stutter concerned. In an ASHA blog post, Craig Coleman explains this serious issue:
“Recently, Speech Pathology Australia (the national speech-language pathology association of Australia) submitted a proposal to the Australian Government Department of Treasury that would require Medicare rebates be made available for children who stutter, but only if they are treated using the Lidcombe Program.”
Much is said on today’s episode. Jane Fraser begins by sharing her experience at the Stuttering Foundation hearing from families who do not always find success using Lidcombe Treatment. Jane stresses that a major concern about the SPA proposal is that “one size does not fit all” in stuttering treatment. Ms. Fraser is asked about the Stuttering Foundation’s statement on this issue and a recent Stuttering Foundation blog post. Next, Elaine Kelman is asked about the International Fluency Association’s press release which explains why they feel the Australian Proposal is not fully consistent with evidence based practice. Craig Coleman and Bob Quesal then join the conversation and discuss how there are better ways to advocate for people who stutter then by choosing only one treatment approach to reimburse. Mr. Coleman and Dr. Quesal share their concerns about the possible negative ramifications of the SPA proposal and much, much more.
StutterTalk invited Gail Mulcair, Executive Director of Speech Pathology Australia or another SPA representative on air to discuss these issues. SPA did not accept the invitation to participate.
Craig Coleman, MA, CCC-SLP, BCS-F is an assistant professor at Marshall University and a Board-Certified Specialist in fluency Disorders. Mr. Coleman is currently serving as coordinator of ASHA SIG 4 (Fluency) and as a member of the ASHA ad-hoc committee to revise the scope of practice in speech-language pathology. Craig is an adjunct instructor at Indiana University of Pennsylvania and Co-Director of the Stuttering U. summer program for children who stutter, their families, and SLPs.
Robert Quesal, Ph.D., CCC-SLP is a person who stutters, a professor emeritus of Communication Sciences and Disorders at Western Illinois University, a fellow of the American Speech-Language Hearing Association (ASHA) and a retired board certified specialist in fluency disorders.
Related Links:
Speech Pathology Australia’s proposal/budget submission to the Australian Government for 2015-2016 – link
The Stuttering Foundation’s Response/Statement titled Another Blunder from Down Under – link
Craig Coleman’s post/petition – A Dangerous Precedent from Australia: What It Means and What Happens Next – link
Speech Pathology Australia’s Response/Statement – link
Craig Coleman’s ASHA blog post, A Controversial Proposal on Stuttering Treatment from Speech Pathology of Australia: What It Means and What Happens Next – link
ASHA blog post by Ann Packman, Mark Onslow and Deborah Theodoros – link
International Fluency Association Press Release – link
Craig Coleman joins Peter Reitzes to answer the question Is there a best stuttering treatment?
During today’s episode, Mr. Coleman is asked about a number of comments made about stuttering by Carrie Clark, a speech-language pathologist, on her podcast and on a video. Topics include:
Is there a best stuttering treatment?
Is there such a thing as typical or normal stuttering?
Does everybody stutter?
Does the American Speech-Language Hearing Association support and back specific stuttering treatments?
Can parents respond to stuttering in ways that “will make sure…that stuttering does not become a bigger problem for your child”?
CRAIG COLEMAN, MA, CCC-SLP, BCS-F is an assistant professor at Marshall University and a Board-Certified Specialist in fluency Disorders. Mr. Coleman is currently serving as coordinator of ASHA SIG 4 (Fluency) and as a member of the ASHA ad-hoc committee to revise the scope of practice in speech-language pathology. Craig is an adjunct instructor at Indiana University of Pennsylvania and Co-Director of the Stuttering U. summer program for children who stutter, their families, and SLPs.
Effectiveness of Interventions for Preschool Children with Fluency Disorders: A Comparison of Direct Versus Indirect Treatments (article) from the National Center for Evidence-Based Practice in Communication Disorders, American Speech-Language-Hearing Association, by Frymark, Venediktov & Wang (2010)
StutterTalk® is a 501 (c)(3) non-profit organization dedicated to talking openly about stuttering. StutterTalk is the first and longest running podcast on stuttering. Since 2007 we have published more than 700 podcasts which are heard in 180 countries.
15 May 2016
Stuttering and Insurance Reimbursement (Ep. 579)
Podcast: Play in new window | Download
Subscribe: Apple Podcasts | Google Podcasts | Stitcher | TuneIn | RSS
Katie Gore joins Peter Reitzes to discuss stuttering and insurance reimbursement. Ms. Gore is asked about general health care terms such as co-pays, “case studies” and victories from her private practice in advocating for clients with their insurance companies, peer-to-peer meetings with insurance companies, how people who stutter and parents may consider advocating for themselves, how speech-language pathologists may consider advocating for clients, pre-authorization with insurance companies, the importance of contacting insurance companies with questions before beginning treatment, using pre-tax income to pay for treatment (such as flexible spending accounts), gap exceptions, diagnostic criteria and codes and so much more.
StutterTalk reports with great pride that Katie Gore has advocated so hard for clients that she has actually, on occasion, been informed by insurance companies that she has “maxed out” in the number of letters she is aloud to submit on a client’s behalf. Even so, when this occurs, Katie continues to advocate for her clients by assisting them in writing letters to their insurance companies.
Special thanks to the great Craig Coleman for recommending Katie Gore for today’s topic.
Katie Gore, MA, CCC-SLP is a speech-language pathologist, Director of Speech IRL and co-leader of the City of Chicago’s chapter of the National Stuttering Association. Ms. Gore made a splash last summer with her post The Australian Budget Lidcombe Proposal Debate: A Primer in Memes.
Links: