[Dysphagia] More on Head and Neck Cancer

[RingoCC at comcast.net (Carol Ringo)]

Thank you, Eric and Christa.  That is a good idea, and I will certainly ask
the oncology nurses to explicitly screen for these (though we wouldn't be
addressing xerostomia, right?  The oncology nurses do that at our facility.)
Do you have any experience with the Therabite?  If so, do you find insurers
paying for it?

Carol Ringo, Ph.D., CCC
Speech-Language Pathologist
Concord Hospital,
Concord, NH

-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of Christa Likes
Sent: Monday, April 24, 2006 1:00 PM
To: Dolinger, Eric; 'Carol Ringo'; dysphagia@b9.com
Subject: RE: [Dysphagia] More on Head and Neck Cancer

I agree with Eric. I have not had any denials so far. Almost all of my
patients have at least one deficit I can target on the plan of care, i.e.
xerostomia, dysphagia, dysphonia, etc. prior to beginning XRT, chemo, etc.
(especially if they've already had surgery).   I do a full evaluation and
education session with them before they begin XRT, chemo (or at least in
their first week or so of treatment) and typically follow them one a week or
once every other week throughout their treatment. Their deficits almost
always magnify about the 4th week of XRT if not before.
  Hope this is useful- Christa Likes, MSR,CCC-SLP

"Dolinger, Eric" <EDolinger@Christianacare.org> wrote:
  The pre-emptive approach is really becoming the standard of care.
Interestingly, havent really gotten many (any?) denials.

Many of these patients do have speech/voice/swallowing problems prior to
their treatment regimens...use that as your entrance point

eric

Eric Dolinger, MA CCC-SLP
Senior Speech Pathologist
Christiana Care Health System 
Phone 302-733-1015
Fax 302-733-1061
edolinger@christianacare.org


-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com] On Behalf
Of Carol Ringo
Sent: Sunday, April 23, 2006 9:19 PM
To: dysphagia@b9.com
Subject: [Dysphagia] More on Head and Neck Cancer


Hi,



For those of you who work with head and neck cancer patients undergoing
radiation or concurrent radiation and chemo, what is your model of service
delivery? We opened an oncology center at my hospital within the last
couple of years, and there is an increasing awareness by the physicians,
nurses and dieticians in our center that these patients are at risk for
trismus, as well as dysphagia. I have been asked what services I can
provide to the head and neck cancer population. My thought was that I would
be able to see these folks before the start of their treatments, for
education and counseling, and to offer preventive exercises, but my director
informs me that this kind of service is not covered by most (all?) private
insurance companies. Under this scenario, she feels we must wait until
problems develop and then have patients referred when we can bill insurance
companies for evaluation and treatment-or have them referred with the
understanding that they will be responsible for the bill. Do you provide
nonbillable education, counseling and preventive services to these patients?
If you have found a way to bill for these services, how do you do so? I am
all for providing the services as part of the "package" that they sign on
for when they begin their treatments, but I am not an employee of the cancer
center, and my director needs to keep her eye on her budget and the bottom
line. Any ideas out there?



Thank you,



Carol Ringo, Ph.D., CCC-SLP

Concord Hospital

Concord, NH



_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia



Christa P. Likes, MSR, CCC-SLP
Certified Speech-Language Pathologist
Center Coordinator of Clinical Education (CCCE)
Regional and Oncology Rehabilitation Services
Spartanburg Regional Healthcare System
101 East Wood Street
Spartanburg, SC 29303
Phone: (864) 560-2132
Fax: (864) 560-2199
Pager: (864) 560-6070 #5421
Email: cclikes@yahoo.com
This e-mail, including attachments, may include confidential and/or
proprietary information, and may be used only by the person or entity to
which it is addressed.  If the reader of this e-mail is not the intended
recipient or his or her authorized agent, the reader is hereby notified that
any dissemination, distribution or copying of this e-mail is prohibited.  If
you have received this e-mail in error, please notify the sender by replying
to this message and delete this e-mail immediately.
		
---------------------------------
How low will we go? Check out Yahoo! Messenger's low  PC-to-Phone call
rates.
_______________________________________________
Dysphagia mailing list
Dysphagia@b9.com
http://lists.b9.com/mailman/listinfo/dysphagia