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  • 1.  Collateral offsets

    Posted 08-10-2015 17:44

    "Market prices" for most procedures are available in most areas by CPT code, and represent "Usual, customary and reasonable" values. They are published annually, and are available at 50th, 75th, and 90th percentiles. Home care rates are also available by survey of every state. Collateral offsets are not part of market prices. I have no interest in calculating these unless I am specifically asked to do so. If I am asked, I require that the values of the offsets be provided to me with the appropriate funding sources and their reliability. I will then make the calculations and provide the adjusted numbers. I do not wish to dive into the weeds of researching what collateral sources are available, and how reliable they may be for future offsets. This is far too speculative for me to testify on to a reasonable degree of certainty. If someone else wants to do that, that is their business and their problem. It's just cost shifting in my opinion. And that opinion is to a reasonable degree of certainty. ;-)

    Have a great evening. 


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    Kent Arnold Jayne
    President
    kentjayne@sprynet.com
    Cedar Rapids, IA United States
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  • 2.  RE: Collateral offsets

    Posted 08-13-2015 10:33
    I was asked about this yesterday in court--about Medicare--and my response was that Medicare doesn't pay the whole cost, nothing does, and the person will need supplemental insurance.  The attorney in that case and others, has said that they aren't allowed to consider Medicare in court (this is Florida).  I agree with those colleagues who say we use retail costs, so anyone can do what they want with the figures.

    Speaking of which, I have twice lately been told that all life care planners do is arithmetic, and I wonder if anyone else has encountered this.  In one situation, I had the presence of mind to say that I am hired because I know what to add, but I would like some better responses to this criticism.  





  • 3.  RE: Collateral offsets

    Posted 08-13-2015 10:43

    While I understand that we do much more than "arithmetic," I will leave it to the members of this forum with more experience than I have to expound upon that. The very first thought I had, when I read that statement was, "Even if that were true, all Architects do is arithmetic, but there is a reason we still hire them to design buildings, and not college math instructors or attorneys." Perhaps, instead of having a Pharmacist compound his next prescription, the attorney would prefer to have it done by a 20 year old Math major at ASU. After all, it's only arithmetic, right.


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    Dirk Leverant
    dirkleverant@gmail.com
    Phoenix, AZ United States
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  • 4.  RE: Collateral offsets

    Posted 08-13-2015 12:03
    Roger Weed wrote a great article about the LCPer being a general contractor and having to know what he/she was qualified to do and what to hire another expert for.  This is one reference that came up on a Google search:

    Weed likened the life care planner to a general contractor for a building project. "The life care planner is the general contractor for the client's future care needs," Weed told The O&P EDGE. "He or she knows who to go to, what questions to ask, and when to bring in specialists, much like a contractor might bring in an engineer to solve a specialized problem."


    Kathryn Reid, MA, CRC, CCM
    Rehabilitation Counselor & Case Manager
    Reid Case Management, Inc.
    www.reidcm.com 
    Seattle, WA

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    On Thu, Aug 13, 2015 at 7:43 AM, Dirk Leverant via IARP Connect






  • 5.  RE: Collateral offsets

    Posted 08-13-2015 14:21

    Please consider referring to our published standards of practice to answer this type of question.  The SOP delineate a variety of highly skilled cognitive tasks that rely on specialized knowledge.  We need to take credit for the whole process of creating a LCP, not just the visible/tangible math seen in our reports.

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    Karen Preston, FIALCP
    Consultant
    rnsconsult@aol.com
    Sacramento, CA United States
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