July 2007 Newsletter




Consultants in Dysphagia Evaluation and Management
817-514-MBS1 or 1-888-514-MBS1
Clinical Café Newsletter
By: Ronda Polansky M.S. CCC-SLP
July 2007
Happy Independence Day!
Monthly Motivator – Faith
Like a bridge, faith requires only that we trust in its ability to carry us where we are meant to be.
DiagnosTEX Holiday – DiagnosTEX will observe the holiday on Wednesday July 4th as we celebrate our country’s Independence and honor our veterans and current military.  We will be operating all vans on Tuesday July 3rd and Thursday July 5th.  Please keep this in mind when scheduling your MBSS.

Dates to remember this month
18th – Dental Awareness Day
22nd National Parents day
2nd-9th – National Nurses in staff development Days
8th-14th National Therapeutic Recreation Week

A recommended CEU course by a fellow SLP
I highly recommend the class at speechpathology.com  “The clinical implications of laboratory values in the management and treatment of dysphagia in adults”, by Russell Mills, and John Ashford.    It is .2 CEU’s for $69.  Mariana MS CCC-SLP

New DiagnosTEX SLP handout
The new SLP handout is “Changes in Swallowing in Aging”.  Ask for yours next time we see you.
This is great to use to educate families and patients when dysphagia develops as they age.
Remember all past handouts and newsletters can be viewed on our website www.dysphagiadiagnostex.com

Medicare Internet Resources
Center for Medicare and Medicaid Services – www.cmms.gov/medicare
Documentation Information – www.asha.org/members/slp/healthcare/documentation.htm
Medicare Advocacy – www.medicareadvocacy.com
Medicare Fee Schedule – www.asha.org/members/issues/reimbursement/MFS_index.htm
Provider information – www.cmms.gov/providers/default.asp
Reimbursement & Coverage issues – www.cmms.gov/mcd/search.asp
Coding issues – www.cmms.gov/medicare/hcpcs


DiagnosTEX Authorization Form
Our authorization form is a required form.  This gives us the authorization to do the study but also to collect payment.  Please make sure that the patient and or family read the form as it states that:
As the Responsible Party I agree to the following statements:
·        ____I understand it is my responsibility to pay any deductibles, co-pays or any other balance not paid by my insurance company.

  • _____In the event insurance eligibility cannot be determined; I understand that I am responsible for payment of all charges.


  • _____In the event my insurance company reimburses me in error, this payment will be forwarded to DiagnosTEX, LLC.

We will now require that the patient or family initials be next to these bulleted items as we have had many calls stating they “did not read” this in the authorization form.  Please make sure they are aware of these items and understand these.  If you ever have any questions, please contact our billing office and speak to Carolyn. We have included a new updated form for you to make copies.

Mobile MBSS – A life in the day of mobile………………………………………………………..
Obstacles – traffic, construction, train tracks, non working traffic lights, agitated patients, families, and/or nurses (and sometimes agitated SLP’s ha!), patients who threw up on the van, threw barium AT us, ADD-ONS, Texas stormy summer weather, getting stuck driving behind Mrs. Daisy who just turned 101 yesterday, maintenance issues, bathroom breaks (yes we go too! J), and sometimes things that we could never have anticipated, etc.
ETA this is our goal!  Often times we call ahead and let you know we are on our way and will be there in “15-20 minutes”, but please allow us a few minutes of flexibility as we never know when we will hit “all the traffic lights, get stopped by a train which stopped right on the cross way, get caught behind construction as they sit along the curb eating lunch, a traffic accident that every one in the vicinity has to rubber neck, and/or allow Mrs. Daisy time to make it 2 blocks to her hair appt. J”, etc. Funny, but often very true.  Bad weather can cause us all kinds of delays because of traveling as well has having to bring the patients out to the van.  It is the nature of this business and the obstacles we always encounter being mobile all day long.  Our goal is always to get to get you within 24-48 hours and stay on schedule for everyone involved including our own staff.  Often times we arrive at a facility and we are asked to add on, maybe one, maybe two or more.  Many times we schedule a facility the day before and the next morning we have paperwork for 2 more add on’s for that facility.  This causes us to push our schedule back at a minimum of 30 minutes per patient.  If you are the facility adding on, it typically does not effect you unless we arrive early to get the others added, but next time if you’re the facility after the add on’s, it will. DiagnosTEX feels every patient and family member is as important as the other, and we are not in a position to prioritize the patients, so we do our best to meet everyone’s needs, within reason. Please understand the nature of this business, the complexity of scheduling, and our sincerest 100% effort to get to you on time!

Dysphagia Tidbit   –  True Vocal Folds vs. False Vocal folds
The vocal folds, also known popularly as vocal cords, are composed of twin infoldings of mucous membrane stretched horizontally across the larynx. They vibrate, modulating the flow of air being expelled from the lungs during phonation. Open during inhalation, closed when holding one’s breath, and held apart just a tiny bit for speech or singing; the folds are controlled via the vagus nerve. They are white because of scant blood circulation.  The vocal folds discussed above are sometimes called ‘true vocal folds’ to distinguish them from the false vocal folds. These are a pair of thick folds of mucous membrane that sit just above, and protect, the more delicate true folds. They have minimal role in normal phonation, but are often used in screaming and the death grunt singing style. The false folds are also called vestibular folds and ventricular folds. They can be seen on the diagram above as ventricular folds. False vocal folds, when surgically removed, can regenerate completely.