President’s Notes
by Mim Aretsky, LCSW (BR)

As usual, there has been a lot going on with LACSW. We are heading into the legislative session and the legislative committee has been working with our lobbyist, Maxine Cormier. Once again, Maxine could not resist our charm and has agreed to renew her contract with LACSW. I’m not sure that everyone knows, but we are amongst the only member state within the Clinical Social Work Federation (CSWF) that employs our own lobbyist. We have found that this has been an invaluable way to make sure that clinical social work issues are attended to. We will be looking at bills which have been prefiled as well as talking with our membership about issues they feel are important. If you have any clinical social work issues you feel may have a legislative remedy, please call Debbie Fernandez, LCSW (BR) or me and give us your input.

I also met with Thea Lobell, the new Executive Director of NASW-LA. Ms. Lobell is very interested in NASW working with LACSW on many projects, particularly legislative. Plans are in the works for our respective legislative committees to meet to see how we can work together.

At our last Board meeting, we wrangled with the budget. While our budget is small, we will be spending our funds to make sure that clinical social work needs and concerns are represented in the legislature, in our schools, and in our community.

Lastly, I would like to thank Laura Myers,LCSW (NO) for her dedication as our Treasurer. I know this has been a difficult and time-consuming job for Laura, and we thank her. I’m pleased that Laura will continue on the Board.

Charlene Spears, LCSW (SHR) has now taken on this job. She is quite the technical person and very computer literate. Charlene will keep the books on her computer, which may help us with financial projections.

Please remember to check our website (LACSW.org) and to call or email me with concerns (miriamaretsky@msn.com).

Managed Care Update
Leesa Sitter, LCSW, DCSW (Shr)

LACSW is keeping abreast of managed care issues on the state and national level. Blue Cross/Blue Shield (BCBS) is credentialing clinical social workers for a segment of its business from which we were previously excluded. Those who choose not to joint the panel will need to collect their fees from the client as any out-of-network benefits are sent to the client. Sample consultation and collaboration forms are included in this newsletter.

Tri-Care was contacted by LACSW members after an unannounced fee reduction. The original fees have now been reinstated. Concerns have also been voiced about American Psych Systems (APS) regarding reduced fees and delayed claims and authorizations. LACSW is checking into this.

Blue Cross/Blue Shield Notes:
The Blues for Social Workers

Terry Zenner, LCSW (LAF) offers this account of his conversation with “Rebecca” of La. Blue Cross’s provider contracting department (1-800-716-2299):

To get any payment from BCBS to social workers or to their clients, the social worker must have a provider number. With that number, whether “of old” or new, BCBS can tell whether the social worker has signed the new contract offered in the fall of 2002.

Benefits payable will still depend on the patient’s policy; some pay for out-of-network, some don’t. If the social worker has not signed the new contract, any benefits payable will go directly to the patient. No payment or Explanation Of Benefits (EOB) will go to the social worker “due to privacy.”

“I did not have my wits about me to ask at the moment why that absurd explanation, since the social worker already knows more private matters than BCBS does about the purpose of the visit and the reason for the claim.” says Terry.

Terry wants to remind social workers that they are still free to choose NOT to contract with managed care.

PLEASE NOTE: BCBS of Alabama says it doesn’t have to pay Louisiana social workers—but they do! AND—

BCBS Federal is managed by Magellan, and pays Magellan’s rates. After the eighth session, you must file a treatment plan.

Managed Care-Free: What’s Your Story?

In LACSW’s January Board Meeting, there was a discussion regarding our diligence in protecting our rights, as well as our clients’ rights, when working with managed care companies.

Several of us pointed out that we’d also like to see LACSW promote discussion of becoming managed care-free, or of reducing the segment of our income that is managed-care dependent.

To this end, we have decided to include a “managed care-free” column in each newsletter. Please share your ideas and success stories with carving out niches which have reduced your dependence on managed care contracts.

Terry Zenner, LCSW (LAF) is a great promoter of private pay practice; check out his website at www.terryzenner.com to see the kind of programs he’s developed and how he educates the public about the advantages of private pay.

Also, read Psychotherapy Finances, which highlights private pay niches in each issue.

Please share your stories and ideas for how we can support one another in developing managed care-free practices.

BC/BS Attestation Change
by Karen Collier, LCSW and Leesa Sitter, LCSW

Blue Cross/Blue Shield (BC/BS)is finally credentialing clinical social workers as providers to furnish services on a segment of its business that previously just had physicians or psychologists as paneled providers. We also contacted BC/BS about the attestation form included in credentialing packets and this has since been removed.

Clinical social workers routinely contact clients’ physicians for continuity of care but due to confidentiality issues do not have one identified physician who consults on clients not under their direct care. See the two types of sample form letters which meet the consultation/collaboration requirements of the vendorship law.

BCBSLA’s Dawn E. Cantrell, Vice President of Network Administration, says providers with questions can call Network Administration at (800)-716-2299, option 3 or (225)297-2758.

Treasurer’s Report—11/1/02-12/31/02
Laura Myers, LCSW (NO)

LCSW Membership Report
by Larry Gooch, LCSW (BR)

LACSW currently has 53 members.

While this number is of concern to us, a review of our history indicates much ebb and flow related to politically “hot” years.

In its inception year, LACSW had 35 member; in 1981 the number was up to 69, but the following year, it was down to 44. The years of greatest membership were 1986 (109) to 1989 (94); then the numbers hovered in the 50’s until 1993, when membership shot up to 93. However, by 1995, the membership numbered 53. Our average membership has been 66.

Please remember to “recruit” any LCSWs you know who are not members. Remind them that our organization is actively protecting their rights as private practitioners.

You can call me at 225-923-0764 with names of any potential members and I will contact them.

History shows that our best method of recruitment is your own personal testimony to your friends. Please consider whether your coworkers and peer group members know about LACSW!

Grievance About a Managed Care Claim?

Any problems you are having with managed care companies are of interested to our Board members who oversee managed care issues. Judy Holland, LCSW, Karen Collier, LCSW, and Leesa Sitter, LCSW are monitoring and intervening when possible.

Also, if you are considering filing a grievance with the Insurance Commission, Maureen Powell, LCSW, suggests you look at its website: www.ldi.state.la.us

LACSW wishes to thank
SYNERGY HOSPITAL

(4040 North Blvd, BR, 225-343-1994)
for donating help and space for our Board meetings.

New NASW-LA Director, Thea Lobell, Welcomes Dialog

I am honored to have this opportunity to introduce myself. I have begun to travel around the state. I am impressed with the dedication to social work values as well as the openness and friendliness of everyone; it is great to be back in Louisiana. I am originally from here and received my Bachelor’s in Business Management and my MSW from LSU-BR. I was in Florida for the last 8 1/2 years.

My clinical experience has been varied. I worked in an intensive outpatient program with adolescent substance abusers, leading group, family and individual counseling sessions. I have a passion for providing tools to parents for success. I led an intensive parenting program in a medium security male prison in Florida.

My immediate previous position was Director of Training and Technical Assistance with the Florida Council Against Sexual Violence in Tallahassee. I developed and delivered clinical skills training for sexual violence counselors from all disciplines.

Lastly, I am a Ph.D. candidate in Clinical Social Work with a minor in Women’s Studies at Florida State University’s School of Social Work. I completed an extensive clinical advanced practicum over 9 months, providing individual, marital and family therapy through the FSU Marriage and Family Therapy Clinic. My dissertation is on Sexual Violence Against Women 60 and Older.

I have been warmly welcomed by your organization and greatly appreciate the kind words, meetings, and lunches. I am enthusiastic about meeting more LACSW members and working closely together. Our organizations are in a great position to create synergy around social work in Louisiana.

Please feel free to e-mail me at exec@naswla.org or give me a call at 225-346-1234. I wish you all the best.

Sincerely,

Thea Lobell