posted
Check this out from the ISDA website, they say their guidelines are just that- guidelines! How can insurance companies use it to deny coverage!! Unless they are practicing medicine!!
Standards, Practice Guidelines, and Statements Developed and/or Endorsed by IDSA.
Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. [Institute of Medicine Committee to Advise the Public Health Service on Clinical Practice Guidelines, 1990] Attributes of good guidelines include validity, reliability,reproducibility, clinical applicability, clinical flexibility, clarity, multidisciplinary process, review of evidence, and documentation. [Institute of Medicine Committee to Advise the Public Health Service on Clinical Practice Guidelines, 1990] Standards, Practice Guidelines, and Statements Developed and/or Endorsed by IDSA
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to the guidelines listed below to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.
The clinical practice guidelines development program falls under the auspices of the Standards and Practice Guidelines Committee (SPGC). While the SPGC is charged with the review and approval of guideline topics and guideline drafts, guideline development is performed by topic-specific expert panels. Expert panels adhere to a rigorous process that is outlined in the ``Clinical Practice Guideline Development Handbook.''
Questions regarding the IDSA guidelines program should be directed to: Jennifer Padberg, MPH, Director of Standards and Quality Improvement.
NOW QUOTE THAT TO YOUR INSURANCE COMPANY!!
quote:
It is important to realize that guidelines cannot always account for individual variation among patients.They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. ISDA considers adherence to the guidelines listed below to be voluntary, with the untimate determination regarding their application to be made by the phsician in the light of each patient's individual circumstances.Posts: 242 | From Mississippi | Registered: Oct 2006
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bettyg
Unregistered
posted
quote:Originally posted by MommaK:
Check this out from the IDSA website, they say their guidelines are just that- guidelines!
How can insurance companies use it to deny coverage!! Unless they are practicing medicine!!
Standards, Practice Guidelines, and Statements Developed and/or Endorsed by IDSA.
Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances.
[Institute of Medicine Committee to Advise the Public Health Service on Clinical Practice Guidelines, 1990 ]
Attributes of good guidelines include: . validity, . reliability, . reproducibility, . clinical applicability, . clinical flexibility, . clarity, . multidisciplinary process, . review of evidence, . and documentation.
[Institute of Medicine Committee to Advise the Public Health Service on Clinical Practice Guidelines, 1990]
Standards, Practice Guidelines, and Statements Developed and/or Endorsed by IDSA
It is important to realize that guidelines cannot always account for individual variation among patients.
They are not intended to supplant physician judgment with respect to particular patients or special clinical situations.
IDSA considers adherence to the guidelines listed below to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.
The clinical practice guidelines development program falls under the auspices of the Standards and Practice Guidelines Committee (SPGC).
While the SPGC is charged with the review and approval of guideline topics and guideline drafts, guideline development is performed by topic-specific expert panels .
Expert panels adhere to a rigorous process that is outlined in the ``Clinical Practice Guideline Development Handbook.''
Questions regarding the IDSA guidelines program should be directed to: Jennifer Padberg, MPH, Director of Standards and Quality Improvement .
NOW QUOTE THAT TO YOUR INSURANCE COMPANY!!
quote:
It is important to realize that guidelines cannot always account for individual variation among patients.[b]
They are not intended to supplant physician judgment with respect to particular patients or special clinical situations.
ISDA considers adherence to the guidelines listed below to be voluntary, with the untimate determination regarding their application to be made by the phsician in the light of each patient's individual circumstances.
posted
Well, this is there to fend off complaints. It is similar to the statements made by CDC, NIH, FDA about lyme being a clinical diagnosis, but if any doc actually tries to do this and has a lot of lyme patients in the practice, he is in danger of state medical board action anyway.
In short, when the ins cos and the medical boards want to enforce compliance, all these boilerplate caveats get brushed away easily. Besides that, not very many doctors are actually going to read these guidelines since they are very long; they will get the gist of them from medical diagnosis books like Conn's Current Therapy.
The only way to stop ins cos from practicing medicine is to sue them and most people don't have the energy or money. So, they just take these guidelines as gospel. You don't like it, tough, according to them.
However, if the federal and state health agencies had not made such a botch of lyme, the ins cos would not have a leg to stand on and the state boards might spend their time and taxpayers money going after the bad guys instead of the good guys.
Posts: 8430 | From Not available | Registered: Oct 2000
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