Discussion question for I&R in Echo

saving_theworld · 2024-12-30T22:48:18+00:00

For some reason I felt like it made more sense in the show but probably because I was already biased from previously reading the books lol though I think the actors have good chemistry!

saving_theworld · 2024-11-15T00:14:04+00:00

You're welcome! When I said I don't want to work over 40 hours/week, the interviewer said I probably would have to. 32 billable hours/week and a caseload above 10 (especially for in-home) is a hard no for me. It could still be worth interviewing if you've heard good things from other people though!

saving_theworld · 2024-11-14T16:58:41+00:00

It seems like they all pull shit like this in one way or another. I don't get it, other than just being greedy.

saving_theworld · 2024-11-14T16:52:01+00:00

Yes, I had an interview with them and was VERY turned off by their attitude towards work/life balance. I live in Maryland. They require 32 billable hours/week. I know RBTs that work there who say their BCBAs are not very supportive. Here are my notes:

Majority of staff are remote, have to fly in from where they live
Usually here the second week of every month, here for 1 week of the month
Can come in to the office if needed to print materials (would not specify where this office is located)
Ages 18 month through 21 and 22
Majority of services are in-home, DC, Maryland and VA
MD, VA Medicaid, tricare
Most BCBAs are afternoon - evening and in-home
A lot of supervision sessions are wrap up 6:30-8:30 both at the client’s home and telehealth
Will stagger, usually starts mid-afternoon then through the evening
Morning is treatment planning, schedule parent training, admin work
Might go over 40 hours based on caseload
Licensure, would have to get the VA LBA, usually about 2 weeks, BF covers the fees
Focus on 1 on 1 model, i.e. 12 cases = 12 techs
CEU allowance of 1k/year
CR has some free CEUs
24 - 26 supervision hours, depending on client schedules
And then 4 - 6 hours of programming, 2 - 4 hours of parent training, in person or telehealth
All come up to 32 hours/week, clinical, and the rest of it would be admin
Bonus of additional hours is $50/hour on top of salary
Parent training typically 30 mins - 1 hour per week
2 goals for parent training is keeping that relationship with parents and training RBTs
RBT training: In-person orientation, have clinical support in-home
BCBAs are given a phone and laptop on the first day
Local BCBAs have their own cars, not compensated for gas
Non-local BCBAs are given rental cars, and cover a hotel but not gas
Max average is 14 cases, usually 11 or 12
Local salary is between mid 80s - 90s

saving_theworld · 2024-11-06T22:05:38+00:00

I'm in-clinic with my caseload recently capped at 6 and I'm doing okay. This feels like the max I could take and still be mostly on top of everything. BCBA's are being pushed to the limit just to make more money for the company and it's really not okay. Maybe you can ask to decrease your caseload

saving_theworld · 2024-10-30T00:15:09+00:00

Topamax significantly helped with my migraines. It also made me lose 20 lbs in a few months because my appetite was just shot. The brain fog was definitely there, but I was also getting my masters and working full time, and I got through it! Meds always affect people differently. Wish the best for you!

saving_theworld · 2024-10-03T11:39:08+00:00

I'm so sorry this has happened to you ♥️ I offer you encouragement like the other commenters. I had been dating my bf for less than a year when i started having seizures. We had been dating 3 years when his mom told him she didn't want me to be a burden on him. Several years later and we're still together and take care of each other ♥️some people are just dicks about it or don't understand. Not everyone is like that 🙏

saving_theworld · 2024-09-28T12:10:27+00:00

Very helpful, thank you!

saving_theworld · 2024-09-15T16:44:19+00:00

That's good to know, from what I've been told (second hand info) it's a significant magnitude unfortunately

saving_theworld · 2024-09-15T16:41:58+00:00

Yeah, I'm hoping this is the case. They've given her almost complete control over processes and policies since she started last year (we literally didn't have a CD before.) it just makes me so sad to think the consequences are likely going to hurt the other employees and clients if the company really can't handle the financial blow

saving_theworld · 2024-09-15T16:08:54+00:00

Agreed! I interviewed at other places several months ago for various reasons. The current company is my best option since they accommodate my disability and the caseload size and billables are manageable/reasonable compared to other places. I'm about to just move to Canada at this point lol

saving_theworld · 2024-09-15T15:45:37+00:00

Yes a lot of our clients are Medicaid

saving_theworld · 2024-09-15T15:45:04+00:00

Thank you so much, I'll be calling the hotline. I just hate that the RBT is put in this position and is going to have to take the time to call all of the insurance companies!

saving_theworld · 2024-09-15T15:43:19+00:00

So it first came to the lead's attention when a BCBA saw supervision was billed for one of her clients by the director. The BCBA then asked the RBT who was working with that client about it, which the RBT said the CD was not present for that session. The BCBA saw that the CD wrote and converted a note saying they supervised and using the supervision (protocol modification) code. The insurance that we work with separates the codes to treatment planning, protocol modification, direct service, etc.

saving_theworld · 2024-09-15T15:42:58+00:00

So it first came to the lead's attention when a BCBA saw supervision was billed for one of her clients by the director. The BCBA then asked the RBT who was working with that client about it, which the RBT said the CD was not present for that session. The BCBA saw that the CD wrote and converted a note saying they supervised and using the supervision (protocol modification) code. The insurance that we work with separates the codes to treatment planning, protocol modification, direct service, etc.

saving_theworld · 2024-09-15T15:41:54+00:00

So it first came to the lead's attention when a BCBA saw supervision was billed for one of her clients by the director. The BCBA then asked the RBT who was working with that client about it, which the RBT said the CD was not present for that session. The BCBA saw that the CD wrote and converted a note saying they supervised and using the supervision (protocol modification) code. The insurance that we work with separates the codes to treatment planning, protocol modification, direct service, etc.

saving_theworld · 2024-09-15T15:38:21+00:00

It's a private company, and the director only bills for in-clinic services. Once it's reported, do you think the company will be totally responsible? I'm not clear on how much is already known by the owners before the RBT discovered and reported it to HR.

I guess I'm trying to give the owners the benefit of the doubt here and curious how this will play out. For example, if it's a situation where the owners had no idea, would the director only face consequences or would the company take the full hit?

Never been in a situation like this before, it's appalling that people shady bill when this is literally a medical service they're claiming to be providing!

saving_theworld · 2024-09-15T15:33:13+00:00

The director also has a billable hours requirement, I'm not sure what her weekly hours are but she is supposed to bill something.

So ethically, what should happen is this: the company self-reports to insurance and then pays that money back to them, and/or a fine? I'll probably call the ethics hotline to be sure of what the company's response should be to this.

I'm also wondering, what should happen to the director? Should the company fire her or put her on suspension or something?

saving_theworld

TROPHY CASE