title: Impact of laryngologist and speech pathologist coassessment on outcomes and billing revenue.
abstract: OBJECTIVE
  This study investigated financial and treatment implications of a speech-language pathologist (SLP) performing a voice evaluation at the initial laryngologic visit.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Medical records from 75 consecutive adult voice therapy patients during a 3-month period were categorized into two groups: group 1 (n = 37) represented patients who underwent a medical speech evaluation (MSE) at the initial voice assessment with the laryngologist (+SLP), and group 2 (n = 38) represented patients who did not receive an MSE (-SLP). Data collected included age, gender, voice diagnosis, number of therapy sessions attended and cancelled, reason for discharge, and pre- and post-voice therapy Voice Handicap Index-10 (VHI-10) scores.
  
  
  RESULTS
  Patients in the +SLP group had fewer cancellations (P = 0.001), greater change in VHI-10 from pre- to post-therapy (P = .001), and were more likely to be discharged from therapy having met therapeutic goals (P = .007) than patients in the -SLP group. In addition, lost revenue over 3 months due to cancellations/no-shows was $2,260 in the +SLP group compared to $7,030 in the -SLP group (P < .001).
  
  
  CONCLUSIONS
  Concurrent voice evaluation by an SLP and laryngologist at initial diagnostic visit affects therapy attendance, voice therapy outcomes, and ultimately SLP and departmental billing revenue. Results may be due to more appropriate therapy referrals from SLP assessment of patients in conjunction with a laryngologist.
  
  
  METHODS
  4.
authors.affiliation: Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Juliana K
authors.initials: JK
authors.lastname: Litts
authors.affiliation: Department of Otolaryngology, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Jackie L
authors.initials: JL
authors.lastname: Gartner-Schmidt
authors.affiliation: Department of Otolaryngology, University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Clary
authors.affiliation: Department of Otolaryngology, University of Pittsburgh Voice Center, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
authors.forename: Amanda I
authors.initials: AI
authors.lastname: Gillespie
mesh_terms: D055154:Dysphonia / Q000191:economics / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013066:Speech-Language Pathology / Q000191:economics / Q000592:standards*; D014833:Voice Quality; D014834:Voice Training
keywords: Voice Handicap Index-10; Voice therapy; adherence; multidisciplinary evaluation; outcomes; voice evaluation