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Dear Members,
The delistings have created significant challenges for our profession and our patients. The Alberta Association of Optometrists (AAO) Private Insurance Task Force was established to address ongoing concerns related to insurance delisting practices, and we want to assure you that we are moving forward with urgency to resolve these issues.
This email provides an update from this week on the recent activities of the Task Force. We remain committed to advocating for fair treatment and protecting the sustainability of optometry in Alberta.
CAO Update:
The Canadian Association of Optometrists (CAO) recently shared an update through their member newsletter on their ongoing efforts to address the insurance delistings. This week, they met with the Canadian Life and Health Insurance Association (CLHIA) and several major insurers to better understand the delisting and appeal processes from the industry’s perspective. The CAO emphasized concerns over the lack of clarity and transparency, particularly around unintentional “fraud” by providers. They are prioritizing education and risk management through the CAO Task Force on Billing and Fraud Prevention and will soon release training materials and a webinar on billing best practices.
From our meeting with the CAO, they are working to gain clarity in three key areas:
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Delisting Process: Understanding how and when delisting occurs, and the reasons behind it.
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Relisting Efforts: Developing a clear relisting process and collaborating with members to help them get relisted.
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Education and Support: The CAO is focused on providing optometrists with education on billing best practices and compliance with insurance requirements. This includes, as noted above, working with CLHIA to create optometry-specific materials and webinars.
The CAO is also exploring avenues for further action, including government relations strategies. They have retained a government relations firm to review the entire situation and provide recommendations. We will ensure our new Government Relations firm is connected and working in collaboration with the CAO.
The CAO noted that the optometry profession is ahead of other health professions in responding to the issues of insurance delistings, as many have not yet undertaken any formal action.
Legal Counsel Update:
Our legal counsel is actively working on appeal responses and engaging in discussions with insurance investigators to explore options for supplemental appeals. We are taking a strategic and comprehensive approach in order to build the necessary tools and resources that we need to support our members throughout the process.
Government Relations Firm Update:
Our goverment relations firm is actively working to engage the Alberta government. We will also be reaching out to the Superintendent of Insurance for Alberta to share our concerns and see if there is anything that office can do with regards to the delisting problem. A meeting with the Chief of Staff to the Minister of Health is scheduled for next week to discuss the issue further and gain insights as to how the Minister might be able to assist or engage on our concerns.
Allied Health Professionals Collaboration:
The Allied Health Professionals Collaboration is engaging with other health professional associations in Alberta to discuss opportunities for allied support and coordinated action. Additional information will be shared with our members in the coming weeks.
We recognize that this is a stressful time for our members and want to assure you that we are taking this matter very seriously. We sincerely thank both affected and unaffected members for their valuable feedback. While other professions have yet to take action, we are proud to be leading the way, moving forward proactively, and forging a clear pathway for progress.
Sincerely,
Dr. Pamela Giles
Chair, AAO Private Insurance Task Force
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