A Voice for the Voiceless

How one speech-language pathologist is speaking up for her patients to try to get them the treatment they deserve

Starr Cookman is a speech-language pathologist by training, but her role has come to encompass so much more. “I become many things to my patients,” she says. “Sometimes a resource and a teacher, but more times than not, a counselor or adviser.”

Most recently, she’s added a new role to that list: Advocate.

When a patient that Starr’s team had successfully treated for muscle tension dysphonia — or, vocal cord spasms — was denied payment for the treatment by her insurance company, Starr found that her calling to give a voice to the voiceless took on new meaning. She became determined to speak up for her patient.

The insurance company had agreed to pay for the treatment, Starr explained, but when the bills arrived, the company balked, and Starr discovered the code was divided into two bulletins, which made it slightly misleading.

“That really bothered me,” she says. “It felt like a bait and switch, it felt illegal and wrong.”

Though not always the case, as some insurance companies do cover these services, Starr realized changes needed to be made. She scoured the provider’s bulletins, highlighted misleading language and noted what she described as cherry picking of research. Then she provided the company with signed letters and pages of references.

Starr is not sure if these objections made it through to decision-makers, but they did impact her. The experience transformed Starr into a dogged advocate for her patients who works closely and effectively with her colleagues to get the best outcome.

Now, Starr tries to stay knowledgeable about the current policies her clinic’s insurance providers have, and is able to give guidance to her patients during the appeal process. Furthermore, she always appeals insurance decisions at the state level to give patients a better chance at winning their case. Harnessing the advocacy support that ASHA provides, Starr works together with her peers and support staff to streamline the appeals process as much as possible.

In her line of work, Starr understands the importance of having a voice. “When a chronic voice problem comes into play — a chronic inability to sound like you, a fatigue and an effort every time you go to talk — the voice becomes this all-important, overarching problem and people are overwhelmed by the disability and discomfort,” she says.

Helping people recover that voice is part of what drew Starr to her calling as a speech-language pathologist. Now, as an advocate, she does more than heal her patients’ voices — she helps them speak out.