Information for Administrators

At InScope Mobile Diagnostics, we require a written referral from a licensed physician to initiate services. As a Fee-for-Service company, we can bill insurance with a Letter of Authorization (LOA) in place, signed by an authorized representative. Please note that arrangements for insurance billing should be made in advance. Ensure these documents are provided to proceed with our services.

MOBILE SERVICES THAT ARE RELIABLE AND COST-EFFECTIVE

Our services are performed and completed in your facility making it the easiest option for you. 

Benefits of On-Site Swallowing Assessments

Costs

  • Usually <1/3 Hospital Costs including travel
  • Medicare reimbursement of FEES is higher than VFSS (typically)

Time

  • 20-minute instrumental procedure at resident’s bedside
  • Completed report on-site within 24 hours
  • No travel time for patient
  • Your patients wont miss other important therapies like OT and PT
  • Comprehensive reports with color photos and video upon requests within 24 hours

Medicare Will Cover

  • Staff SLP study prep time with endoscopist
  • Staff SLP counts education/therapy time with her patient
  • Physician captures their consult time

Convenience

  • Appointment fits Staff SLPs schedule
  • Study completed at resident’s bedside or during an office visit or where facility requests
  • FEES completed within 48 hours of initial referral time (excluding weekends and holidays)

WHAT DO WE DO

Mobile FEES

(Fiberoptic Endoscopic Evaluation of Swallow)

  • FEES is an instrumental examination performed by a qualified and licensed speech-language pathologist (SLP).
  • Typically, FEES is ordered by a physician whose patient presents with dysphagia (a swallowing disorder). FEES is a reliable instrumental examination that provides a comprehensive assessment of the upper aerodigestive functions of swallowing.
  • FEES assess anatomical structures involved in the pharyngeal phase of swallowing, assesses physiology and sensation of those anatomical structures within the pharynx, aids in the assessment of secretions severity and secretion management, provides direct-assessment of swallowing of food and liquid, and assesses the response to therapeutic maneuvers and interventions designed to improve swallow physiology.
  • Mobile services available statewide.


Educational Services

Appalachian-Zenith Training and Education Courses (A-ZTEC) is an American Speech Hearing Association (ASHA)-approved CE Provider that partners with InScope to deliver in-service training for nursing staff in skilled nursing facilities, speech-language pathologists (for CE credit), and physicians. We also provide on-site supervisory training for SLPs in FEES administration and distribute newsletters focused on oropharyngeal dysphagia, including assessment, treatment, and the importance of strong oral care practices. In addition, A-ZTEC offers a range of continuing education courses for medical SLPs.



If your facility contracts with InScope and uses our services, customized CE courses are available to your therapists at a discounted rate. Contact us to inquire about current pricing and course options.

Why Use FEES Instead of MBSS?

  • Mobile FEES exams examine physiological swallow characteristics like swallow efficiency and airway protection without leaving the patient’s room!


  • A clinician is able to evaluate a patient while voicing, performing non-speech tasks, as well as eating and drinking different liquids and solids.

        In addition, a clinician can: 


  • View the larynx in detail 

  • View secretion management 

  • View velopharyngeal tissue health, closure,
  • mechanics, and competency 

  • View the hypopharynx tissue health and mechanics

  • View laryngeal tissue health and mechanics

  • View structural symmetry

  • View activation of pharyngeal walls 

  • View whether cervical spine health
  • is impacting the swallow

  • View reflexive and voluntary cough


  • Identify lesions

  • The staff SLP can request the use of compensatory strategies and get real time feedback.

  • The patient and patient’s family can ask questions and

        discuss the exam with endoscopist and staff clinician.


  • The patient is included in therapy and diet decisions within minutes of exam completion.

Clinical Services

  • On-Site or in-office instrumental assessment of patients suspected of oropharyngeal swallowing disorders. Assessments include the use of nasopharyngoscopy and the Fiberoptic Endoscopic Evaluation of Swallow (FEES) protocol. 
  • Post-assessment consultation with Staff Speech Pathologist, other staff and/or patients.
  • 24-72 hour comprehensive, two-page report of assessment results with color pictures
  • Direct staff participation in assessment administration (part of assessment time is counted toward Staff Speech Pathologist’s work productivity). 
  • Same-day response for scheduling patient assessments within 24 hours to 1 week.
  • Professional interpretation of swallow physiology
  • Exercise-based and compensatory strategies recommended tailored to target the errored swallow mechanics
  • Staff clinician can make specific requests during the examination

Accessible Instrumental Diagnostic Procedures

InScopeMobileDx was established in response to a need for accessible, economic , and objective instrumental diagnostic procedures for pediatric and adult populations in the state of Nevada, and Arizona. InScope provides an opportunity for patients to receive convenient, cost-effective, cost-efficient, accurate, and safe instrumental exams in their own environment.

Swallowing Problems in Skilled Nursing Facilities

Did you know...

SWALLOW INSTRUMENTAL VISUALIZATION ASSESSMENTS (FEES/MBSS) ARE “BEST PRACTICE” (American Speech and Hearing Association, 2021)

43%

of skilled nursing facility residents have difficulties eating (Clinical Intervention in Aging, 2013)


67%

of patients on a modified diet or liquid did not have dysphagia upon reevaluation with FEES (Bice et al., 2024)

61%

of patients in a skilled nursing facility with a feeding tube did not have dysphagia (Bice et al., 2024), suggesting the need for a FEES exam

66%

cheaper to use mobile video-endoscopy than

of an ambulance & hospital-based 

x-ray swallow study

          ⭐ Mobile Instruments exams (FEES) guide clinical decision-making.

          ⭐ Continuing acute care diet recommendations in a skilled nursing facility increase costs incurred by the facility                        (Bice et al., 2024)

          ⭐ Altered diets can lead to malnutrition and dehydration!

          ⭐ Modified diets negatively impact patient QOL (Bice et al., 2024) and can lead to malnutrition and dehydration,                      which lead to increased infections, reduced wound healing, and increased re-hospitalizations.

          ⭐ Unnecessary diet preparations, nutritional supplements, dysphagia-related illness like UTIs and

                 Hospital readmissions COST YOU MONEY!

          ⭐ Instrumentals (FEES) help your facility avoid the expensive negative outcomes later!

          ⭐ New imaging is required to inform treatment when medical status changes (Bice et al., 2024)