ABOUT

Board Certified Patient Advocate, Certified Senior Advisor®, Certified Health Coach & CPA (retired)

As Board Certified Patient Advocate and a Certified Senior Advisor, (CSA)® I have a broad-based knowledge of the healthcare system and the specific health, social and financial issues that are important to seniors.  These certifications require passing rigorous exams, a background-check, meeting continuing education requirements and upholding the highest ethical standards for the benefit and protection of the health and welfare of my clients.

Successes

INSURANCE

  • Contacted Board of Directors/Senior Medical Director of national health insurance provider to resolve local bureaucracy that resulted in delayed discharge home from Nursing facility   

  • Guided the choice of Medicaid Long Term Care and Medicare Supplemental insurance plans

  • Deciphered Medicare Summary Notices; identified avoidable out of pocket costs

  • Processed appeal of insurance company claim denial

  • Filed emergency claim denial appeal, expediting timing from 1 month to 72 hours 

  • Researched and clarified complex health insurance coverage rules, including those for durable medical equipment

DOCTORS

  • Identified specialists to diagnose and treat conditions that had been misdiagnosed

  • Challenged misdiagnosis by a specialist, obtained second opinion and avoided unnecessary surgery

  • Assisted with implementing lifestyle changes to reverse or improve various conditions including pre-diabetes and high blood pressure 

  • Attended doctors visits and procedures to assist clients in understanding and communicating with medical teams

  • Identified oversights in blood work results that required medical attention

HOSPITAL & SKILLED NURSING FACILITIES

  • Successfully challenged denial of ongoing physical and occupational therapy 

  • Identified patient over-medication due to recent weight loss, resulting in improved alertness and engagement

  • Challenged nursing staff's assessment of patient recovering from heart surgery, resulting in additional testing that identified a brain hemorrhage that was then successfully managed

  • Appealed hospital's premature discharge plan, obtaining patient additional care needed

  • Obtained improved quality of life for patient in Skilled Nursing Facility by partnering with social workers, nursing staff, aids and therapists

 

HOME HEALTH CARE

  • Interviewed and assessed LPNs being considered for home care

  • Compiled comprehensive list of needs for consideration in Medicaid Conflict Free evaluations to ensure maximum level of coverage would be considered

  • Partnered with management to obtain required level of home LPN care

 

Board Certified Patient Advocate & Certified Senior Advisor (CSA)®

Serving Long Island, New York

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Certified Senior Advisors (CSAs) have supplemented their individual professional licenses, credentials and education with knowledge about aging and working with seniors. It is recommended that you verify the validity of any professional’s credentials in which you conduct business and be sure you completely understand what those licenses, credentials and education signify.  The CSA certification alone does not imply expertise in financial, health or social matters. For more details visit: www.csa.us

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