631-312-0741 info@kathyquinnadvocacy.com
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
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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
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Guided the choice of Medicaid Long Term Care and Medicare Supplemental insurance plans
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Deciphered Medicare Summary Notices; identified avoidable out of pocket costs
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Processed appeal of insurance company claim denial
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Filed emergency claim denial appeal, expediting timing from 1 month to 72 hours
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Researched and clarified complex health insurance coverage rules, including those for durable medical equipment
DOCTORS
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Identified specialists to diagnose and treat conditions that had been misdiagnosed
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Challenged misdiagnosis by a specialist, obtained second opinion and avoided unnecessary surgery
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Assisted with implementing lifestyle changes to reverse or improve various conditions including pre-diabetes and high blood pressure
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Attended doctors visits and procedures to assist clients in understanding and communicating with medical teams
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Identified oversights in blood work results that required medical attention
HOSPITAL & SKILLED NURSING FACILITIES
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Successfully challenged denial of ongoing physical and occupational therapy
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Identified patient over-medication due to recent weight loss, resulting in improved alertness and engagement
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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
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Appealed hospital's premature discharge plan, obtaining patient additional care needed
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Obtained improved quality of life for patient in Skilled Nursing Facility by partnering with social workers, nursing staff, aids and therapists
HOME HEALTH CARE
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Interviewed and assessed LPNs being considered for home care
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Compiled comprehensive list of needs for consideration in Medicaid Conflict Free evaluations to ensure maximum level of coverage would be considered
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Partnered with management to obtain required level of home LPN care