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ABOUT

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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.

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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