Holiday Hospital Dangers Spell HERO for Patient Advocates

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heroThere is no time like the present to keep your clients out of the hospital. Just raising the issue may make you a hero to them.

I realize how dramatic that sounds, but bear with me here.

Think about any workplace you’ve ever worked in during the holidays. Employees, even customers, are not nearly as focused on the work-at-hand as they are during non-holiday times. They may be taking sick days or personal days off (shopping and baking take precedence!), they may be leaving work early to see their kids in the Holiday Concert at school.  They may be laughing and joking about how someone behaved at the office party the night before, or maybe they are distracted by thoughts of the shopping that isn’t yet done, or the in-laws (who they never really get along with) who are arriving tomorrow.

And that’s the point. There are dozens of time and thought-consuming distractions during holiday times. Then, as the holiday date draws closer, the most senior staff members (if not everyone) begin checking out for days or weeks of vacation time. Important questions go on a shelf until those folks return to work. Less senior staff, or part-timers, are the ones left to make snap decisions when called for, no matter how dire those decisions are. They make them to the best of their ability, but there’s always a question about whether they are making the right decision.

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Advocate for Patients and the Environment, Too

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Among the dozens of details that needed attention after my father died, was figuring out what to do with the virtual pharmacy we found in his apartment.  Dad was a firm believer of better living through chemistry – and he had dozens of prescription bottles, supplements and vitamins, patches and more, in the bathroom, the kitchen and next to his desk.  I think CVS could have stocked up from his stash.

Among them were drugs he had taken that hadn’t worked – so the entire rest of the prescription just got put away.  We also found dozens of herbal supplements he had tried over the years ranging from dandelion weed, to pomegranate capsules, from controlled substances like hydrocodone and oxycontin, to the leftovers of some heavy duty prostate cancer drugs.

We had to dispose of them, of course.

The social worker and nurse from hospice came by to log the amount of the remaining pain meds they had prescribed in his last few weeks – but they were not allowed (state law I think?) to take the leftovers with them. I asked how they suggested we dispose of them, and the nurse replied, “Just flush them.”

I almost fell over.  Flushing drugs is one of the most dangerous things we can do to our environment, in particular because it taints our drinking water. Studies have shown traces of human drugs in the water supply of every metro water supply in the US. Beyond that, fish have been found to be genetically altered by human drugs in rivers and streams.

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“In the Mood” – How Glenn Miller, Johnny Mercer and the Andrews Sisters Helped Dad Weather His Pain

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(Posted October 2012)

I’ve just returned from Florida, having spent almost two weeks with my sisters, taking care of details since Dad died.  There were plenty of tears – of course.  But even more laughter – because despite our mourning, we shared many marvelous family memories as we uncovered this treasure (good grief – our grade school report cards!) or that one (did we really wear our hair like that in the 80s?)

And of course, there were the conversations with the more than 100 people who attended Dad’s memorial service. (Quite surprising really – they were mostly in their 80s and 90s.) It was a memorial service like few others –  exactly what he requested – a celebration – a party! …including an open bar and hors d’oeuvres afterwards.  The readings and passages were part-mournful, but more than that, they were an homage to a man loved and respected by many.  My sisters and I were so very proud of the man who was our father.

Included in the celebration service was music, of course.  But not what you might expect.  Instead we put on a Glenn Miller CD, and a mix of other music from the 1940s. In the Mood, Candy, Boogie Woogie Bugle Boy —   Dad would have loved it.  I know his friends did.

The music – it was an important part of Dad’s life – and his death.  In fact, through his final few days, I asked his hospice nurse to turn on the TV cable channel that plays1940s music – because it brought him so much pleasure to listen to the songs he shared with Mom as they were dating, fell in love and married.  It seemed to work well, taking his mind off his pain, as he finally relaxed, slept, and then passed. Continue Reading →

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When Potential Clients Won’t Buy the Milk

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Does this sound familiar?

You get a phone call from a prospective client who would like to talk to you about possibly helping her out.  The story may vary, but the bottom line is that she is stuck and needs help from someone who can help her manage some aspect of the healthcare system. She thinks you might be that person.

As part of your marketing, you happen to offer a free consultation, which maybe takes place right then and there on the phone, or maybe you make an appointment to meet with the potential client…  Or perhaps you simply have a conversation whether it’s considered a free consultation or not….

An in-depth conversation takes place.  This potential client has a dozen questions about her situation, and to the best of your ability, to showcase your capabilities, you answer her questions. You feel great about the conversation because you know you’re impressing her with your abilities.

At some point the potential client says, “Thank you. You’ve given me a lot to think about. I’ll call you again if I decide I need your services further.”  And you both hang up.

You’re stunned. You feel as if everything went so well… you were able to answer her questions, you referred her to some good resources…  yet – she didn’t hire you.  Where did you go wrong?  What should you have done differently?

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How Health Advocates Can Save Money for Their Clients

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Over the past few years, increasingly, I hear from patients who (usually after hospitalization) feel that they have been unfairly billed for medical services.They contact me because they find an article or two I’ve written at my Patient Empowerment site at About.com about medical billing and insurance.

When I say increasingly, I mean – since the first of this year the numbers have really spiked.  I mean, really spiked. As if the medical billing universe has decided that no one should get a correct bill anymore, and everyone should be required to pay for something they didn’t think they should pay for.

Now – I don’t have the ability to help people get their bills corrected when there really are mistakes.  I leave that to the professionals (and yes, of course, I refer almost all those folks who contact me to engage with a billing specialist listed at AdvoConnection.)

However, there are a few general troubleshooting ideas I have for them, like:

  • Since insurers seem to change their in-network list of providers on a whim, you must always check to be sure the doctor you’re about to see is still considered in-network (even if he or she has always been in-network before.)
  • Likewise with insurance formularies – co-pays, in particular for newly developed drugs, seem to change overnight. Many Tier 3 drugs are now Tier 4 (which, to me, means, let’s just throw out a huge number and charge the patient!) and patients are blindsided by the increased cost.
  • Yes, it’s possible your insurance covers most of your hospital stay, but that the anesthesiologist does not accept your insurance – you’ll have to negotiate payment with those who don’t accept your insurance.
  • The Affordable Care Act (healthcare reform) does have a list of preventive tests you no longer pay co-pays for, but that doesn’t mean the doctor won’t recommend a test or a drug that will not be covered as “free.” You need to check the list.
  • Balance billing is illegal in most states, yet it happens every day. If you think you have been balance billed, then use that term when you call the doctor’s billing department.  If they don’t back off the bill, then ask them to explain why it ISN”T a balance bill.  And if the answer is not satisfactory, then tell them you plan to report them to CMS. Maybe they’ll change their minds.

Things like that.

So what does this have to do with being a health advocate?

If you are a billing advocate, this is probably your bread and butter – the work you do on behalf of your clients every day.  Thank you for that!

But if you another flavor of health advocate, say medical-navigational, then the fact that so many billing problems are occurring, with increasing frequency, provides an opportunity for you to make a real difference for your clients – because you can be the person with the yellow flag.  It’s entirely possible that you can save your client enough money to pay for your services – or more.

The key is to provide your client with that “inside information” that medical bills rarely turn out to look like a client expects they will – so what you would like to do on their behalf is to double check all pricing before services are actually delivered.

(Of course, that will be mostly impossible in an emergency situation, but should work just fine in most other situations.)

I would even go so far as to say, that not checking pricing ahead of time could create problems for them – AND you – because if they end up being blindsided on a bill based on something you recommended, and the bill is correct, it will reflect on you – and your client won’t be happy.

I’ve put together a list of good practices, ideas and “how to” links you can use to save money for your clients.

AdvoConnection members: find this list by logging in to your membership dashboard, finding the Client Services Center, then Client Relations. Look for NEW!

Not a member? You can access this list, too – and much more.  Join us!

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FOR PATIENTS | FOR ADVOCATES | FOR POTENTIAL ADVOCATES

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