Liane and Herb - Case History

Support Services:

Planning & Organization

Finance Management

Meeting Management

Medicare Case Advocacy

Ambulance Firm Communications

Case Management

Family Communications

Check-ins and Case Updates

Emotional Support

Intake Story
Liane and her out-of-state daughter first contacted Brennan Care Services (BCS) from a local financial management referral to see if we could undertake a review of recent ambulance billings, Medicare, and co-insurance payments. Liane's husband, Herb, had suffered a massive and debilitating stroke six months previously. He was cared for in a skilled nursing facility, and Liane was religious about daily visits to monitor his progress. This routine left her scant time to focus on the deluge of ambulance billing communications which flooded in because of 32 ambulance transports and hospital visits in this same six-month period. When BCS arrived at her apartment, Liane was overwhelmed by the accumulated mounds of sorted, unsorted, and/or unattended Medicare, ambulance providers, insurances, care facilities, hospitals, etc. records. In addition to her daily care duties for her husband, she was also in the midst of a complicated transferal of assets and the establishment of a trust with her attorneys. Liane needed help and an advocate who would sort through, prioritize and follow-up on the numerous claims which seemed to grow exponentially in proportion to her caregiving tasks.


Organization - Advocacy - Communications - Case Management
BCS quickly completed a chronological table of reimbursed and unreimbursed ambulance transports; sorted the Medicare, ambulance company, and co-insurance billings/payments and other financial and agency transactions which had transpired or failed to transpire over the previous six months. BCS took immediate action item to contact the two ambulance carriers and their respective billing staff to form an action connection to prevent dunning notices or other actions which might damage an unblemished credit record. BCS chronologically separated Medicare case numbers, ambulance codes, secondary insurance payments, and additional hospital and pharmaceutical records to present a clear picture of what had been paid, unpaid, or was in transition.

Most importantly, BSC took the time to listen carefully to Liane's experiences with the ambulance firms; the treatment her husband received at the hospital and care facilities; and the Medicare communications required for the on-going shift of her husband onto the Medicaid system through the establishment of a trust. Because of this attention, BCS was able to quickly grasp the successes and failures over the course of Herb's treatment. BCS also analyzed the complete billing records to determine whether full reimbursement for services had been achieved from the responsible parties.

After a thorough review of one ambulance company's services, Liane asked that I act on her behalf to address a particularly upsetting issue - on one routine ride, they dropped Herb on his head from a standing gurney height. The results I was able to attain through my advocacy for her husband were more than satisfactory - the end result included a complete and thorough verbal and written apology, a $3,000 settlement for pain and suffering and free ambulances rides for the rest of Herb's life. With the other ambulance firm, we were able to set up a reasonable plan for payments while we were filing appeals with Medicare. Moreover, we discovered that the ambulance company had misfiled with Medicare on four different transports which they agreed to pay. Since each of these transports was typically $650.00 + in each direction, the savings for Liane was substantial. In addition, BCS was completely successful on two additional Medicare transport hearings and won back the entirety of previously paid amounts from Medicare denials. Upon investigation of the medical records for care, one of the Care Centers where Herb was treated also took responsibility and reimbursed Liane for two unnecessary ambulance rides which were on their watch.


Trust Administration Assistance
Once the sword over her head regarding the ambulance payment responsibilities was removed, BCS next assisted and advocated for the management of the trusts established for Herb and Liane's care. The attorney firm responsible for setting up the trusts for Herb's care did an excellent job in setting up the shift of assets to Liane from Herb so that he became eligible for Medicaid benefits some six months after the initial stroke. However, their follow-up in explaining to Liane how she was to manage these new and, especially for a woman who had never undertaken such a welter of accounts and reporting responsibilities, complicated arrangements was far less successful. In addition, Liane was daunted about the prospect of even picking up the phone at $75 per hour.

I reviewed the substantive matters of the trust and how monthly funds were to be distributed in fairly short order. We reviewed the accounts every month for approximately three months and then Liane was comfortable enough to accomplish this on her own which she has now for over a year.


Respite
Liane has had occasion to leave town and has hired BCS to look after Herb's needs even though he is in a care facility with an excellent reputation. About once every six months, Liane will call BCS to request this assistance. BCS will spend a daily 3-hour amount of time to look after Herb's eating and to make sure he has companionship and occasions to move around the grounds, weather permitting, and outside. Herb is still verbal and had practiced internal family practice medicine before his stroke; he has a lively mind and, despite the left-side bias which the stroke has left in its wake, grasps elementary and some complex reasoning in conversation. For BCS, Liane, and Herb, this relationship has been an excellent association built on trust, advocacy and rapport.