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Houstonhealth started the topic InterQual criteria used for insurance denial in the forum +ADL Forum: Directory Listed APHA Members Only 1 year, 4 months ago
Has anyone been able to fight “InterQual” critieria medical necessity denials? I’ve had this used by the N.P. “case manager” and a hand surgeon to deny knee replacement surgery.
Here’s the WEIRD part, the orthopod only wants to do a partial knee replacement on client’s left knee after doing a successful one on the right knee. The denial is for…[Read more]
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Stephanie Schulz, BCPA replied to the topic Hello! in the forum APHA Academy 100 Days to Launch <br>(Summer 2024) 1 year, 4 months ago
I am laughing because I had to do a double check. We have a few people named Michelle in this cohort and I thought I responded to you on the other thread, LOL 🙂
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Stephanie Schulz, BCPA replied to the topic Hello All! in the forum APHA Academy 100 Days to Launch <br>(Summer 2024) 1 year, 4 months ago
Great to have you with us, Michelle! Many nurses chose to venture out into the role of advocacy, sounds like you have some great experiences to utilize in your practice!
Thanks for your intro!
Steph -
Stephanie Schulz, BCPA replied to the topic Hello All! in the forum APHA Academy 100 Days to Launch <br>(Summer 2024) 1 year, 4 months ago
Sounds like you exactly where you need to be, Donna! We will be focusing on business skills here and as we move through the course, if there are additional questions you have don’t hesitate to ask!
Steph
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Trisha Torrey replied to the topic Marshall Allen, a Tenacious Journalist, Dies at 52 in the forum General Conversation 1 year, 4 months ago
If you are interested, APHA did an Expert Call-in with Marshall right after he published his book “Never Pay the First Bill.”
He had the ability to delve into the dark sides of healthcare, then figure out steps we mere mortals (patients!) could take to work the system the way we needed it to work for us.
A real loss…
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Michelle Liptak started the topic Hello! in the forum APHA Academy 100 Days to Launch <br>(Summer 2024) 1 year, 4 months ago
Hi,
My name is Michelle Liptak, I am a RN with a background of leadership and adult critical care. I currently work as a telehealth nurse with a Palliative Care program. I am excited to venture out on my own and break the traditional RN role that I have been practicing in for years. I am thrilled to start this course and learn more!
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Michelle Liptak changed their profile picture 1 year, 4 months ago
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Michelle Liptak replied to the topic Hello All! in the forum APHA Academy 100 Days to Launch <br>(Summer 2024) 1 year, 4 months ago
Hi,
My name is Michelle Liptak, I am a RN with a background of leadership and adult critical care. I currently work as a telehealth nurse with a Palliative Care program. I am excited to venture out on my own and break the traditional RN role that I have been practicing in for years. I am thrilled to start this course and learn more!
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Lisa Balsam, RN, BSN, BCPA, CPC, CRC replied to the topic Lisa in the forum APHA Academy 100 Days to Launch <br>(Spring 2024) 1 year, 4 months ago
Hey There-
Happy to chat with you about it! Send me an email: lisa@clarityhealthadvisors.com or call my cell 206-427-0651
Lisa
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APHA Member Services replied to the topic Marshall Allen, a Tenacious Journalist, Dies at 52 in the forum General Conversation 1 year, 4 months ago
When Deb and I (Dena) took over APHA, we had met with Marshall to learn more about his work and ways that we could collaborate. I just went back through our email exchanges and revisited my fondness for his work. He was emphatic about empowering people to lower their healthcare debt. He brought a gift into the world and left it making a…[Read more]
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adriagross started the topic Apparently Different in the forum General Conversation 1 year, 4 months ago
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adriagross replied to the topic Marshall Allen, a Tenacious Journalist, Dies at 52 in the forum General Conversation 1 year, 4 months ago
I spoke with Marshall a couple times – he was amazing and I was shocked to hear of his death. I was wondering how old he was – 52….WOW….
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AnnMarie McIlwain replied to the topic Marshall Allen, a Tenacious Journalist, Dies at 52 in the forum General Conversation 1 year, 4 months ago
Marshall pried open the opaque door of the health insurance industry and held them accountable. I will miss his passion for truth and justice and the learning it provided me as an advocate.
Thank you Karen.
AnnMarie McIlwain
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Gail Gilberto replied to the topic Bed and Wheelchair alarms in the forum +ADL Forum: Directory Listed APHA Members Only 1 year, 4 months ago
Sorry for the lateness of this response: As CMS changed its stance on the type of exit alarms utilized, so as not to be considered a restraint, it is best to check with the facility and see what they are allowing, if any.
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Kazadvocate started the topic Marshall Allen, a Tenacious Journalist, Dies at 52 in the forum General Conversation 1 year, 4 months ago
Many of us are saddened and shocked by the sudden death of Marshall Allen. Marshall was an inspiration; his work encouraged me to write and be a “polite pit bull” in the world of insurance navigation. He was a call-in guest for an APHA member podcast 2 years ago:
marshall-allen-never-pay-first-bill.
If you wish to support the Allen family, there…[Read more] -
Cheryl Kauffman, PT, BCPA replied to the topic Sub acute Care in the forum General Conversation 1 year, 4 months ago
Obviously this reply is too late. I’m guessing your client needed an LTACH. Unfortunately, those all seem to be owned by for-profit companies. You could check their medicare ratings: https://www.medicare.gov/care-compare/?providerType=LongTermCare
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Cheryl Kauffman, PT, BCPA replied to the topic Transporting Clients in the forum General Conversation 1 year, 4 months ago
I don’t provide transportation, but do offer to go with clients in a taxi/uber/etc.
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Cheryl Kauffman, PT, BCPA replied to the topic Solo ager patient needing home upkeep help in the forum General Conversation 1 year, 4 months ago
Late reply. For some reason I hadn’t been receiving APHA emails. The Village to Village Network can be a great resource.
https://www.vtvnetwork.org/content.aspx?page_id=0&club_id=691012
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Cheryl Kauffman, PT, BCPA replied to the topic CMS starts paying for patient navigation in the forum General Conversation 1 year, 4 months ago
Very interesting. So many questions! First off, why start a new credential when we already have BCPA in place? Sigh. Katy, can you say more about the $40 reimbursement? That sure wouldn’t go far.
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Cheryl Kauffman, PT, BCPA replied to the topic Bed and Wheelchair alarms in the forum +ADL Forum: Directory Listed APHA Members Only 1 year, 4 months ago
In my experience it’s not so much about which alarm you use — there are many — but about staff responsiveness. There are mats that go on the chair or in the bed, and there are motion detector systems. It’s odd to me that the facility doesn’t have a system in place.
Cheryl Kauffman, PT, BCPA
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