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Navigating people's medical care to enhance life

About Patient Advocators

What is a patient advocator and why do you need one? Patient advocates are professionals that help people get the best medical care possible. Whether trying to understand a diagnosis, find the top physicians, evaluate treatment options, track your medical history or lower your financial exposure, we have the experience and the team to help you navigate the world of healthcare and make good choices.

There are a number of issues impacting patient care today and these issues can lead to lower quality care and higher costs. Patient advocacy has emerged as a new field to help people more effectively deal with the realities listed below:

  • Patients have less time with doctors;
  • Insurance companies are increasingly denying coverage for diagnostics, medications, treatments, hospital expenses, etc;
  • Family members cannot provide hands-on support because they often live apart from one another and/or they cannot take the time off from work;
  • People are frequently diagnosed with more than one medical condition and using several medications which makes it difficult for physicians (particularly in an emergency setting) to make fully informed decisions for patients unless they have a clear and easily accessible medical record.
  • Medical error is the third leading cause of death in the U.S. and the most common reason cited is communication problems.

Patient Advocators LLC can help individuals and families reduce their vulnerability to these factors by delivering the knowledge and support you need to make well informed decisions in concert with your medical team.

Team

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Nan

Registered Nurse

Nan is a registered nurse with over 25 years of critical care nursing experience at several of the top hospitals in the U.S. including Children’s Hospital of Boston, NYP/Weill Cornell Medical Center and both UCLA and Cedars-Sinai Hospital of Los Angeles.

A compassionate, high-performing nurse, she has worked in Adult Intensive Care, Transplant, Pediatric Medical Surgical ICU, Neonatal Intensive Care, Trauma and Telemetry.

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Fluent in French and a tireless volunteer for many organizations including Big Brother Association, the Boston Ballet and the Head of the Charles Regatta, Nan always looks for ways to improve the lives of people.

Nan resides in Miami and will travel within the US to work with clients if the client requests.

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AnnMarie

CEO

AnnMarie is a certified oncology patient navigator who brings over 25 years of experience in the healthcare field where she worked as a senior marketing executive for several major pharmaceutical companies including Johnson & Johnson. She has worked extensively with physicians, nurses, and pharmacists throughout her career and her professional success has been dependent upon her ability to successfully collaborate with doctors, in particular, to get results.

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For the past 10 years, AnnMarie has worked extensively with oncologists, urologists, emergency room physicians, hospital residents and sub-acute attending physicians to manage the care of her father-in-law. Her advocacy has taken her on countless trips to Memorial Sloan Kettering Institute, Hospital for Special Surgery and Morristown Memorial to name a few healthcare facilities. She likes to think she has had something to do with a few of the 20+ lives her 87 year old father in law has lived.

When AnnMarie was a teenager, she experienced a life-threatening blood disorder that was cured as a result of having access to the top doctors in the field of hematology and oncology. Even at the age of 15, AnnMarie intuitively understood the importance of advocacy by choosing to play an active role in her care. Upon being discharged from a 10-day hospital stay, the attending physician asked AnnMarie “don’t you ever give up” in response to questions she had before walking out the door. That experience left her with a profound sense of gratitude for medical professionals and the importance of selecting the right doctors and treatments to maximize life.

If you Google AnnMarie McIlwain you will find that before becoming a personal advocate, she helped mitigate the jobs crisis by founding and creating a company called CareerFuel®. A “Cliffs Notes” for how to find a job or start a small business, this digital content company helped many during the worst economic crisis this country has experienced since the depression. Guiding others to the top resources while also inspiring them with videos and blogs that she wrote and produced, AnnMarie is happiest and most effective when coaching others.

Recognized as authoritative, AnnMarie’s work has appeared in Forbes, Huffington Post, Business Insider and AARP and other top media venues while her CareerFuel videos are among the most heavily followed career-related videos on YouTube. Since graduating college, AnnMarie has actively volunteered for children with life-threatening conditions, multiple schools and Girl Scouts. Her volunteer efforts have led to a number of awards including the CBS Spirit of Philadelphia Award. She is also a regular blood donor.

Perhaps you or your loved one will be her next project as she uses her knowledge, resourcefulness and communication skills to navigate the ever-shifting world of medicine.

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Adria

Insurance Expert

Adria is a licensed insurance broker with 25 years of experience in the insurance business. Certified in medical billing and claims consulting, Adria spent most of her career working as an examiner and underwriter for the top insurance companies in the industry. An active member of the leading professional organizations including the American Medical Billing Association and the American Academy of Professional Coders, she is at the forefront of the changes in healthcare insurance.

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Over the last four years, Adria has saved her clients over $5,000,000. During September, 2015 alone, she lowered the combined healthcare bills for two clients from $647,000 to a total of $44,000 (a 93% reduction). She works with individuals to understand, manage and reduce their health insurance bills by negotiating directly with the insurance companies on their behalf. Adria’s passion to successfully advocate for one client’s insurance needs led to this testimonial: “We are absolutely ecstatic that you were capable of reversing the multiple medical insurance denials. You took an amazing interest in not just the case, but a true and heartfelt interest in the ordeal that our daughter had gone through. It was as you were working with your family. And for that alone we are truly grateful to you. Thank you for your responsive, professional and empathetic characteristics.”

A nationally-recognized expert, Adria is frequently in the media with appearances on CBS and MSNBC and in USA Today. The author of a recent article in The Boston Globe wrote “Maybe I should have hired Adria Goldman Gross” after his insurance company denied many bills following minor surgery leaving him with huge out of pocket expenses.

A self-described bulldog when it comes to protecting her clients’ interests, Adria gets results that you can literally take to the bank.

 

Services

  • Research diagnosis and treatment options (including clinical trials)
  • Identify doctors, surgeons, physical therapists and at-home nursing care
  • Assist with obtaining second opinions
  • Accompany you or a loved one to medical appointments and/or the emergency room. Liaison with healthcare providers to help you understand the medical condition, treatment options and next steps
  • Monitor hospital stays and interface with the medical team to understand the diagnosis, testing and treatment plan
  • Monitor you or a loved one following admission to a rehab, sub-acute facility or nursing home
  • Organize your medical records to better facilitate intelligent medical decisions and reduce the risk of medical errors
  • Analyze your medical bills to determine if there are ways to reduce your financial obligation and negotiate with insurance companies
  • Manage your medical bills

Decision making

You and your family make the medical decisions for you and your loved one. Our role is to provide you with the facts to enable an informed decision.

Completed Assignments

Patient challenges have included mental health, cancer, heart disease, Parkinson's disease and aging.

Locations include: New York City; Westchester, New York; Bernardsville, Summit and Livingston, New Jersey; Mystic and New Haven, Connecticut; San Francisco, California; Ann Arbor, Michigan; Nashville, Tennessee; Atlanta, Georgia; Albuquerque, New Mexico; Denver, Colorado, Portland, Oregon and multiple cities in Florida.

Doctor-related

  • Accompanied patients to appointments with primary care doctors, neurologists, urologists, oncologists, concierge physicians, cardiologists and nutritionists and advocated for the patients during the appointments
  • Met clients at the emergency room, managed their care and stayed with patients until they were transferred to a room
  • Worked on site in multiple hospitals with several patients to ensure they were getting the best possible care
  • Advised a family whose college-aged son was rushed to the emergency room
  • Secured appointments with well-regarded psychiatrists, neurologists, orthopedists, primary care doctors and cardiologists
  • Identified the top hospital based and private practice based eating disorder specialists in a major city
  • Facilitated the release of two hospital patients who were being kept involuntarily
  • Identified the top Autism Spectrum Disorder programs/resources and developmental pediatricians in a major city for a family with a newly diagnosed child

Rehab/At-Home Care/Assisted Living/Long-term Care

  • Recommended at-home nurses aide and nursing services and managed the relationship for the patient
  • Evaluated rehab facilities with 1st/2nd/3rd recommendations
  • Established relationship with rehab teams and monitored patient progress/care
  • Identified and evaluated assisted living facilities and long-term care facilities
  • Facilitated a psychiatric evaluation to complete a supportive housing application which was later approved
  • Identified LTC facility with dementia capabilities and negotiated insurance approval
  • Reviewed medication regimens to ensure that patients were taking as prescribed
  • Obtained and delivered medical equipment

Medical History

  • Created three medical timelines covering several decades to use during doctors’ appointments
  • Completed an electronic medical record and shared with the patient’s children

Insurance

  • Reinstated a client’s Medicare Part B benefits
  • Advised a client on how to minimize out-of-pocket expenses for an upcoming surgery
  • Advised a client on how to gain coverage for a denied, and much-needed, procedure
  • Resolved tens of thousands of dollars in declined insurance bills by identifying the "rule" that enables COBRA and Medicare