Barbara A. Brody & Associates, Ltd.

Working for Individuals, Patients and Family Members since 1992

We work through the details while you focus on the "larger picture."

Health care was once a private interaction between you and your physician. Now it seems that the insurance carrier, Medicare, the Federal and State has regulated the care you are given. Barbara A. Brody & Associates, Ltd. is the instrument you need to cut through the tedious tangle of bureaucracies.

We  navigate and advocate on your behalf.


 

Coverage Assessment

Assessment of ACTIVE or POTENTIAL medical insurance coverage (private carriers and Medicare).

Long Term Care

Help you evaluate the costs and benefits of LTC at every stage of your life.

Financial Exposure

Personal financial exposure analysis and audit of expenditures (physician fees, hospital charges, etc.)

Barbara Brody Patient Navigator and Advocate. Photo by hannamonika 2011
Claims Review

Appeal/review of claims in which the level of reimbursement is in question.

Coordination of Benefits

Liaison with private medical insurance carriers, COBRA, The Affordable Care Act (Obama care), Medicare and long-term care to maximize level of benefits & reimbursement.

Expense Management

Administrative management of your medical expenses.

SOLUTIONS THAT WORK FOR YOU

Medicare As Secondary and Medicare (Primary) have separate and distinct rules for reimbursement.

An individual or his book keeper may pay bills that are disallowed by Medicare.  This is where an experienced Patient Advocate/Patient Navigator is able to help and save you quite a lot of money. Since 1992, I have followed every change Medicare has made.

A client asked me to look at his medical expenses. He had Medicare as Secondary but his business manager paid every medical bill without a review of the charges. Over a five year period, “Mr. Smith” overpaid in excess of $100,000 in clinical lab bills. I worked on his behalf, and he was reimbursed over $100,000.

Reimbursement over $100,000!

This case study demonstrates how being a Patient Navigator and Patient Advocate are intertwined.

 In early 2017, an attorney referred a client to me.   “Mr. Jones” was taken by ambulance to a world-renowned Medical Center in Manhattan. The hospital accepted his Affordable Care Act insurance.  The specialists assigned to him were out of network.  It was clear that Mr. Jones’ diagnosis of end stage kidney treatment required out-patient renal dialysis.  The Medical Center had two renal dialysis out-patient facilities in New York and a couple of facilities about 20 miles away. The patient’s family was told that the New York City renal dialysis centers were out-of-network.

I was determined to challenge why the New York City centers were out-of-network while the 20 miles away facilities were in-network.  After much investigation, the financial manager found a contract, dated 2014, which included the two New York facilities.  She was also instrumental in having the in-network specialists wave their fees.

 People with End Stage Renal Disease are eligible for Medicare.  I worked with the Social Security Administration to have Medicare be Mr. Jones primary insurance.

 My work as a Patient Advocate and Patient Navigator saved Mr. Jones from a great of stress and a great deal of money.

Finding a way to make it work

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