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Engagement Awareness
for Championing Care

share your story
​Real Stories from Real People
patients & families having a voice, sharing experiences at the ground level 

How dare you ask about co-pay

3/8/2022

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I went to the doctor, had a diagnosis that I needed a commonly done elective surgery - it was not urgent, emergent as in life threatening. The surgeon stated it needed to be delayed because of Covid. After elective surgeries were being scheduled again, the surgeon's office stated I needed to come back in and be assessed all over again before they could reschedule. 
When I called the office, I asked if they were going to bill me for a second co-payment charge, when I was already diagnosed, and I am being told to come back in due to their cancelation; and was put on hold after the admin stated she had no idea.   
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That by asking a simple billing question, the Supervisor was called in and stated to me that the admin did not like my asking, that with that attitude, they did not want me as their patient. The surgeon was the customer and not me.
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​To speak directly with the surgeon to determine what assessment was necessary to determine any changes he needed to know for my elective surgery, when there was no change in my condition; and to let me know what follow up blood work I could get done without any office visit, for his updated information to perform the surgery safely.
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To go to Healthgrades and share my story with a poor patient satisfaction rating, including that by speaking with the admin and rudely being treated by her Supervisor, I was branded, discriminated against for a simple question if I was going to be billed a second co-pay; and, the poor rating of him included losing my faith in his practice, my business, and any possible future referrals. 
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Hospitals are Acute Care & ERs are for emergencies

2/15/2018

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Hospitals are classified as acute care centers for treatment of acute conditions, so I can go home and recoup/rehab. Emergency rooms (ERs) are part of Emergency Departments (EDs) as the point of entry to be stabilized for admission as an inpatient or go immediately to surgery. If it is not life threatening or severe, I should first go to an Urgent Care Center (UCC). 
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Hospitals are reviewed by the Center for Medicare and Medicaid Services (CMS)/insurances and will receive denials of payment if there was not a medical necessity to be there. It is important to partner with clinicians and Case Managers when it is ambiguous regarding the correct, safe and proper treatment for Inpatient versus an Outpatient, because "Insurance claim denials cost hospitals $262 billion annually", and so, hospitals should never be treated as a hotel or doctor office.  
Hospitals are reviewed by the Center for Medicare and Medicaid Services (CMS) regarding denied reimbursement if I come back in less than 30 days with the same condition, and so it is important to make sure that I am receiving the right code associated with my admitting and discharge primary diagnosis for accuracy of my care. The Care Manager can assist if there are any questions regarding admission & discharge coding of diagnosis in my medical record.
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How long should I be in the hospital?

1/14/2018

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My dad was readmitted into the hospital. They needed to plug something? for a pleural effusion, first needing to get his blood work correct from his blood thinners (10?). They said his blood work was good Friday night but because it was a holiday weekend, they were not going to do the procedure until Monday. He was in the hospital for seven days. 
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The staff should tell me or write down the lab and value they were monitoring, the name of the procedure, or I should have recorded with my phone. The procedure should have been done when his blood work was stable so he could go home for the holidays. 

The number of days as an inpatient is public knowledge. My dad should only have been in the hospital for
4-5 days; I could have called case management or the Chief Experience Officer for the hospital. ​[see resources, file for # days in the hospital]
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Patient Assessment, Quality Care Standards

7/10/2017

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My mom was in the hospital for kidney stones and they did a great job coming in regularly to ask how she was doing and managing her pain every few hours. Her only complaint was the ten pounds of fluid they put on her.
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They were supposed to be assessing my elderly mom to make sure they were not causing a hospital acquired condition (HAC), such as pulmonary edema when her GFR was 52. The nurses should have been touching her to see her swelling (edema); they were supposed to not only be tracking her urine amount, but straining it to see if stones passed, and have her on a bed that automatically weighed her to see that she was retaining fluid which is dangerous with someone with high blood pressure (hypertension).
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​Clinicians should always assess the patient - look, listen, feel - even when stable to always have a baseline, and to monitor if treatments are being successful, to avoid complications before machines alarm.
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"They took such good care of me, they were so nice!"

8/1/2016

1 Comment

 
An elderly woman with confusion, vomiting, weakness and malaise is taken to the ER, admitted for a three day hospital stay and discharged. She was given a patient experience survey with the response, "Oh, they took such good care of me, they were all so nice."
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​My primary care physician had me on meds that caused my sodium to drop and he never checked it, and there was no care coordination with any of the other five doctors he kept referring me to.​
​The admitting attending-hospitalist should not have walked in and asked me why I was there or how much IV fluid I was given - she was supposed to have been fully briefed from the ER doctor and read the electronic medical record to tell me along with review of my plan of care and advanced directives with me.
​The admitting nurse should have introduced herself, read the record in front of her on the laptop, instead of asking a confused person the same questions already clearly uploaded. She should have known my life threatening primary diagnosis, she should have done a full physical and level of awareness assessment to establish a baseline upon admission to compare to as treatment was given instead of only touching her keyboard. She should have called in a case manager to coordinate advanced directives to be done and begin discharge planning of an elderly confused person with complications from lack of follow up by primary care physician, and to also contact that physician regarding the admission.
Numerous staff throughout the three days should have been doing level of consciousness (LOC)/awareness checks to note the increased confusion which can be caused by raising sodium too quickly; they should have contacted the primary physician for the last time labs were checked, and the discharge planning status was not supposed to be To Be Determined (TBD) two hours after the discharge order was written; planning should have been initiated the first day admitted. 
A hospitalist who had never seen me wrote the discharge summary incorrectly, changing it from the admission of low sodium (hyponatriumia) which i was treated for, to reflect symptoms for low potassium, with the discharge diagnosis of hypokalemia.

There is a difference between experience questions that do not reflect quality care delivered, and that of value care delivery along with engagement questions. There is a Population and Experience Officer in health systems and to contact them regarding poor care coordination, clinical quality assessments and poor engagement and listening of extended family members - while still in the hospital to ensure good care.
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    I wish I knew

     a voice for the public to share & learn about healthcare experiences; because the universal response heard after healthcare struggles is,
    "I wish I had known ..." 

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  • DHC
  • AWARE
    • why is it needed
    • about us
    • I wish I had known
    • resources
    • education benefits
  • Blog
  • ART
    • Healing Home & Repose
    • Healing Moment & Touch
    • Healing Peace
    • Healing Gift & Hope
    • Healing Love & Ripple
  • Books
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  • PACE
  • Contact