Penny
Schoeler
June 2012
Penny
Schoeler
,
RN, BSN
Case Management / 5 South
The Christ Hospital Health Network
Cincinnati
,
OH
United States

 

 

 

Penny had a patient with a large non-healing abdominal wound. The drainage required an ostomy bag over the wound and catheter connected to a suction pump. Penny worked diligently to get the supplies and pump covered by insurance. The patient discharged home but due to the wound suction pump motor burning out she was re-admitted.

On the second admit the insurance company was denying coverage of supplies. Penny spent many hours appealing the insurance company’s decision. Eventually, after her diligence and perseverance the insurance company revisited their policy. They discovered an error in their policy and the patient ended up with her supplies covered by insurance.

If Penny had not spent many hours fighting the insurance company, this positive outcome would not have been achieved. Penny managed to change an insurance company’s policy in favor of the patient. That is a miracle and directly related to Penny’s perseverance as a patient advocate!