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Immediate Advocacy We are the Medicare Quality Improvement Organization, working to improve the quality of care for Medicare beneficiaries. Our site offers beneficiary and family-centered care information for providers, patients, and families. Welcome! |
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immediate advocacy: real life examples
Through the Immediate Advocacy process, Kepro serves as an advocate for those people who have Medicare to access needed health care.
how immediate advocacy helped a medicare patient when his niece wasn't satisfied with how his condition was being handled.
Joe has been a type 1 diabetic (insulin dependent) all his life. He lost his spouse several years back and now lived alone. He was enjoying life. For the most part, he was doing a very good job of managing his condition, including eating the right foods, walking and exercising, and trying to stay at a good weight.
He recently had a foot ulcer (open sore) appear. He knew what to do because he had visited his doctor in the past for this same issue. This time was different. He developed an infection and had to be admitted to the hospital as an inpatient.
While he was in the hospital, his niece, Chloe, visited. It had been a while since she had seen him because she lived in another state. When she heard her favorite uncle was in the hospital, she decided to schedule a vacation to spend some time to see how he was doing (besides him being in the hospital).
She visited other family and friends while she was there. A few of them said that Joe didn’t seem like himself lately. They said that he hadn’t been very active and has been, for the most part, staying home.
During the following days, Chloe went to the hospital to visit her Uncle Joe. They talked and got caught up on different things that were going on in their lives. When she asked why he had been staying at home, he said that he didn’t feel like going out.
To Chloe, that seemed like a red flag because her uncle was a social and active person. He usually enjoyed being out doing something. To help ease her concerns, she planned to be with her uncle when the doctor was going to see him. She asked the charge nurse when the doctor would visit so she could be there.
She was able to talk with the doctor when she came in, but only briefly. The doctor was behind on her rounds and didn’t pay her much attention.
Chloe wasn’t very happy about the doctor’s attitude. She wanted to get some answers to be sure her uncle was okay and knew that she needed help talking with this doctor, who seemed too busy to talk to her.
After talking with a couple of community organizations, she was given information about an organization called Kepro that was a Beneficiary and Family Centered Care Quality Improvement Organization – or BFCC-QIO – who may be able to help with her situation.
She asked her uncle if it was okay with him if she called. He didn’t really see the need, but he knew his niece wanted the best for him so he said “yes,” she could call.
Chloe called Kepro’s Immediate Advocacy department to get help with communicating with the doctor. Once connected with a nurse from Kepro, Chloe talked about the situation with her uncle and how the doctor didn’t seem to have time to talk with her.
The nurse talked with Chloe about the Immediate Advocacy process, and Chloe agreed to proceed and said that her uncle gave his permission for her to call.
The nurse from Kepro called the hospital and couldn’t get connected with the doctor but did talk with a social worker. The social worker let the doctor know about the call and asked that she call Kepro. Kepro was able to schedule a call that included Kepro, the doctor, and Chloe, the patient’s niece. After a good conversation, the doctor said that she would look further into her uncle’s condition and assess for depression. She also asked the doctor when she would be in to see her uncle again so they could talk again.
Chloe was glad that Kepro helped her to get the information she needed and help her to talk with the doctor.
If you are on Medicare and are not happy with the care you received or if you need help working through an issue that needs to be taken care of right away, please call Kepro and ask about Immediate Advocacy services.
Read more about Immediate Advocacy.
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