Friday, October 28, 2011
Grateful for good news!
I am so hungry for some good news to appear on the front pages of the two major newspapers in the Greater Boston area. Anything will do. Maybe the good news is being covered elsewhere; maybe I am reading the wrong newspapers? The other day when I had had enough I turned to read some of my emails and low and behold, there was the gold. It was from a social worker who was writing about an extraordinary experience she and her aging Dad had had with a local social worker whose unstoppable advocacy actions took her breath away. Some of the names of the organizations and people in the following have been changed because I want to focus on the exceptionally powerful positive actions of one of our own rather than on what appears to be negative actions of the organizations in the story. What follows is our front page story—a story of simple greatness, positive energy and superlative professional actions. Here is the email letter we received
I am writing to tell you about a clinical social worker, at UMASS Memorial University Campus in Worcester. My father had a stroke in early July and was hospitalized at UMASS where he received excellent care by the stroke team. He had ‘Company X’ insurance.
In mid- August, once my Dad’s medical condition had stabilized, the stroke team recommended moving him to an acute rehabilitation facility. The team believed that acute rehab of 3-4 hours per day was the course of treatment to pursue for his best possible recovery.
The Clinical Social Worker was the case manager assigned to my Dad for discharge planning. We discussed which acute rehab facility would be best and the social worker went to work preparing the necessary paperwork to get my Dad moved to the rehabilitation facility.
Despite the stroke team's unanimous recommendation for acute rehab the insurer denied the transfer and proposed moving my Dad elsewhere. The Clinical Social Worker asked if we wanted to appeal the insurer’s decision and we agreed emphatically. She worked tirelessly to get the information needed to review the medical facts in my Dad’s case but to no avail. The insurer never even reviewed the medical record in this case.
I hired an attorney to work with us and with our Clinical Social Worker to get a reversal of the denial. After several phone calls and emails, late on a Friday afternoon, the insurer reversed the denial and my Dad was sent to the facility we had wanted to get the medical treatment he needed and the care his medical team prescribed.
I write this to let you and your organization know of the exemplary work that this individual did for my Dad and my family at a very stressful and critical juncture in his medical treatment. This person is a tenacious advocate for her patients and a credit to your profession. We were very lucky to have her working with us.’ The social worker is Heather Miller, LICSW.
A grateful client’
Now, that is great news!