Services

Nurse Life Care Planning

Nurse Life Care Planning is a specialized area of nursing practice dealing with individuals who have sustained a catastrophic injury/illness. The nursing process and nursing care plan are the foundation of nurse life care planning.

Just as in nursing school and clinical settings, we use the nursing process to formulate a plan of care. The Nurse Life Care Plan process follows the standards set forth by the American Association of Nurse Life Care Planners (AANLCP®) including:

The Nurse Life Care Plan is a tool used for estimating medical and non-medical needs of a client with a catastrophic injury/illness. RN Law uses a collaborative approach and communicates with the patient, various health care providers, and the patient’s family members.

The Nurse Life Care Plan is intended to follow the client throughout his/her lifetime and is specific to the individual based on his/her needs. It is an estimate of medical and non-medical needs as well as costs based on the recommendations of providers and may be modified or reviewed as life situations change. As Nurse Life Care Planners, we may be designated as an expert witness and asked to testify during court proceedings, depositions, or trials.

Life Care Plan Reviews

A Life Care Plan Review is requested when the opposing counsel has completed a Life Care Plan in a litigated case. Attorneys and insurance carriers request a Life Care Plan Review to assess the validity of a case.

Opposing Life Care Plans may be under or overestimated when determining future needs and costs. There may be errors in calculation. Opposing Life Care Plans may leave out essential future needs or exclude probable complications/secondary diagnoses related to the injury/illness.

A Life Care Plan Review assists the attorneys and insurance carriers in preparation for the settlement or trial process. As Nurse Life Care Planners, we may be designated as an expert witness and asked to testify during court proceedings, depositions, or trials.

Medical Cost Projections

Medical Cost Projections are often referred to as an abbreviated Life Care Plan. This can be deceiving as the goals are the same – projected care with costs. BUT, the why and how the goal is attained is the difference between a Medical Cost Projection and Life Care Plan.

Medical Cost Projections can be referred at any point in the case – before, during, or near the settlement. Projecting care with costs can be for a specific recommendation (such as surgery), a specific time-frame (10 years versus life expectancy), or a specific cost resource (workers’ compensation fee schedule, collateral resource, etc.).

The methodology of a Medical Cost Projection will depend upon the author’s skills, training, and experience. RN Law nurses are licensed, credentialed, and have extensive knowledge in projecting care with costs. Therefore, we qualify as expert witnesses in Medical Cost Projections. Oftentimes, RN Law will communicate with the provider who is the “care expert”, and we are considered the “cost experts.”

Medicare Set-Asides

Careful thought should be given to how personal injury settlement funds are distributed. Per the Medicare Secondary Payer Act, the Centers for Medicare & Medicaid Services (CMS) demands that their interest be taken into consideration when settling cases where the settlement funds include payment for future medical care. Failure to set aside the proper amount may cause negative impacts to future Medicare coverage.

Certain cases benefit greatly from having funds pulled from the sum to ensure that medical needs will be met in the future. Medicare Set-Aside (MSA) is a detailed report which determines future medical care and what is acceptable/covered by Medicare. During the settlement process, it is imperative that one understands when and how the case should be evaluated to assure Medicare’s interest has been taken into consideration.

Medicare Set-Asides can be complex. RN Law specializes in guiding our clients through the entire process including Medicare confirmation/lien verification and reporting, Medicare Set-Aside Arrangement (MSA), submission to the Centers for Medicare & Medicaid Services (CMS), and funding/administration of the MSA. Depending on the nature of the case, all components or specific components of the MSA process can be completed for the referral source.

Case Management

We use a collaborative process to meet an individual’s comprehensive health needs. RN Law’s case management services are utilized in a variety of settings including acute and chronic care in non-catastrophic and catastrophic injuries. Many socioeconomic factors, vocational needs, and family dynamics are considered when building a custom plan. We offer case management during a claim/litigated case as well as within a structured settlement to maximize benefits.

RN Law nurses will provide a combination of services based on case needs which may include the following:

Scheduling
Attending Medical Appointments
Coordination of Care
Negotiating Cost of Care
Alternative Funding Resources
Client/Family Referral/Education

Patient Advocacy

A patient advocate ensures patients don’t get lost in the system. They aid in getting the proper medical treatment and care for all the patient’s conditions.

Patient advocates help patients, their loved ones, relatives, friends, caregivers, and legal representatives navigate the healthcare system in many ways such as communicating with doctors, finding legal help, working with insurance companies, and setting up tests and screenings. They assist with many aspects of a patient’s medical care to make it a little less complicated.

RN Law patient advocates have the tools to ensure a patient is taken care of from their diagnosis through their treatment, recovery, and follow-up visits. We most commonly assist those with chronic illnesses, multiple illnesses, or life-threatening conditions.

An RN Law patient advocate will assist in the following:

Setting up medical appointments and finding second opinions
Helping a patient find financial and legal resources
Assisting a patient find support groups and other social support
Negotiating medical bills and reviewing them to ensure they’re accurate
Resolving disputes between patients and their insurance companies
Resolving conflicts between patients and their health care providers
Communicating with doctors, nurses, therapists, and insurance providers on a patient’s behalf
Explaining things to patients, ranging from medical bills to information on a diagnosis
Helping patients navigate their treatment and care options
Keeping notes of what happens during medical visits