Author: Sherrie Allen, Vice President of Clinical Services
🚨 The Case of the Unnecessary Transplant
Picture this: A middle-aged woman with post-COVID cardiac complications. A shocking recommendation for a heart transplant buried in her records. A price tag of millions added to her Medicare Set-Aside (MSA). But here’s the twist: the suggestion came from an internist, not a cardiologist—and it was about to blow up our client’s budget.
Enter our clinical Sherlock Holmes (aka a certified nurse case manager and Medicare Set-Aside expert).
🔎 The Investigation: Science > Assumptions
We didn’t just read the files—we hit the streets (and the phones!). Here’s how we debunked the myth:
Result: A lean, mean, clinically bulletproof MSA.
🤝 The Secret Weapon? Collaboration!
This wasn’t a solo mission. By teaming up with our client, we:
💥 The Grand Finale: Millions Saved
CMS gave the final stamp of approval: No transplant. No inflated costs. No drama. Our client kept millions in their pocket, and the patient’s care plan stayed rooted in reality—not paperwork myths.
🧠 The Big Takeaway
MSAs aren’t just spreadsheets—they’re stories. Stories that demand:
Ready to turn your MSA “uh-ohs” into “aha!” moments? Let’s collaborate! Reach out to info@allankoba.com and let us show you what our team can do!