Angel in the ER: Firm helps patients who can’t pay
Published: November 16, 2005
Overlooking the Chesapeake Bay is a sleepy-looking office tucked inside the first story of a small, sun-bleached building in Bay Ridge.
The business inside the former gas station boasts 120 employees in 11 states from Maine to Florida and as far west as Oklahoma. Though some people are skeptical about the existence of angels, Advanced Patient Advocacy must seem like one to the 30,000 patients who received its help last year.
But it’s a very successful angel on a purely earthly plane: APA produced $5.4 million in revenue last year. Inc. magazine named it the 166th-fastest-growing company in the nation, but none of its customers are in Maryland.
“A prophet is never recognized in his own land,” laughed company founder and CEO Kevin Groner. “I’ll eventually get here.”
Any person taken to a hospital needing care has to be treated, regardless of ability to pay. In hospitals that hire Mr. Groner’s company, the Advanced Patient Advocacy representative is called in when a patient doesn’t have insurance. [How to Get Cheaper, Better Coverage Without a Traditional Employer Plan]
Using software developed by APA, Mr. Groner’s staff runs information gleaned from interviews through a matrix that includes more than 20 government programs.
“We are an advocate,” he emphasized. “We do not charge the patients. We hold their hand and identify potential payers to reimburse the provider - the hospital - for its service. When the hospital is paid by the government, then we are paid a flat fee or consignment fee.”
The company screens every referred patient for eligibility in myriad programs. For example, APA representatives handle paperwork stressed-out parents might overlook when a sick newborn arrives, like adding the baby to the mother’s existing Medicaid number, making an application for baby and mom if no benefits exist, and initiating Supplemental Security Income claims for sick infants.
It also provides screening and application services for hospital-based charity care, nursing home applications, Emergency Medicaid Services for undocumented aliens, Medicare Modernization Act benefits for undocumented aliens, Veterans Administration benefits, Federal Crime Victims compensation, Indian Health, COBRA benefits from a previous employer, Worker’s Compensation and prescription drug assistance.
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