Navigating The Healthcare Maze
Getting the Right Care at the Right Time and Place Brings About the Right Outcome!
Miriam Sterk, LCSW C-ASWCM, CCM has over forty years of professional experience helping thousands of people. She has expertise is all aspects of Case Management including navigating the health care maze, having effective appointments, creating health care plans that serve your needs, choosing and living in the best retirement community for you, and assistance in selecting your best Medicare/ Medicare Advantage or other insurance options.
Navigating The Healthcare World
Navigating the healthcare world means running into many challenges including:
- Ensuring the availability of your Primary Provider & Specialists
- Dealing with the challenges that occur when electronic medical record systems do not interact.
- Receiving claims for healthcare services that have been denied that negatively affect your credit and even result in liens against your assets.
Miriam can help you navigate these barriers and will create your personalized and affordable Case Management Assessment and Care Plan.
Contact her now to set up your first consultation and start the process of managing you or your loved ones health care.
Make The Most Of Your Appointment
When making an appointment with your primary provider or specialist, many considerations come into play.
Are the providers credentialed by your insurance and do you need a referral? Are they in or out of network? This can have a huge impact on your medical costs. What is their availability and how will you get to your appointment?
You must be clear on what you will be discussing and how you will explain it, as well as what questions you want answered.
- It is also critical to know and own your medical history, medications, and allergies.
- Your energy is likely to be low which can make your visit that much more challenging so it’s important to bring a friend or family member with you.
Did you know you are not considered a patient of the practice until you have seen your provider?
A Peak Performance Plus Case Management Assessment and Care plan will ensure that you are fully prepared for your appointments. As a Certified Independent Case Manager, Miriam is the essential link between the patients, family and caregivers to assess, plan and advocate on your behalf.
Contact Miriam to start your Assessment & Care Plan
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Your Health Vault & Care Plan
Part of keeping on top of your healthcare, and mental health needs, is having all your information organized and accessible.
The My Health Vault Project is the key to managing all aspects of your healthcare. Miriam will lead you through the process of creating your Health Vault. It will contain your medical, behavioral, social, financial, legal, spiritual and community resources with insurance coverage and
medication reconciliation for all levels of care from the highest level of care, in-Patient status, to the lowest level of care, Home and outpatient care.
Negotiating the healthcare system can be treacherous and delays and uncertainty can mean the difference between life and death.
Miriam will ensure you are ready and organized, and will assist you in working with your providers and insurance companies. Contact her to begin your My Vault Journey today!
Living in a retirement Community
Moving into a retirement community is a decision everybody faces at some point in their lives or the lives of their loved ones.
They often market themselves as, “the perfect blend of comfort, social opportunities, and hassle-free living.” However there are often hidden emotional and financial costs that aren’t discussed.
When it’s time to make this decision, Miriam will guide you through all the aspects that are involved in this decision including location, lifestyle changes, identity issues, and new social dynamics.
Read more about this transition in her blog or contact Miriam for a consultation as you begin the decision-making process.
Medicare & Medicare Advantage
Everybody in the world will send you information about “your Medicare plan”. The enrollment process and the associated decisions are overwhelming to say the least.
Miriam will guide you through the process, will ensure you are aware of, and meet all the enrollment deadlines, are well informed of all the choices involved, and will make sure you are set up to “Get The Right Care At The Right Time, In The Right Place, To Get The Right Outcome”.
Read more in Miriam’s blog or contact her today to learn more about your Medicare journey.
Appeals on Denials & Surprise Medical Billing
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you should not be charged more than your plan’s copayments, coinsurance and/or deductible.
“Surprise billing” is an unexpected balance bill. This can happen when you cannot control who is involved in your care — like when you have an emergency or when you schedule a visit at an in network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.
If you or anyone you know has any difficulty in obtaining service for their healthcare needs, contact Miriam Sterk LCSW C-ASWCM or read our latest blog.
Fill out this form to begin your healthcare planning with Miriam
Navigating the world of insurance benefits and disability can be almost impossible, but with the help of Miriam Sterk, the results I desperately needed came very quickly. Miriam understands the intricate workings of the insurance industry, and is able to explain them clearly, so that I could easily choose the best course of action for obtaining the surgery I needed, as well as my Long Term Disability. Miriam Sterk is a lifesaver, and I cannot recommend her services highly enough.
Tanya Young
