Do You Need Help Filing for Free or Reduced-Cost Care?

She Took Them Into Her Home

Amy Potter was Lehigh Valley Health Network's first financial counselor. More than 30 years later, she’s still helping uninsured and under-insured people apply for deductions in the cost of their medical expenses. “When I started, I helped two or three people per week,” Potter says. “Now, I help about 50 per week.” Over the years, she developed relationships with many of these people. However, the bond she made with the Agolla family is extra special.

Catherine Agolla and her young daughter, Michelle, moved to the United States from Kenya. A single mom, Catherine attended school during the day and worked at night. Earning a modest wage, Catherine couldn’t afford to heat their small Allentown apartment. Purchasing medical insurance was out of the question. So, when Catherine needed emergency surgery, she turned to Lehigh Valley Health Network for help.

“I immediately took a liking to them,” Potter says. “Catherine was doing everything she could to make it on her own.” Like Potter does for all who come to her, she did everything she could to get Catherine help. She not only found a surgeon willing to perform the procedure free of charge, she decided to help the Agollas get back on their feet by taking them into her home.

Potter took care of all the household expenses, allowing Catherine to continue her studies and save her earnings. Potter, a mother, grandmother and great-grandmother, says, “They became a part of my family.” She even bought Michelle her first doll.

Catherine eventually received her degree and today works full-time as a computer specialist. At night, she works part-time at a local nursing home. Michelle is a student at William Allen High School and has her mom’s work ethic. She got her first job at age 15. Today, they live in a bigger, warmer apartment and have medical insurance.

More than 10 years after they met, Potter and the Agollas remain very close. On occasion, Potter will surprise them with a bag of groceries or a new outfit for work or school. “In the summer, I take them with me to visit my family down the shore,” she says.

Even after 30 years, Potter says she still feels rewarded knowing she’s helping people. “You can’t imagine how much free care went across my desk over the years,” she says. “Lehigh Valley Health Network really does help a lot of people.”

And so does Potter.

She’s A Stress-reliever

Kathleen Ring of Zionsville loves her job as financial coordinator for cancer patients at Lehigh Valley Hospital-Cedar Crest. “I feel rewarded to be part of a team that works together to heal people with cancer,” she says. It may seem like financial counseling doesn’t really come under the umbrella of healing, but Ring sees it differently. “Stress interferes with healing, and I am able to remove a huge stress factor for many patients.”

One way she does this is by working closely with the billing people in all hospital departments. She makes sure no bills are sent to the patient’s home while they’re in the process of applying for financial assistance. “It takes a while to explore all the options for aid,” Ring says. “Not having to deal with bills pouring in while waiting for aid relieves a lot of stress and worry. Lehigh Valley Health Network’s reduced cost of care program, which is based on a sliding fee scale, is very generous, so we usually succeed in getting help for most people.”

Ring and others in the oncology department hold several small fundraisers during the year to help families who are in dire need—even beyond the cost of their medical care. “We have given people money to pay their electric or heating bills,” she says. “We bought a bus pass for someone who had no transportation, so she could get to the hospital for radiation therapy.” Because the patient brought her small child with her, Ring arranged for a hospital volunteer to baby-sit the child in the clinic while the mother was being treated.

“We sometimes just take up a collection to help patients with small needs. When you’re sick with cancer, even a seemingly small gesture can make a huge difference. People are so grateful. I’m happy to be able to help people at a difficult time in their lives,” she says.

He’s Seen Things from Both Sides

After earning a college degree in business, Shawn Hawkins began his career at Lehigh Valley Health Network in the pharmacy’s accounts payable department. Some of his time was spent talking to people who hadn’t, or couldn’t, pay their bills—an experience that was helpful in his transition from collector to helper.

For the past three years, Shawn has worked as a financial counselor to people receiving cancer care at the health network. “Now I’m seeing the situation from a different perspective,” he says. “Actually meeting these patients has given me a better understanding of their situations, and I have a lot of compassion for them.”

Now Hawkins' job involves helping people navigate the intricacies of their insurance coverage. Many patients with health insurance often find that some procedures are only partially covered, and others aren’t covered at all. Because cancer treatment can include imaging (MRIs, mammograms), surgery, chemotherapy, radiation and medications, expenses mount up quickly. Usually the treatment takes months—and then there are follow-up visits.

“Most of the people I see have health insurance, but because cancer care is so extensive and involved, they find they often owe more than they are able to pay," Hawkins says. "I explore all the other avenues to help cover what their insurance won’t.”

Hawkins determines the eligibility of his patients for various aid programs—from reduced-cost prescriptions to Medicaid. “Lehigh Valley Health Network has a generous aid program, offering fee reductions and, in some cases, free care for people who simply lack resources,” he says.

A life-long resident of Northampton, Pa., Hawkins gets satisfaction from helping people in the community. “When people first come into my office, they think they’ll have to sacrifice their financial security to regain their good health. I give them hope that they can return to a normal life after they get well.” He often sees people he’s helped on the street or in the hospital on a follow-up visit. “They always stop to shake my hand and tell me how grateful they are for my help.”

She Helps Patients in Financial Need

When Maxine Rhode started as a financial counselor 17 years ago, she never thought of the immense impact she would have on her patients’ lives. Her work helps uninsured and under-insured people find a way to pay for their care. But that’s the easy part. Sometimes, they need a little more help. Here are some ways she lends a hand:

It’s not just medical bills. Sometimes people who meet with the financial counselors need help with all of their bills, like rent and electricity. “They bring in stacks of bills. I’ll go over every one and try to figure out where they can get help to pay for these bills.”

It’s the little things that make a difference. Often, Rhode’s patients can barely provide for their families or buy food. “Buying them a cup of coffee or a soda is the least I can do. They light up over that small gesture.”

It takes a little extra time and effort. Rhode once had a young, homeless and pregnant girl seek her help. But after helping the girl, she couldn’t just put her back on the street. “I worked late into the evening until I found her a foster family from my church. I even gave them a play-pen I had for my grandchildren because they weren’t prepared for a baby.”

It’s not about the thanks. People often thank Rhode with cards or homemade cookies. “Most recently an elderly gentleman gave me a thank-you card. I knew he didn’t have the $3.95 to buy the card. I was grateful for the gesture, but I would have been happy with a smile and thank you.”

It’s about showing you care. “Many of my patients don’t have anyone in their lives to look out for them or do nice things for them. So, if one of my patients is in the hospital, I will send him or her flowers, or a fruit basket to try and make their stay a little more pleasant.”

It’s about doing whatever it takes. Rhode is a counselor at Lehigh Valley Hospital—17^th Street, but her patients sometimes need to travel to Lehigh Valley Hospital—Cedar Crest for care. Many have no transportation, so Rhodes offers taxi or bus vouchers. “I want to make their care as stress free as possible. The less they worry, the more they can focus on getting healthy.”

She Knows Where to Look

Pharmacy services financial coordinator Fran Hnat remembers a patient who earned a decent wage but didn’t have medical insurance. To control his illness, he needed two very expensive medications. His monthly prescription bill was $4,900. “No one can afford that, no matter how much money they make,” Hnat says.

So, Hnat wrote letters to the drug company manufacturers explaining why the patient needed financial assistance. She even provided a detailed account of all his personal expenses. “We were able to get the medication he needed at no cost,” she says. “He was thrilled and very appreciative. That’s why I love this job.” It’s one example of why Hnat believes no one should feel they can’t get financial assistance for prescription drugs if they are uninsured or under-insured.

At any given time, Hnat helps as many as 200 people obtain free or reduced-cost prescription medication. She works with Lehigh Valley Health Network’s clinics and financial counselors to identify patients who need assistance. She then meets with patients to gather the information (e.g. income, number of people in household) she’ll need to fill out applications. “Depending on the drug company you’re dealing with, the application process can be very extensive,” Hnat says. “But that’s why I’m here, to help people through the process.”

Hnat goes out of her way to help all her clients. For example, because every application needs to be signed by the patient’s physician, Hnat speeds up the process by hand-delivering the paperwork to get the doctor’s signature. To better serve our diverse community, Hnat plans on returning to school to learn Spanish.

Her dedication resulted in the distribution of over half-a-million dollars in free or reduced-cost medication to the area’s uninsured and under-insured in 2005. “I do what I do because I believe everyone has a right to quality health care and prescription medication,” she says.

She Picks People Up When They Fall

Ask Marjorie Nader why she likes her job so much and she says, “I just like helping people.” As a financial counselor at Lehigh Valley Hospital-Muhlenberg, Nader does more than help people deal with their medical bills. She goes the extra mile to make sure all her clients’ needs are met. Here are some examples:

• She gets them covered. In addition to getting her clients a reduction in their medical bills, Nader helps people find a health insurance plan they can afford. “It’s like a safety blanket. You may never use it, but it’s nice to know it’s there when you need it,” Nader says. “We’re here to help our patients with their medical expenses, but we also have an obligation to see if they are eligible for insurance. It’s best for them in the long run.”
• She finds them medication. Even though some of Nader’s clients have health insurance, they may not be able to afford their medication. “You can get free medication from almost all of the pharmaceutical companies,” she says. “However, the paperwork is time consuming and tedious. I help my clients sort through it so they’ll get the medication they need.”
• She gives them her time. Whether a client needs financial assistance or just someone to talk to, Nader is always there. “I don’t just give up on people after I’ve helped them,” she says. “They can call me whenever they need me. I’ll always give them the time they deserve.”

Although Nader never expected she’d be helping people with their medical expenses, she wouldn’t change her job for the world. “I love it here,” she says. “The people I help are always grateful.”

Nader remembers when one of her clients knitted her a blanket. “I still have it. It’s beautiful,” she says. “People feel an obligation to thank me when I help them with their medical bills, or find them insurance and prescription medication. What job can be more gratifying than that?”

Everyone Needs Help Sometimes

Finding out you need a kidney transplant can be devastating and worrisome. One thing you don’t have to worry about is how you’re going to pay for your medical bills and costly medications. That’s Anita Tantaros’ job.

Working as a financial counselor at Lehigh Valley Health Network for 15 years, Tantaros is a specialist in helping people deal with their transplant costs. “Usually there is a problem coordinating insurances, programs and drug coverages,” she says. “I’m here to help everyone that needs a kidney transplant.”

Much of what Tantaros does is considered life saving. She may not be a physician, but as a financial counselor for kidney transplant patients, she works closely with pharmaceutical manufacturers to get patients important, anti-rejection medications.

She also helps patients with the national Medicare and Medicaid programs. “It can be very confusing,” she says. “I deal with it every day, and it’s still confusing to me. I can’t imagine how confusing it is to senior citizens. I’m just happy I can help.”

Having worked previously in the patient accounting department, Tantaros says her current job is much more fulfilling. “It’s rewarding when you realize you’re making a difference in people’s lives.”