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How QCSS was able to secure over $16,000 in financial advocacy for this patient

Patient Overview: Mr. V.

Like many newly diagnosed cancer patients, Mr. V’s life took a frightening detour when he was diagnosed with Locally Advanced Pancreatic Cancer at the age of 56. When he began treatment, he only had Medicare Part A benefits and had recently lost his job due to the COVID-19 Pandemic. His household income, which included his unemployment and his wife’s income, totaled about $2,000 a month, putting him at around 150% of the Federal Poverty Level.

Medication & Cost

The oncologist prescribed our patient Abraxane, Gemzar, and Creon to treat his Pancreatic Cancer and after consultation with Q Consulting Services and the hospital, he learned that his medications were going to cost him more than $12,000 a month, and did not have appropriate insurance coverage to help with the expense. For this couple on a fixed income, the cost would be impossible to cover. It was at this point that the hospital’s oncology business asked Q Consulting Support Services (QCSS) to step in, with the request that we help the patient avoid incurring an untenable amount of debt and assist the hospital in being reimbursed, where possible, for Mr. V’s treatment.

Outcome

The patient worked on getting additional insurance coverage and signed up for Medicare Part B., while QCSS simultaneously secured free drugs for Abraxane and Creon.

QCSS understands that a patient’s focus should be on their recovery while the physicians, nurse and hospital’s focus should be on patient care. With this in mind, we fully managed the entire enrollment, billing, and ordering process throughout Mr. V’s treatment, alleviating our client, The Greater Baltimore Medical Center, and the patient from this added burden. The patient received his medication for free, and our client avoided a potential loss of over $12,000 a month.

Once the patient secured his Medicare Part B insurance, QCSS then obtained a fund through the PAN Foundation to cover his 20% out-of-pocket expenses. Our client would be able to bill and receive reimbursement through Medicare, while our patient’s out-of-pocket costs were also fully covered.

This patient required more assistance due to the circumstances of his unemployment. QCSS provided further assistance by finding alternative funding options like The Good Days Emergency Relief Fund to help this patient with household expenses and utility payments.

Over three months, we were able to secure over $16,000 in financial advocacy for this patient. This patient was so appreciative of our services and the financial assistance we were able to provide through one of the most challenging times of his life. He focused on his health instead of stressing over the burden of expensive healthcare treatment