October 2015
Theresa
Tillman
,
RN
Summa Primary Care Clinic
Ochsner Health System - Ambulatory Clinics
Harahan
,
LA
United States
Let me first describe what a perfect nurse she is. She patiently goes through sometimes chaotic and long days always with a calm smile that every patient we see. Without complaint, she has accompanied me to far away clinic locations with the same calming demeanor that leads many to have her the nickname Mother Theresa. I have attached 2 examples.
1. A recent new elderly patient of mine came with worsening intractable low back pain. He has been seen in pain management and orthopedic doctors in addition to his primary care doctor. The main therapy that has help with this in the past was aquatic physical therapy but there had been issues with insurance covering this out of network. When this barrier came up prior clinics did not pursue an appeal. I turned this over to Theresa and she was persistent in communicating this patient's unique situation. After several days of back and forth communication with our team it was her dogged work on this both verbally and written that obtained a successful appeal. I saw him in follow up recently and his chronically debilitating pain was almost resolved allowing functionality he hadn't seen in years. I had very little input to the process other than ordering the initial physical therapy and credit our success on this solely on Theresa.
2. Another recent example is a patient of mine with chronic complaints including pain, dizziness and depression. The patient has had other clinics who wrote the patient off pretty quickly because of these complaints, many of which are not fixable. The one thing that has worked well has been taking a higher than typical dose of an antidepressant that this patient was placed on after a hospitalization for severe depression. Recently our patient learned that insurance was no longer covering this higher than normal dosage. The patient became very distraught and there was even an ER visit for possible admission for severe depression. Theresa went the extra mile and researched why the insurance was no longer covering this medicine at this dose. With a simple addendum to a chart note I made she communicated several times to the insurance company and pharmacy while patiently discussing this process with our patient. Upon the most recent visit the patient's affect was the brightest I have seen in the few years we have had a relationship. I learned during that recent visit that the high dose antidepressant was approved by insurance. Most staff would have given up.
1. A recent new elderly patient of mine came with worsening intractable low back pain. He has been seen in pain management and orthopedic doctors in addition to his primary care doctor. The main therapy that has help with this in the past was aquatic physical therapy but there had been issues with insurance covering this out of network. When this barrier came up prior clinics did not pursue an appeal. I turned this over to Theresa and she was persistent in communicating this patient's unique situation. After several days of back and forth communication with our team it was her dogged work on this both verbally and written that obtained a successful appeal. I saw him in follow up recently and his chronically debilitating pain was almost resolved allowing functionality he hadn't seen in years. I had very little input to the process other than ordering the initial physical therapy and credit our success on this solely on Theresa.
2. Another recent example is a patient of mine with chronic complaints including pain, dizziness and depression. The patient has had other clinics who wrote the patient off pretty quickly because of these complaints, many of which are not fixable. The one thing that has worked well has been taking a higher than typical dose of an antidepressant that this patient was placed on after a hospitalization for severe depression. Recently our patient learned that insurance was no longer covering this higher than normal dosage. The patient became very distraught and there was even an ER visit for possible admission for severe depression. Theresa went the extra mile and researched why the insurance was no longer covering this medicine at this dose. With a simple addendum to a chart note I made she communicated several times to the insurance company and pharmacy while patiently discussing this process with our patient. Upon the most recent visit the patient's affect was the brightest I have seen in the few years we have had a relationship. I learned during that recent visit that the high dose antidepressant was approved by insurance. Most staff would have given up.