Karen Lucas
May 2026
Karen
Lucas
,
ASN, RN
Primary Care
Schneck Medical Center
Seymour
,
IN
United States
Due to Karen’s persistence and attention to detail, the patient was no longer responsible for a large balance, and the hospital received appropriate reimbursement.
I would like to nominate Karen Lucas for a DAISY Award. She recently helped a patient who had been incorrectly billed by our wound care facility, resulting in the patient owing over $1,000 out of pocket. Karen personally handled this issue and made several phone calls to our billing department, the patient's insurance company, and the patient. Karen worked on this matter for months, ultimately reducing the patient's copay to zero.
Karen made a special connection with this patient and worked with the healthcare team to get this matter handled appropriately. Karen showed excellent dedication and compassion to the patient, and I believe this deserves recognition. Karen’s diligence resulted in corrected billing and patient relief.
Karen received a phone call from a patient with concerns about his wound care bill. After reviewing the account and the amount owed, Karen felt something did not seem right. She proactively contacted both the billing and coding teams to verify the charges and was initially informed that the balance was due to the patient’s copay.
Unsatisfied with that explanation, Karen contacted the patient’s insurance company directly. Humana advised her that the claim had been billed incorrectly. Karen again reached out to multiple individuals at Schneck, who continued to reassure her that the balance was correct and that it was part of the copay. However, given the significant amount owed, Karen questioned why Humana would not cover any portion of the wound care services.
Through her own research, Karen found an article indicating that a 761 revenue code cannot be billed together with an office visit G code. Armed with this information, Karen followed up with the coding team to share her findings.
As a result, the revenue code was removed, and the account was rebilled correctly. Humana subsequently paid the claim. Due to Karen’s persistence and attention to detail, the patient was no longer responsible for a large balance, and the hospital received appropriate reimbursement.
Karen made a special connection with this patient and worked with the healthcare team to get this matter handled appropriately. Karen showed excellent dedication and compassion to the patient, and I believe this deserves recognition. Karen’s diligence resulted in corrected billing and patient relief.
Karen received a phone call from a patient with concerns about his wound care bill. After reviewing the account and the amount owed, Karen felt something did not seem right. She proactively contacted both the billing and coding teams to verify the charges and was initially informed that the balance was due to the patient’s copay.
Unsatisfied with that explanation, Karen contacted the patient’s insurance company directly. Humana advised her that the claim had been billed incorrectly. Karen again reached out to multiple individuals at Schneck, who continued to reassure her that the balance was correct and that it was part of the copay. However, given the significant amount owed, Karen questioned why Humana would not cover any portion of the wound care services.
Through her own research, Karen found an article indicating that a 761 revenue code cannot be billed together with an office visit G code. Armed with this information, Karen followed up with the coding team to share her findings.
As a result, the revenue code was removed, and the account was rebilled correctly. Humana subsequently paid the claim. Due to Karen’s persistence and attention to detail, the patient was no longer responsible for a large balance, and the hospital received appropriate reimbursement.