Cheryl and Greg Teamann were under a great deal of stress. Greg was having extreme health problems and despite having heart surgery in 2012 to correct the issue, his heart concerns were back. The last thing that they needed was a shockingly large health care bill.
“When I saw a bill for $5,050, I was shocked,” says Cheryl Teamann, a retired teacher from the Wilkinsburg School District. “Here we are under all of this stress and then this? I couldn’t believe it.”
Unwelcome Surprise
Their journey began in the summer of 2011 when the couple was on vacation and Greg started sweating profusely for no apparent reason. He just didn’t feel good, Teamann says—he would start sweating and be clammy and cold. As soon as they returned home, Greg went to his primary care doctor who discovered that his heart was out of rhythm. The doctor immediately put Greg on medication, and, fortunately, his heart was regulated.
But just a few months later in December, Greg again began suffering from symptoms, and this time his doctors decided to do a cardiac ablation, a medical procedure used to correct the rhythm. But right before surgery, the Teamanns received some bad news: A test showed that Greg had blockage in his arteries—blockage that eliminated him as a candidate for ablation. In fact, the blockage was alarming to the doctors.
“He was admitted to the hospital on a Friday and they didn’t let him go home,” Teamann says. “They performed surgery on Monday.”
Once again, the procedure worked for a while, but despite surgery and several other medical procedures, Greg continued to suffer from incidents of an irregular heartbeat over the next few years.
Through each of these medical procedures, Greg was assigned to wear a heart a monitor to keep track of his heartbeat, and cost was never an issue—until the third time in 2015 when they suddenly received a bill for more than $5,000.
Reaching Out for Help
When that bill came through the mail, Teamann immediately began appealing the decision to her insurance company and consulted her physician’s office. When her appeal was rejected, she turned to Lytle EAP Partners, an employees assistance program offered to Allegheny County Schools Health Insurance Consortium members.
Throughout their appeals journey, the Teamanns received support from Kate Scheirman, a patient advocate with Lytle EAP Partners, who took the couple under her care and began advocating on their behalf.
“I can’t say enough good things about Kate. She really helped us through a very difficult situation,” Teamann says.
As they got further into the process, Scheirman and the Teamanns found out that Greg’s physician was just as surprised as they were that the machine wasn’t covered.
“We had always gone to doctors that were in-network and the other two monitors were in-network and covered (by insurance). It never occurred to us that this (monitor) was not,” Teamann says. “Apparently the company (that provided the heart monitor) presented themselves to the doctor as if they were in-network.”
Scheirman helped get the situation sorted out, acting on the Teamanns’ behalf, which allowed them to concentrate on what was important: looking after Greg’s medical care. It’s just what Scheirman does. She helps people go on with their daily lives, their jobs and families as she helps them resolve medical issues.
“That is what I do,” Scheirman says. “My role is to do whatever it takes, whether it is talking to the insurance company or waiting on the phone on hold for 15 minutes. (My job is) to do whatever I can to assist our clients.”
‘Here to Help’
Scheirman and all of the advocates at Lytle EAP Partners have medical knowledge and medical backgrounds that allow them to better assist their clients and ask the questions that clients might not know to ask. And sometimes that isn’t easy.
While many cases are open and shut, some are more complicated and take longer.
It took 10 months for Scheirman and her forces to straighten out the Teamanns’ bill, but she never gave up.
“I take it really personally. I want to help people get the best outcome. Sometimes it might not be the outcome that they want, but it is the best one that we can get to,” Scheirman says.
Getting that support was huge for Teamann, who says she never felt alone once Scheirman became their advocate.
“Kate talked with everyone for us. She would call me every single Tuesday to let us know she was helping us, and she always remained positive. She was assertive with who she needed to be, but she was always polite,” Teamann says.
Thanks to Scheirman’s efforts, the Teamanns’ total health care bill was paid. As they move forward with Greg’s health care, Cheryl says she feels better knowing that Lytle EAP Partners and Scheirman are there should they ever need them again.
“I have actually told friends of mine about her, and she helped them. She is really great,” Teamann says.
And that is exactly what Scheirman and the folks at Lytle EAP Partners want—for people to know they’re here to help.
“We want to make sure no one feels alone,” Scheirman says. “People often say, ‘I just need to know someone is listening and trying to help.’ That is what we are doing.”
