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Office Hour Change

Effective January 16, 2015:

Monday – Thursday
9:00am - 5:00pm

9:00am - Noon

We will be unavailable for appointments or phone calls on Friday afternoons, so that we may finalize our work for the week. This also ensures that we have some uninterrupted time to devote to the needs of our clients.



How to Approach a Doctor’s Appoint as a Guardian

doctor in lab coat

Image via Ilmicrofono Oggiono

We recently attended a neurologist appointment with one of our young guardianship clients. In the past she had a history of seizures, but they had been successfully under control for an extended period of time. During her annual appointment, the doctor started to talk to the client about her interest in driving, considering that her seizures were well-controlled.

This was a very difficult situation, as the client had been determined to be totally incapacitated and had her right to drive removed by the probate courts many years ago. She was so confused – here a neurologist, a high level doctor, started to ask her if she wants to drive. Then here we are, trying to explain to her that the guardianship courts had removed her right to drive. We spent a good bit of time trying to calm her, and to help her to understand this complicated circumstance about her right to drive.

We were also frustrated with the physician. He did not think about the ramifications of what he was saying to her, maybe because he did not recall that the client was in a guardianship, maybe because he was trying to give her some hope and help in being able to drive. Whatever the cause, it was very hard for this client to grasp this. After this, she was distrustful of many of our conversations – regardless of the subject– and she continued to refer back to the doctors’ discussion for a long time afterwards.

So how do we prevent this from happening in the future?

To be fair, doctors and their offices, and frankly ALL of the health care providers in the U.S., are dealing with mountains of shifting sands in our new “Affordable Care Act” health care system each and every day. Each day they are trying to figure out (just like we are) how to work within this new system of moving deductibles, elusive co-pays,  codes that don’t match the diagnostic procedures – all this while trying to focus on their real job – which is providing quality health care to their patients.

To prevent such a mistake happening in the future, remind the office and the doctor (privately, with dignity) before the appointment, or just as the doctor is about to come in. (We often wait for the doctor just outside of the exam room.) Remind the doctor of the legal status of the patient that they are about to see. This may help the doctor to recall this small detail as he/she is seeing the patient and save you loads of work later.

May 2016 Newsletter – What is a Medicare Set-Aside?

Chronicles of a Professional Guardian

Dear Colleague,

Serving as Advocates, Care Managers, Elderly & Disabled Life Care Plan Assessors, and providing Professional Guardian services in Central Florida for over 20 years, we have discovered unique solutions to many difficult problems.

We are continuing our tradition of giving back by sharing our knowledge in the hopes that this information can help others to better serve and care for our elderly and disabled population.

What is a Medicare set-aside?

What is a Medicare Set-Aside?
A new client of ours went to the hospital from his ALF after suffering a suspected stroke. We got notified from the hospital and from the rehabs (who were assessing him for admission) that there is a problem from an unresolved Medicare claim. As it turns out, he was involved in a slip and fall lawsuit three years back. We contacted his (then) P.I. attorney to try to get a clear answer on this. Our fear was that this issue may cause trouble with his Medicare-covered stay at the rehab, especially, if they would not accept him when he was ready for discharge from the hospital, while we were still working to resolve this.

A Medicare Set-Aside, in layman’s terms…

In the past, Medicare had been paying for medical bills where there was a personal injury claim without any kind of reimbursement. Now, the concept is that Medicare is often involved as part of the personal injury settlement process, asking for a bucket of money to be “set aside” to pay the current and future medical bills (that relate to the injury/illness). This is a guessing game of what those current and future costs will be. The money is put into a Medicare Set-Aside Account (MSA), like a trust account. There are VERY specific rules on how these dollars are to be spent. So there are providers popping up who administer these accounts.

If there is reason to believe that there may have been a P.I. settlement in the past, it might be wise for a fiduciary (POA, Guardian, Trustee) to request something from Medicare to know where that stands.

This information would be great to know before there is a problem.

Medicare Set-Aside Accounts Moving Forward

Apparently, we’re going to be seeing these more frequently now as Medicare has become very savvy on not getting stuck with medical bills for beneficiaries that were from a personal injury situation.

Have you run into Medicare Set-Aside issues yet?

Tip of the Month:

Work Around Multiple Birth Dates

Be very careful of a client that has more than one documented birthdate. In general, stick with whatever date that specific agency has used.Example: If social security thinks she was born 1.27.27, leave it like that and use that date whenever communicating with Social Security or Medicare. If her drivers license shows 1.27.31, leave it like that and use that date whenever communicating with DMV. Her passport shows 1.27.33? Same plan. After all, a gal might want to shave a few years off. Can you blame her? 😉

We have learned that trying to change these things, decades after they occurred, can cause big troubles.

Did You Know?

If you drive on Central Florida toll roads and use an E-Pass transponder, you could be getting a bigger discount starting May 1.

But the expressway’s move is bad news for drivers with SunPass transponders, who will no longer be eligible for any discounts when traveling on area toll roads.

Learn more here.

Recent Blog Posts

We learn so much great information in our profession that we want to share with as many people as possible.

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Quick Test: What Kind of Advocate-Entrepreneur Are You?

elderly man reading

Image via simpleinsomnia

What kind of advocate-entrepreneur are you? Or are you maybe a combination of these?


A – Analytical-Entrepreneur: You perform deep analysis of any new client to determine profitability of that case before accepting the client. You are a pessimist in thinking that there will not be enough funds to care for the client.


B – Risk Taker-Entrepreneur: You accept cases where there are no immediately available funds to care for the client. Or where the major assets are a mess, there are title problems or are in unsellable condition. You are optimistic that there are benefits or assets that will be found to pay for the client’s care and needs.


C – Administrator-Entrepreneur: You have created and keep a current, detailed written Policy & Procedures for the whole system you have created.


D – Social Worker-Entrepreneur: You have brought a client to your home for a night during an emergency or for a holiday meal.