Hello, my name is Rosalia Flora. I have been licensed by the state of Florida as a Healthcare Risk Manager for over 15 years. I have earned the designation of Certified Professional Healthcare Risk Manager from the American Society of Healthcare Risk Managers. I have earned the designation of Certified Health Data Analyst and as ICD-10-CM/PCS Trainer Certificate Holder and Ambassador from the American Health Information Management Association. I earned my MBA from Saint Leo University. I have worked as a Director in Florida acute care hospitals for over 30 years; including Shands Hospital and Clinics, Tampa General Hospital, and Florida Hospital.
When illness strikes, most of us are unprepared for the healthcare maze we are suddenly presented with. When you are in pain and afraid, suffering from one or more frightening diagnoses, it is difficult to think clearly. Even for a seasoned healthcare professional, a personal illness can fog a person’s judgment. This is when you need someone by your side; someone to accompany you to doctor’s appointments, or to monitor a hospital encounter, who can think clearly when you cannot. This is when you need a patient advocate and a healthcare navigator.
When you have loved ones who are alone, and you are far away, or burdened with other life obligations, you need someone who can be there for them when you cannot. Someone knowledgeable about the healthcare system and who can listen and record, and to ask those important questions, when your loved one cannot. Someone who can keep you informed of the situation and the needs of that loved one. That is when you need a patient advocate and healthcare navigator to be on your side.
You may or may not know that all hospitals, both for-profit and not-for-profit, are usually paid by Medicare and other third party insurance companies on a flat rate based on your diagnosis. Why that is important to know is that means they all have the same motivation to shorten the length of time you spend in their facilities. If you are admitted with pneumonia, on average, they will receive a flat rate of around $7000.00 for your care. Their way of maximizing their profits is to get the patient out of there within 3 days. If you stay there for 5 or 6 days, they lose money. If you are discharged before you are ready, you are at risk of having to be readmitted to the hospital. A personal healthcare advocate can help you stay out of the hospital.
All Florida hospitals are required to hire licensed Healthcare Risk Mangers to look out for the hospital’s financial well being. Hospital employed Risk Manager’s are not primarily there for the patient’s well being, although that is what they all want to do. But the reality of the hospital business model means there is a natural conflict of interest for the hospital employed Healthcare Risk Manager. A hospital employee is expected to work on behalf of the organization’s best interest.
This is why you need to have your own personal Healthcare Risk Manager, to be your patient advocate and healthcare navigator. You need an “insider” who can work primarily for you, and not for the insurance company or for the hospital. Someone who can assist you and your physician’s to be sure you get the appropriate care, at the appropriate time, and not rack up unnecessary charges while being rushed out of the hospital before you are ready and prepared to safely go home.
Because of my unique set of skills, education, and working experience, I can be your guide through the healthcare experience. Very often, with complex care involving several doctors and therapists, and multiple medication and treatment regimens, keeping your care coordinated and organized can be one of the most challenging aspects of your care. I can be there when you need me, and I can help you keep track of all the various touch-points vital to insuring you are receiving the most appropriate care for your needs.
In addition to the direct healthcare needs, finding and scheduling community services available to you and your loved ones can be frustrating. There are numerous community services in Hillsborough county related to transportation and nutrition, but knowing where they are and how to obtain them can be mystifying. From my years of experience in the healthcare industry, I have a vast knowledge of where, what kind, and eligibility, for those services. I can coordinate the patient’s needs with the appropriate services, at the appropriate times, while coordinating all of these things around doctor and therapy visits.
I am available for individual encounters, short-term assignments, on up to and including long-term healthcare coordination continuance agreements. I provide in-home healthcare risk management assessments of the living situations, as well as risk analysis of a person’s overall healthcare needs. I assist clients with creating ongoing electronic personal health records to include all healthcare providers, their specialty and the conditions they are treating in addition to all medications and therapies, both present and past.
I am available to discuss your concerns and needs during a free initial consultation. I am also available to your loved ones who may not be able to assist you in the ways that I am. I have personally been in that position where a close family member needed help, but due to life’s circumstances beyond my control, I was unable to do all the things for them that they needed. I know how frustrating and lost that felt. Now I am available, and I am offering my services to you and your family, to be there for you and for them whenever you need me.