I'm doing this at home, right now.

Why I do this

I have spent my career in healthcare quality and accountability — the work of measuring whether health systems do what they are supposed to do, and what happens when they don’t. I knew the vocabulary. I knew the regulations.

And I still spent nights on hold. I still got handed decisions with no plan behind them. I still found out about a benefit we had qualified for months after we needed it.

What I kept thinking was: if this is hard for me, what is it like for everyone else?

What got me through

Someone did this for me. Not a doctor — a woman at a caregiver resource center who knew what came next and told me plainly, when I couldn’t see past the week I was in.

She didn’t fix anything. Nobody can fix this. What she did was make sure I was never doing it alone and guessing.

I had one of those. Most people never get one. That’s the whole reason I do this.

What I actually know

Most of what a family needs in these moments is not medical. It is procedural. Which appeal has a clock on it. What a plan is obligated to do once you file a grievance in writing. When a denial stops being the plan’s own decision and becomes reviewable by someone outside it.

That California has an independent review process for care that has been denied, delayed, or changed. That there is a Medicare review organization handling hospital discharge appeals every week, in volume. That in-home support hours are routinely denied and routinely restored on appeal. Almost nobody knows any of this, and all of it is knowable.

I know the other list too — the one that is in no handbook. Authorizations and extensions. The monthly check-ins. The supplies that don’t arrive. Arranging coverage so you can go to work. Seven years of it, and counting.

How I work

I advise; you act. I won’t file your appeal or make your calls — you’re the one with the authority to do that, and it was never the hard part. The hard part is knowing which appeal, by when, and what to put in it. Most families get one attempt. My job is making yours the right one.

I am paid by you. Not by a facility, not by an agency, not by an insurer, not by a plan. I take no referral fees from anyone, and I don’t accept them for sending you somewhere either. My rates are published on this website because you should not have to ask what something costs.

I keep a small caseload, and I do this alongside other work. Both of those are deliberate and I’d rather you heard them from me. The families I work with are usually in the worst month of their lives. That is not work anyone should be doing at volume.