Nadene Bradburn BCPA, MHA

At 24, I was on top of the world, working for a global consulting firm with large health systems in Chicago. Then one day, an ambulance took me to my client’s ER. Doctors discovered a brain aneurysm. What followed was two surgeries, paralysis, and a journey through nearly every level of care. Over eight months, I went from visiting doctors to understand my headaches, to a 911 call, to two craniotomies, three weeks in the SICU, two months of acute rehab, and five months of outpatient therapy. I returned to work not just consulting on health systems—but having lived through them, as a patient, in the 1990s HMO era. That experience reshaped me. I joined the Board of Directors of an internationally influential Disability Rights nonprofit and started a peer support group for young professional women with disabilities. I earned my master’s in health systems management at the same academic medical center where I had once been a patient. When I finished my degree in 2000, a former client hired me into lead programs I already knew as a patient. In my 25+ years in the industry I held Director-level positions in inpatient and outpatient department operations, medical staff development and med student training, and the EMS system in an urban area with 1.4 M people. I was part of a group to expand primary care into underserved areas because keeping people healthy helped them live longer. But I also knew firsthand that while people are living longer, our healthcare infrastructure has not kept pace. Those longer lives sometimes aren’t worth living. My own aging family and friends had to be vigilant to navigate our convoluted healthcare system and protect their rights, dignity, and quality of life. In 2018, I became a volunteer Long-Term Care Ombudsman, where I witnessed how easily older adults can fall through the cracks. COVID only magnified the brokenness of the system. That’s why I started my own advocacy practice: To help families navigate elder care with the clarity, compassion, and strength I know they deserve.

Rush University, M.S. Health Systems Management, 2000 University of Chicago, MA 1996 Mount Holyoke College, BA 1994

Services include: • Insurance denial review, internal appeals, and external Independent Review Organization (IRO) appeals • Medicare Advantage coverage disputes and prior authorization challenges • Observation status vs. inpatient admission advocacy and patient rights • Long-term care insurance (LTCI) claim navigation and elimination period disputes • Hospital billing review: UB-04, Explanation of Benefits (EOB), and balance billing disputes • InterQual criteria analysis and level of care determination challenges • Care transitions: hospital, IRF, SNF, ALF, memory care, home health • Facility contract review • Discharge planning advocacy and unfair discharge challenges • Skilled nursing facility (SNF) and assisted living facility (ALF) placement, vetting, and transition coordination • Fluent in hospital operations and administrative structure — communicating effectively with case managers, utilization review teams, discharge planners, social workers, and hospital administration • Inpatient and outpatient department workflow navigation • Long-term care planning: Medicaid spend-down, LTCI benefit triggers, reverse mortgage and life insurance riders as LTC funding vehicles • Emergency and urgent advocacy: same-day response to hospital hallway calls, unexpected discharge, and acute patient rights concerns • Former 911 Dispatcher: trained in high-stakes triage, rapid assessment, and emergency communication under pressure Experience with: • Hemiplegia — personal lived experience, including physical rehabilitation, assistive device navigation, and adaptive equipment • Spasticity management • Stroke and post-stroke recovery and rehabilitation • Stroke-related motor deficits • Transient Ischemic Attack (TIA) and stroke warning sign navigation • Arteriovenous malformation (AVM) • Craniotomy recovery and post-surgical care coordination • Traumatic brain injury (TBI) • Epilepsy and seizure disorder management • Neuromuscular conditions and inpatient/outpatient rehabilitation • ADA accommodation and accessibility advocacy • Dementia and memory loss, including behavioral expressions and cognitive decline • Frail elderly and medically complex older adults • Multi-system chronic illness in aging populations • Post-acute care: skilled nursing, subacute rehabilitation, long-term care • Complex insurer-hospital billing disputes involving multiple facilities and transfer episodes

• I offer a FREE Initial Consultation
• I offer TeleAdvocacy Service
• I am insured
• My geographical area of practice is DMV--District of Columbia, Maryland, Northern Virginia