AALNC Pittsburgh Chapter

Please join the Pittsburgh Chapter this Wednesday, September 16th at 6:00 pm EST for our monthly virtual Happy Hour.

We hope that you'll join the conversation this Wednesday, September 16th at 6:00 pm EST. No membership required. All are welcome, whether you're new to the scene or a familiar face, we would love to see you. Happy hours are a great way to introduce yourself to our community, ask questions that you may have about legal nurse consulting and make connections. No need to pre-register, simply hop on with our Zoom link found here: https://aalncpittsburgh.org/events-education/

The Pittsburgh Chapter invites you to our September 9th presentation, "Let's Talk About Billing: An Interactive Roundtable Discussion."

We hope that you can join us on Wednesday, September 9th at 5:30 pm EST via Zoom for this great topic and one that every LNC must understand. Our panel consists of experienced members from many diverse backgrounds and & LNC job descriptions and they will be sharing their own experience and expertise with attendees: Tamara Karlin-Boissier, RN, LNCC-AALNC President, Jennifer Parks, RN, LNCC- AALNC Immediate Past President, Robin Axtell, BSN, RN, LNCC-AALNC Director at Large, and Pittsburgh Chapter Board members, Linda Fowler, DrPH, RN, NHA, Dr. Beth Brant, APRN, CPNP-PC, LNCC, AFN-C, SVFN-C, IVSE-C, NCSN, MCP-C, Karen V***a, BSN, RN and Diane Mead, RN, BSN, ACC.

Our Topics:

-Retainers & Contracts

-Time Tracking & Billable Hours

-Hourly vs. Flat Fees

-Factors to consider when formulating your rates

-Expert Witness vs. Behind the Scenes vs. Subcontracting

-Travel Expenses

-Invoicing

-Record Keeping & Taxes

-Delinquent Invoices

This presentation is free to Pittsburgh Chapter members and is $20 for non-members. For more information and to register, please visit: https://aalncpittsburgh.org/events-education/

Last Wednesday, the AALNC Pittsburgh Chapter enjoyed a wonderful evening together at LeMont Restaurant, complete with beautiful views of the Pittsburgh skyline!

Since we typically connect over Zoom, there’s something extra special about getting together in person. We were also fortunate to have AALNC President Tamera join us for the evening!

Great views, great conversation, and even better company. 💙

The Pittsburgh Chapter invites you to our Virtual Happy Hour this Wednesday, August 19th~

We hope that you will join us at 6:00 pm EST for our monthly virtual happy hour. All are welcome, both members and non-members. Whether you're a regular or new to our scene, we would love to see you. Our happy hours are a great way to introduce yourself, get to know others, share information and ask questions. You never know when you will make that one special connection that helps start your LNC career or elevate your established practice. The Zoom link can be found here:
https://aalncpittsburgh.org/events-education/

Closing our week of celebrating with a Postcard from our president, Stephanie A Kress in Pittsburgh, PA

Why I Love Pittsburgh

I was born, raised, educated and began both my nursing and LNC career in Pittsburgh. The city is an epicenter for education, healthcare, law and the arts and to this day, over half of my legal work originates here. I love the blend of the beautiful city skyline and its outlying countryside and waterways. I have had the honor and privilege to be a member and serve the AALNC Pittsburgh Chapter since 2012 and attribute much of my success to my involvement with our organization.

Wishing everyone a Happy LNC Awareness Week!

Closing our week of celebrating with a Postcard From Pittsburgh, PA- Stephanie A Kress

Why I Love Pittsburgh

I was born, raised, educated and began both my nursing and LNC career in Pittsburgh. The city is an epicenter for education, healthcare, law and the arts and to this day, over half of my legal work originates here. I love the blend of the beautiful city skyline and its outlying countryside and waterways. I have had the honor and privilege to be a member and serve the AALNC Pittsburgh Chapter since 2012 and attribute much of my success to my involvement with our organization.

Wishing everyone a Happy LNC Awareness Week!

A Recipe for Success from Karen V***a

Success as an LNC isn't just about reviewing records.

It is also about creating habits to keep you fueled, focused, and prepared for opportunities.

𝗠𝗶𝘅𝗲𝗱 𝗕𝗲𝗿𝗿𝗶𝗲𝘀 𝗢𝘃𝗲𝗿𝗻𝗶𝗴𝗵𝘁 𝗢𝗮𝘁𝘀

Ingredients:
• 2 handfuls of mixed berries of your choice
(My favorites are blueberries and sliced strawberries)
• 1/2 cup rolled oats
• 1/2 cup vanilla protein shake
• 1/3 cup plain Greek yogurt
• 2 Tbsp. chia seeds
• Optional: drizzle of honey or maple syrup for more sweetness
• 2-3 Tbsp. mixed granola

Instructions:
1. Mix the rolled oats, vanilla protein shake, plain Greek yogurt, chia seeds, and optional honey or maple syrup together.
2. Refrigerate overnight or for a minimum of 4 hours.
3. When ready to eat, add in your mixed berries and mixed granola. Sometimes I might add some water if the consistency is too thick for my liking.

It is a satisfying breakfast before diving into medical records.

𝗕𝘂𝘀𝗶𝗻𝗲𝘀𝘀 𝗧𝗶𝗽 𝗼𝗳 𝘁𝗵𝗲 𝗪𝗲𝗲𝗸: 𝗖𝗵𝗲𝗰𝗸 𝗬𝗼𝘂𝗿 𝗦𝗽𝗮𝗺 𝗙𝗼𝗹𝗱𝗲𝗿

I recently noticed 2 emails in my spam folder that looked familiar.

One from a fellow LNC.
The other appeared to be from a paralegal with an attached file.

Before clicking anything, I contacted both to verify the emails.

My fellow LNC confirmed her email, resulting in a new case opportunity. The one from the paralegal?

It was spam.

Sometimes your next opportunity is sitting in your spam folder. Other times, it's a phishing attempt.

Here's to building healthy habits, growing our businesses, and continuing to learn from one another.

Happy LNC Awareness Week!

A day in the Life… of an LNC

As I drink my morning coffee, I scroll and make thoughtful reply posts to LinkedIn. Honestly, this is my form of marketing right now. It works for some, but not for others. I do this every day, whether I work clinically as a med-surg and ICU nurse or from home as an LNC. Folks do all sorts of marketing. Many do vendor tables at attorney conferences, lunch-and-learns at attorney offices, or get in front of local chamber of commerce meetings; send emails, make phone calls, or drop off materials/baskets of goodies in offices for marketing. All are viable options! Attending AALNC conferences in person has been beneficial.
Once or twice a week, I figure out a LinkedIn post to write and usually post it with a picture.
Then I gather my last-minute thoughts for a Zoom or phone call with an attorney for a case review and have that call.
I then check my email and respond to priority emails.
In no particular order, I do case triage, focused medical record review, research, scheduling and billing/invoicing, administrative tasks (such as organizing case files on my laptop, downloading or uploading files, blocking time on my schedule to get affidavits of merit notarized, make physical files for my cases, deposit checks, order office supplies, keep a running list of expenditures for tax purposes), report writing, chronology building, and research on medications, procedures, or standards of care.
As an expert witness, I still work clinically, so I am strategic about when I review records vs. when I work clinically. Sometimes this means I am working nights and weekends, and yes, even some holidays if necessary. But, getting deeper into my LNC practice, I am learning to be more thoughtful about my boundaries, about what cases I take and what timeframes I tell attorneys I can accomplish their medical reviews in. I no longer take “anything that comes along,” and I can be more selective. For instance, I find Epic and Cerner records much easier to navigate than Med Tech records. It takes me a very long time to review Med Tech records, and I do not particularly enjoy it. I will do them, but I know it will certainly take me longer to navigate than other records, so I allow extra time if I know records are coming in that form.
I belong to AALNC chapters, so I try to attend educational opportunities, meetings, and happy hours when my schedule allows. This serves the purpose of support for me in the form of getting questions answered that I might have and allows me exposure so others see me and my specialty, so they get to know me more (other LNCs tend to refer to those they know, like, and trust), and me giving support to others as well. I have also joined other groups, such as Facebook groups for LNCs, LNCExchange, and Juris Educational Resource Knowledge (J.E.R.K.). All these groups post about potential cases I may be interested in. When I see a posting for a med-surg or ICU nurse, I send my CV and fee schedule RIGHT AWAY. The early bird often gets the “case” in this instance.
As an LNC business owner, I always have my “business” on my mind. Some days, I get home from a 12-hour shift at the hospital, and I do not have the energy to do much more. Some days, I respond to an attorney's or paralegal's email during my lunch break from work. Some days, I do not have the information they need until I return home, but I do let them know that is when I will respond.
As an LNC business owner, you have the opportunity to make a business what YOU want to make of it. You get to set those rules. As an LNC subcontractor, you will follow someone else’s rules, but you also do not have to worry about the “LinkedIn” posts or other types of marketing. That is the beauty of LNC work. You get to make it what you want it to be.
Wishing everyone the best of luck as they venture forward in this journey.
Feel free to reach out if you have questions!
Denise Harvey

Wisdom from the Witness Chair
10 Tips for Testifying Experts and LNCs
Beth Ann Wagenbrenner Brant DNP, APRN, CPNP-PC, LNCC, AFN-C, SVFN-C, IVSE-C, NCSN-E, MCP-C

Whether you're preparing for your first deposition or your 50th trial, I hope these 10 tips help you feel more prepared, confident, and credible when it's your turn to testify.

1. First Impressions Matter
Your testimony begins before you speak. Arrive early, dress professionally and conservatively. Maintain a polished and understated appearance. You want the jury to remember your opinions – not your appearance.

2. Credibility
Your credibility is your greatest asset. Be honest, objective, and willing to say, "I don't know" or "I don't recall" when appropriate. An expert's strength comes from accuracy, not from having an answer for everything.

3. Listen First
Listen to the entire question before answering. A thoughtful pause is a sign of professionalism, not uncertainty. Answer ONLY the question asked and resist the urge to volunteer more information. NEVER interrupt!

4. Stay in Your Lane
Know the limits of your expertise and stay within them. It's perfectly acceptable to say, "That's outside the scope of my opinion." Staying in your lane protects your credibility.

5. Simplicity Wins
Your main role is to explain medical and nursing concepts in a way that the judge and jury can understand. Avoid unnecessary medical jargon and explain concepts clearly. Your goal is to educate, not impress.

6. Preparation
Preparation builds confidence. Review your report, the records, and the opinions you've formed, but don't memorize your answers. Know your work well enough to have a conversation about it.

7. Stay Calm
If opposing counsel becomes aggressive, DO NOT take the bait. Stay calm, remain professional, and let your demeanor reflect the confidence you have in your work. Jurors don’t like a bully attorney or a defensive witness. The expert who remains composed will leave a stronger impression.

8. Own Your Opinion
If your opinion is supported by the facts and your methodology, do not be afraid to stand by it. Confidence comes from preparation and integrity, not from arguing.

9. The Pause
Never be afraid of silence. Taking a moment to think before answering allows you to provide a complete, accurate response and gives your attorney time to object if necessary.

10. Your Body Speaks Too
Maintain good posture and avoid distracting gestures. Look at the attorney asking questions but when answering, engage the jury. They are your audience. Speak slowly and clearly so everyone can hear and understand you. Let your body language reinforce your testimony, not distract from it.

Testifying as an expert witness is both an honor and a responsibility. Your role is not to "win" the case or advocate for one side or the other. It is to educate the judge, attorneys and jury by providing objective, evidence based opinions grounding by your knowledge, experience and the medical record. Stay objective. Answer honestly. Protect your credibility. When you leave the witness stand, the jury may not remember every word you said but they will remember the impression you made.

Sharing a tip from our own member, Diane Mead

WAY BACK THEN . . .

I was minding my own business when Linda Fowler, LNC reached out with a referral to review a case. Literally, I was minding my “own business” which is called Bethany Hospice and Palliative Care. We started operations in 2005 in Western Pennsylvania after I left Corporate America a year earlier.

I was not looking to moonlight on another job as my 60-hour work week in a start-up company with 35+ employees was enough. Or so I thought . . . Linda’s call was different. She shared some details of the case she was sending and I was hooked. It was eye opening to see how other providers operate. Receiving this initial referral revealed opportunities to serve those who needed help navigating the hospice benefit, and an opportunity to create better processes for my own hospice company. I started to learn through others’ mistakes and utilized attorney perspectives to help shape policies and procedures for better patient outcomes. As I took on more cases, Bethany became better because I was proactive with care issues based on the cases reviewed.

I have provided legal opinions and testified to the standard of care in hospice according to CMS guidelines for this federally funded benefit.


THAT WAS THEN – THIS IS NOW:

I found it very interesting to review patient care processes and explain why the inner workings did/did not ensure that the hospice standard of care was met. ALL hospices must comply with the regulations and follow the rules to participate in this this federally funded program.

I have learned more than I ever thought from attorneys, other hospice providers, and communities about the reality of informed consent and understanding the hospice benefit. The results can be devastating when education, communication, and understanding are lacking.

While I continue to evaluate legal cases, my focus is transitioning to proactively educating the community and other healthcare providers as to how to administer the hospice benefit appropriately. Everyone wins when hospice is done right versus defending services because it was done wrong.

I have served in different roles in the Pittsburgh Chapter since joining, including President. The advice I want to give for THEN and NOW is the same – get involved! It doesn’t matter if you get involved in big or small ways – just get involved! Amazing people are guaranteed to cross your path!

If you’re interested in getting more involved, we encourage you to join a chapter! The link to join us can be found on our page or simply send us a message. We would love to have you!