Who We Are
Mary Ann Gilman, RN, CEO
Mary Ann, a professional Registered Nurse for over 20 years, has provided direct patient care and supervised caregivers in a variety of medical settings. She has been charge nurse of hospital units, administrator of home health care agencies, and director of outpatient psychiatric programs. She has developed, marketed, and managed many health care services.
Her introduction to case management was with providers of home health care and infusion therapy for private duty and Medicare recipients. She has performed pre-certification and concurrent on-site and telephonic reviews for group health insurance. She has also reviewed medical records, prospectively and retrospectively, for disability and workers compensation and managed peer to peer physician reviews. Mary Ann serves as Treasurer on the board of directors of the Dallas/Ft. Worth Chapter of Case Management Society of America.
In starting long-term care claims services for an investigative company, Mary Ann developed assessment tools for insurers, drawing on her home health experience in performing onsite assessments. She designed customer-specific tools and managed a case coordination program to assist long-term care insurers with maximizing cost-containment on claims through ongoing monitoring of claimant condition, care needs, and care provision. In addition to providing customized handling of expedited medical records retrieval by phone and fax, Mary Ann facilitated claims investigations utilizing licensed investigators for background checks, pharmacy canvases, and in-person medical record retrieval.
With her broad background in nursing and knowledge of long-term care claims, Mary Ann marketed and implemented specific claims solutions for insurers. She was the account manager for 38 customer accounts, providing sales and service on numerous long-term care claims products. She negotiated contracts with home health care agencies and individual licensed health care professionals to perform assessments and other services across the country.
Throughout her career, Mary Ann has gained extensive knowledge of elder care, community resources, payer requirements, care providers, contract stipulations, and governmental regulations. She has personally written grants and responses for proposals for health care concerns and has presented programs on fraud identification and prevention at national long-term care insurance conferences.