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Jim was the CEO of a construction company in Northern Alberta. He was 43 years of age. He developed an abnormal heart rhythm. He was investigated with a cardiac echocardiogram. This showed his right ventricle to be markedly enlarged.
The doctors assumed that Jim had Arrhythmogenic right ventricular dysplasia / cardiomyopathy (ARVD/C) which is a rare familial disorder that may cause ventricular tachycardia and sudden cardiac death. Jim was not able to access specialised cardiac investigations in his Northern Community. Jim was a concierge care customer at a private healthcare clinic but the clinic was not able to investigate his condition.
Jim retained RCM Health to assist in determining what options were available to him for further investigation and care. A noted cardiac surgeon at a major US University medical centre had assisted RCM Health in the past. He referred Jim to a very experienced cardiologist at the same medical centre. Jim was fully investigated. He was found to have a patent foramen ovale. This is a hole between the atria or upper chambers of the heart. This leak was causing the enlargement of the right ventricle.
The cardiologist offered to close the opening with a small device without operating.
RCM Health asked the finance department for a case rate. We got a quote of $215,000 for the procedure. RCM knew the procedure costs $15,000. The hospital asked for a deposit of $215,000 to proceed.
We discovered that the hospital priced the $15,000 procedure and had included the cost of $200,000 for possible complications. We learned that if there were no complications, that the $200,000 would be returned to Jim. This required a discussion with the CFO at the medical centre and we confirmed this in writing. Jim had no complications and had the $200,000 returned after the procedure.
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