The healthcare system can be challenging to navigate and can be confusing, especially during a time of illness. To have someone on your side, to help you with the ins and outs of doctor visits, insurance companies, and social support may sound too good to be true. Well, a patient advocate will do just that and more. A patient advocate is a healthcare professional that looks out for your best interests and guides you through the healthcare system.
Insurance is confusing and can be hard to interpret. A patient advocate will help you understand your policy, what’s covered, and if there will be any additional expense to you after insurance. Your advocate will also be able to help you if you have coverage through multiple insurance companies.
As a patient, you have certain rights. For example, if you wish to check out of the hospital, you have the right to check out against medical advice (AMA), but that comes with some concerns. Your patient advocate will be able to explain what happens, why you might want to stay and provide any additional information you need to make an informed decision regarding your health care.
Some advocates specialize in billing or payment support. Your advocate can explain what’s on your bill and what the charges are for, exactly. They will also be able to negotiate on your behalf with insurance or hospital billing departments. They can work out payment plans, dispute denied claims, and in some cases arrange for co-pay relief.
Your patient advocate will be your voice when it comes to addressing complaints, too. If you or your family have issues with your caretaker or housekeeping, they can handle these minor issues for you. On the other hand, if you experience an unprofessional physician or staff member, the advocate can escalate your complaint to the proper channels until a resolution is found.
Do you have family that is far away? Alternatively, perhaps they are not able to attend doctor appointments or tests with you? An advocate will work with your family and make sure they understand what is happening. They will explain tests, procedures, diagnosis, and even treatments available to you. Advocates can help arrange for in-home care, home medical equipment drop off, and prescription fills or re-fills.
When searching for a patient advocate, you can consult your local hospital or doctor’s office. Be sure to let your healthcare team know that you are working with an advocate and list them on your HIPAA forms. If they are not listed, your doctor will not be able to release any of your medical information to them. Advocates can be extremely helpful in cutting through all the healthcare red tape and making sure that you have all the information necessary to make informed decisions. There is usually a fee associated with hiring a patient advocate, and those fees can vary depending on your location.