As our mission states, we are going to provide consumers with information about Healthcare Advocacy and other related topics. To start, we are going to set the stage to introduce you to Healthcare Advocacy, what is a Healthcare Advocate and Why is a Healthcare Advocate is important. We will provide specific suggestions, solutions and tools for the consumer to use.
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Our inaugural newsletter told a scary story about Jay Herron, Co-founder of Healthcare Advocacy Insights and his Medical Emergency. His Medical Emergency highlights how the medical treatment process can vary significantly within the same Healthcare System. It further shows how a patient is “Set Adrift” without information and follow up instructions.
The reason for sharing the story is to “Connect the Dots” when a Medical Emergency happens to you or a family member. “Connecting the Dots” will show how a healthcare advocate can guide a patient through a very
fragmented process.
So, let’s begin.
Navigating the U.S. healthcare system can be scary and confusing. You may ask yourself, Am I getting the best care for my current medical needs? Should I get a second opinion? And other important questions. You may wonder if a prescribed treatment is necessary or if an expensive prescription is worth the price. You might even struggle to understand your medical bills or wonder how you’re going to pay for them.
At times like these, you could use a champion —someone to support you through your healthcare journey. That someone goes by the title “Healthcare Advocate.”
As we “Connect the Dots”, our first step is to start with the foundation of Healthcare Advocacy. This will help the Healthcare Consumer to understand their current level of Advocate support. In addition, we will start “Connecting the Dots “by explaining Advocate responsibilities, questions to ask, benefits and how to find an advocate.
Healthcare Advocacy Defined
Everyone getting medical treatment should have someone to support them to help raise questions, take notes, enhance communication with medical staff and make sure they are receiving patient-centered care. This person is called a Healthcare Advocate. An advocate can also help organize support from others, run errands, and generally support a patient’s needs throughout their care and treatment.
There are three (3) different ways we can define a Healthcare Advocate. The following helps you decide which approach you can take.
1. PROACIVE Healthcare Advocate
A Proactive Healthcare Advocate refers to the efforts made organizations to support patients in accessing healthcare services, understanding their rights, and making informed decisions about their health. Advocates are professionals hired by patients to assist patients in various ways, including navigating complex medical systems, understanding treatment options, and addressing billing issues. We have included a list of Healthcare Advocate resources.
2. Default Healthcare Advocate
Unfortunately, the most common is a Default Healthcare Advocate. Since most healthcare consumers are not prepared for a medical emergency, a family member or a friend by default becomes your advocate. The Default Advocate will provide the same services as a hired advocate.
3. AI Healthcare Advocate
Which “Dot” do you connect too? Take some time to make that determination.
Healthcare Advocate Responsibilities
Healthcare Advocates are equipped to help with a range of medical and financial concerns. The list below outlines what patients can expect.
· Schedule your medical appointments, tests, and treatments
· Coordinate financial and legal resources
· Connect with support groups or agencies
· Help lower your medical costs through insurance
· Liaise with your provider’s case manager
· Resolve issues with your health plan or providers
· Clarify medical bills
· Review healthcare options with you
· Arrange second opinions
· Identify billing errors and negotiate to save you money
Questions a Healthcare Advocate Can Assist in Addressing
Most patients are unsure what to ask healthcare providers. The following list of questions may help guide you.
· Where will I receive care, and what are my transport options?
· Who do I contact for evening or weekend care?
· Can you explain my health condition?
· What are my treatment choices?
· Who can I speak with if I’m overwhelmed?
· How do I get financial help for care?
· Can you clarify my medical bills?
· How long until my next appointment?
· Can you help me switch providers if I’m unhappy?
· When can I be discharged?
Who May Benefit from a Healthcare Advocate?
If you are receiving treatment from a health care system you need an advocate — that is, someone (whether family, friend or a professional) to provide support to the patient and family, and to guard against any of the many mishaps that make medical error one of the leading causes of preventable death in this country. The sicker, less “on top of things” the patient is, the more that an advocate is needed.
Healthcare Advocacy can be misunderstood as to how important it really is. The average consumer has no idea how it works. Our goal is to fill that gap with common sense and easy to understand information.
Ways to Locate a Healthcare Advocate
You don’t have to look far to find a healthcare advocate. Some advocates are on staff at medical institutions, while others are volunteers at non-profit organizations. You can also find advocates in private practice.
Unless you really want to meet in person, you can communicate with your advocate through an app, text, email, video chat, or a patient portal.
These resources can help you start your search:
AdvoConnection. This directory provides access to individuals or businesses offering patient navigation services locally. Private advocates typically charge by the hour or offer a flat rate.
National Association of Healthcare Advocacy (NAHAC). The NAHAC directory allows users to search for an advocate by location or area of expertise.
Patient Advocate Foundation (PAF). PAF supplies free case management assistance for patients or caregivers dealing with one of the listed serious or chronic health conditions.
Hospitals. Many hospitals employ advocates who address complaints and grievances related to inpatient stays. Hospital advocacy is included without additional costs and may be available post-discharge.
Senior living facilities. Nursing homes and assisted living communities often have advocates available to assist with problem resolution for residents and caregivers. Their services are part of the facility fees.
Health plans. Health insurers may provide a case manager, such as a social worker or registered nurse. It is recommended to confirm any limitations on service frequency or duration with the provider.
Employers. Some employers may include patient advocacy services within their benefits packages.
PS Financial Advocacy: Some healthcare advocates may lack expertise in medical financial issues such as billing, coding, denied claims, or appeals. Specialized companies handle these concerns; examples include Resolve Medical Bills, Clear Healthcare Advocate, Amazing Healthcare Consultants, and Medical Billing Gurus. Search online to find more options.
Anticipated Topics of Upcoming Newsletters
How to Develop a Proactive Planning and Emergency Check List
Are you Prepared for a Medical Emergency
What is a Healthcare Proxy
What is a HIPPA Release Form
What is the Durable Power of Attorney
What is the Patient Bill of Rights and Responsibilities
A Healthcare Advocate Checklist
Jays’ story sets the stage to “Connect the Dots”. By understanding the foundation and understanding of Healthcare Advocacy, the healthcare consumer will be in a better position to respond when a medical emergency happens.
Our next newsletter will guide the consumer through how to develop a Proactive and Emergency Preparedness Check List.
Share your feedback in our newsletter. If you have a story for our readers, email us with details and contact info. All messages are kept confidential.
OUR EMAIL ADDRESS: advocacy@haiadvisors.com