Most of us only have a vague understanding of the healthcare system. It’s not just the incredible number of therapies, treatments, and procedures that are within the realm of possibilities, but also the financial entanglements it can create. Fortunately, there’s a calling known a patient advocate who can help us sort through it all.
What is a Patient Advocate?
In the most general sense, a patient advocate is a person or organization that acts as a liaison between the patient and healthcare providers. They are case workers, typically having a background in healthcare – such as registered nurses – or social work.
Some of the functions that a patient advocate performs include:
- Providing explanations of medical procedures to be performed.
- Providing options to the recommended treatment.
- Disclosing the cost of various treatments.
- Completing paperwork for admissions.
- Helping the patient navigate the healthcare system.
- Filing paperwork with insurance companies.
- Following up with the patient, healthcare provider, or insurance company.
- Recommending follow-up treatments and therapies for a patient.
- Arranging outside support services, such as counseling.
If you hire a patient advocate to represent you, it could cost $150 to $200 or more per hour, but there may be less expensive and even free services available if you can’t afford the cost.
Some employers offer patient advocacy as an employee benefit. Hospitals often have them on staff, however it’s important to understand that one employed by the healthcare provider may be required to represent the provider’s interests first. There are probably patient advocacy sources provided at the state level as well. If you are unable to find a free source, check out the Patient Advocate Foundation to see what they may have available.
Why might you need a patient advocate?
The Healthcare System is Too Complex for Ordinary People
This is a fact of life in the 21st century. Unless you work in the healthcare system – preferably on the clinical side – you will be confronted with terms, procedures, financial entanglements and other complications that seem to be beyond human comprehension.
It’s not just that you or me or anyone else lacks the brain power to understand, it’s just that it really is that complicated. Not fully understanding the process could result in unnecessary treatments, missed opportunities for better alternatives, and spending more money than is necessary.
A patient advocate can help you navigate the system, as well as many of the complications at the periphery.
It Promises to Get Even More Complicated
If you‘ve been following the unfolding of the oncoming Affordable Care Act, a.k.a., Obamacare, you know that healthcare is threatening to get even more complicated than it is now. This will be true if only because the Act is requiring a very long list of changes, and change only means greater complexity.
You Need Someone Inside the System Who is Working on Your Behalf
A patient advocate can help you to work with the system. The advocate has greater understanding of the process flow, the clinical implications, and the financial requirements.
Even more important, they will have access to people in the system who can help to expedite your case. Not only do they know exactly who to contact, but they can get in touch with them much quicker than you could on your own. When you are pressed to make important decisions in a hurry, that fast access can be a critical factor.
If money is an issue, the patient advocate can guide you in a way that will minimize the direct cost to you, and even make recommendations for payment options or financial assistance.
Warning: Having a Patient Advocate is No Reason to Not Get Involved
With all of the positive effects a patient advocate can have on your case, it’s important to remember that they are there to assist you, not to completely relieve you of the burden and responsibility for your case. It is much the same as hiring an investment advisor to help you to choose investments and manage your portfolio. They can make recommendations, but you still need to be aware of what is happening and to contribute to the process.
You will need to learn all that you can about your condition and the treatment options. And you will also need to get involved in some of the mechanical processes, particularly if you are paying the advocate. $200 per hour is a heavy fee to pay for gathering general information or making follow-up phone calls. Ultimately, you are responsible for the outcome – the patient advocate is there to help you do that. But they can make it faster, more efficient, and less expensive along the way.
Have you ever used a patient advocate? Leave a comment with your thoughts!