The Benefits of Having a Patient Advocate

Patient-Advocate

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!














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7 Comments
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  1. Cherie

    Nice article on one way to be a more informed Health Care Consumer. It’s important that we ask questions of our providers and facilities rather than just accepting recommendations blindly.

    • Hi Cherie – Sometimes we don’t know the right questions to ask, and that’s where a patient advocate can help. I’m always of the opinion that we should always seek outside opinions anytime we’re facing a complicated situation. I’ve never used a patient advocate, but I have friends who are in the medical field (one is a doctor) who I consult with regularly anytime I don’t understand something. It really helps!

  2. Over the course of a year, I received no less than 14 bills that were WRONG from MacNeal hospital in Berwyn, IL. Basically, I was charged for the “discount” deducted. Bills 1-9 I took care of by printing up my insurance information and sending a copy. They never replied, but did not bill for that again. Wrong bills 10 and 11 came on the same day, so I sent everything to the corporate. I did the same with bills 12 and 13. Number 14 went to the CEO. Then the hospital called saying that it was due to “training errors” and the hospital administrator would go over my bills personally. There is a billing agency whose address is on Payshpere Circle in Chicago. They bill for a number of health care providers. The doctor bill from a different biller was always perfect. That begs the question: what happens to the over charges they collect? I saved me thousands of dollars to check the bill against the insurance online.

  3. clydewolf

    After a stroke or heart attack one may not have time to locate and consult with an advocate.

    With this complex health care system we have created, I some times ask if I am better-off than my grandfather or father? Yes medical science can do many near miracles. Medical science can keep us alive for a very long time (read about Karen Ann Quinlan http://en.wikipedia.org/wiki/Karen_Ann_Quinlan), and that longer living period has created another industry, nursing homes. In some situations the prolonged life is not what the patient would want and one over which they have no control.

  4. Health care advocate is a good way to assist people having problems with health care problems. How I wish all companies have this people in their rooster to assist employees with their needs.

  5. The use of “Patient Advocates” have been around for years. My wife was assigned one around 10 years ago from our insurance group when she got sick. Our medical bills were quickly approaching the one million dollar mark due to the life saving measures that the medical professionals were using for her. We understood that the patient advocate (P/A) was on the side of the insurance company and that was her focus. My wife and I saw this as an asset to help us stay organized with the barrage of bills coming in when we were fighting for my wife’s life. Our (P/A) taught us that it was okay to question doctors, procedure and recommendations. This was a counter cultural to the way we were raised not to question doctors. It has taught us that all of the people in the healthcare system are human. They can err and they need the Savior as much as you and me.

  6. Hospitals employ nurses that have the title of Patient Care Advocate. Be aware that although they market themselves as being liasons for the patient, their focus is to discover what clients are unhappy enough to sue the hospital. Disguising themselves as advocates allows them to discover the details of an event that took place. It is then their role to contact the hospitals risk management department, meanwhile they are to make the client feel listened to and validated which has been proven to minimize the chances of a lawsuit. They will also twist/turn the events to make someone believe that perhaps they misunderstood what happened at the hospital. The advocate will always be an attractive person with a nice personality as this also is a strategy to minimize their being sued. Be aware that most department managers at hospitals are now held by attorneys although their name tag will not show that. I have worked in several Saint Louis Hospitals for more than 33 years. being informed is your best defense and knowing a healthcare professional who can give you sound advice from the inside of the system is your best bet.

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