The healthcare system today is increasingly fragmented. Patients see multiple specialists, and they end up scrambling to keep track of their treatment. Moreover, they are prone to confuse medical bills and insurance coverage. This is a challenge that even the most informed patients face. Healthcare advocacy can play a critical role in easing patients’ challenges while navigating the healthcare system.
Healthcare advocates give patients and their loved ones much-needed customized assistance navigating the healthcare system. An advocate will assist patients in accessing health care, help them make informed decisions, and guide them through insurance questions, medical care, and legal and administrative tasks. Families can hire personnel who work for advocacy organizations or independent health advocates. Insurance companies, hospitals, and employers may also offer patients health advocates. This piece focuses on the things you need to know about patient advocacy.
What Do Patient Advocates Do?
Patient advocates such as GNAnow Patient Advocates assist patients and their loved ones in many ways. They communicate with doctors, work with insurance companies, find legal help, and set screening and tests. They are there to make all the aspects of the patient’s medical care as less complicated as possible.
Some patients have to deal with a scary diagnosis, and it is at such times that the healthcare system becomes overwhelming and confusing. A patient’s advocate works as that individual’s guide and could be more than that. The Institute for Health Improvement describes patient advocates as sponsors, supporters, believers, campaigners, promoters, backers, spokespeople, and campaigners.
A social worker, a loved one, or a chaplain can sometimes fill the role of patient advocate. Hospitals have also added professional staff to fill that void in recent years. Patient advocates may also work for businesses dealing with health care advocacy or independently.
What Are the Key Responsibilities of a Patient Advocate?
As mentioned above, what patient advocates do may vary. Here is a rundown of the key responsibilities:
- Assist patients in understanding their financial responsibilities and insurance coverage. They may also negotiate healthcare plans on behalf of the patient with the facility. The advocates strongly understand how the healthcare system works and the medical billing process.
- Handle patient complaints or those from their families and report them to concerned authorities in the facility. They excel in interpersonal skills, problem-solving skills, and communication. These attributes go a long way in ensuring that the patient’s concerns are resolved to their satisfaction.
- Patient advocates explain patient rights. This is usually necessary whenever a patient wants to check out of a hospital against medical advice. The advocate employs communication skills and empathy to convey the requisite information for patients to make the right decision.
- Assist a patient’s loved ones in understanding what has happened and what they can do.
- They work with the financial and billing departments in the hospital to ensure patients get accurate invoices. They act as intermediaries between the insurance company and the provider and greatly understand how medical billing and coding work.
What Questions Can Patient Advocates Help You Answer?
Most advocates earn certifications, while some have worked as registered social workers, health plan administrators, or nurses. That combination of training and experience will help you find answers to questions such as:
- Where to go for care?
- Whom to contact if you need care on the weekend or evening?
- How to get financial assistance for your care?
- Whom to talk to when you feel overwhelmed?
- How long will you have to wait for your next appointment?
- When to go home
- How to switch to a different provider
Do You Always Need a Patient Advocate?
You don’t necessarily always need a patient advocate. You are good to go if you can process medical information and make informed decisions about your care. Also, a supportive family member, friend, or partner may remove the need for a patient advocate.
You can advocate for yourself if you are up to the task. You can also seek the support of an advocate further down the line if the need arises. It is worth noting that you and your caregiver must be willing to question the system, speak up, and understand your rights.
How to Find a Patient Advocate
You won’t have to look far to get a patient advocate. Some are staff at medical facilities, and others are volunteers for non-profit organizations. You can also get advocates from private practice.
Below are some resources to help with your search for an advocate/.
- National Association of Healthcare Advocacy (NAHAC) – The NAHAC directory can assist you in finding an advocate by area of expertise and location, or both.
- AdvoConnection. The directory connects you with offering services in your area. It is worth noting private advocates charge a flat rate or hourly fee.
- Hospitals. Many facilities have advocates on staff to handle grievances and complaints.
- Employers. It is in your best interest to understand whether your employer offers advocacy services as part of their benefits package.
Closure
Patient advocates are there to assist patients who do not feel comfortable or can’t speak up for themselves within the healthcare system. They provide other services, as this piece covers, ensuring you have an easy experience.
It is essential to settle for an advocate that is qualified, experienced, and has skills for the job. Interview potential advocates and ask for references before making a decision.
