Health Newcomer: The Patient Advocate

The average doctor visit lasts less than 15 minutes, so if you've got lots of questions—about your illness or medical bills or insurance claims, what do you do? Until now, your recourse has been to ask a nurse, social worker, or the staff at your health insurance company.

Over the past decade, however, a go-to person known as a patient advocate has appeared on the health care roster. This person can provide answers, education, support, and care to patients.

Patient advocates fulfill many roles, even, in some cases, staying with hospitalized patients around the clock to help guard against medical errors, says Betsy Gardiner, R.N., president of Health and Patient Advocates in Arlington, Va. “Their educational and professional backgrounds vary, so check references carefully before hiring an advocate,” she says.

Differing credentials

Some advocates have medical training, others don’t. Some have worked in hospitals or doctors’ offices. Some are consumers who have spent time advocating for themselves or family members and are willing to share what they’ve learned.

Advocates’ services aren’t certified and tend not to be covered by insurance. Consumers should have a clear understanding of charges for services and payment options before hiring an advocate.

“There’s no standard fee for services, either,” Gardiner says. “Some advocates charge next to nothing; others anywhere from $100 an hour to thousands of dollars a day.”

Still, if you can afford it, the services of the right advocate could end up saving you money if medical claims are processed correctly.

“Plus, there’s really no way to put a price tag on peace of mind, if an advocate can help you feel less beleaguered by the health care system or better informed about your condition,” says Gardiner.

Services for hire

Advocates vary in the services they provide. Here are some examples:

  • Health care management. Major conditions can generate piles of bills and insurance forms. Some advocates organize medical records and help resolve insurance coverage disputes.

  • Condition and treatment education. People diagnosed with cancer, heart disease, or any other complex condition can hire an advocate to answer questions and investigate relevant clinical trials and research.

  • On-site support. People with complex treatment plans may find it helpful to have someone at their side to make sure the right questions are asked and important procedures are followed.

  • Facility searches. Hiring an advocate to research and present suitable nursing or stroke rehabilitation options can be cost-effective, especially if the loved one in need of care is in another state.

A working relationship

Some doctors welcome the extra set of eyes and ears an advocate can provide. Others find the presence and opinions of an extra person unnecessary, at best, and intrusive and distracting, at worst.

“But as long as health care remains as complex and as prone to mistakes as it is,” Gardiner says, “advocates are likely here to stay.”

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