Patient Advocates assist patients being treated at a medical facility, and they help answer any questions or concerns the patients may have regarding their care and the health care system. The patient advocate acts as a liaison, facilitating communication between the patient and medical professional during the patient’s stay in the health care facility. The advocate’s duties vary depending on their employer, but they include interacting with newly admitted patients, documenting and investigating patient complaints and issues, following up with patients, and performing analysis on the overall quality of care at their institution.
When working directly for a hospital or another medical facility, the patient advocate’s job is to help the patient and their employer; patient advocates ensure that the hospitals work to improve its services to prevent future claims or issues. When working independently, patient advocates work with the patient and their family. They help individuals learn how to choose the best insurance policy, get the most from their benefits, and follow up with medical service providers, as well as provide assistance and support to patients who may have been denied services. Also, some patient advocates help clients work with employers for insurance- or job retention-related issues.
This position may be either part time or full time, and the hours may vary depending on the organization and type of clients. Patient advocate jobs require a minimum of a high school diploma or equivalent. Experience working with customers or patients in a related role is required, and experience working with the Medicaid/Medicare systems are a plus. Excellent written and oral communication skills are needed, and the patient advocate must adhere to patient confidentiality standards at all times.
Patient Advocate Tasks
Schedule and confirm patient appointments, check-ups and physician referrals.
Answer telephones and direct calls to appropriate staff.
Greet visitors, ascertain the purpose of visit and direct them to appropriate staff.
Compile and record medical charts, reports, and correspondence.
Interview patients to complete insurance and privacy forms.
Like the for-profit advocacy groups, patient advocates in the shape of healthcare assistants are in the early years of building an actual career to help patients in these ways. Not that patient advocates are new; in fact, many of them have worked as “case managers.” The roots of case managers most often come from social work, and these advocates have been coordinating care for patients for many years. Because they work directly with the patient, they are highly trustworthy.
In the past several years, however, there has been a shift in the way these professionals build their lists of services. Some are former doctors, nurses or other trained healthcare professionals who help patients through their decision-making. Others are good organizers and can provide transportation or even bill tracking and payment assistance. Still others provide transition assistance as older patients move into assisted living and nursing homes.
If you are interested in becoming a patient advocate, it’s best to understand this scope of possibilities. You may also wish to start your own patient advocacy business.
Why Should You Pay for Private Advocacy Services?
While so many of the services we get for our health care are covered by our insurance, individual advocates are not. That may initially sound like a negative — that to get help from a patient advocate or navigator you would have to pay for the service out of your pocket. But that’s real to your benefit. Here’s why:
When services are covered by your insurance, they are, by definition, limited. Your doctor won’t spend as much time with you because she will only be reimbursed X amount of money. Or, your stay in the hospital will be limited because your insurance only covers X number of days. Your insurance dictates your care.
But when you pay for something privately, then the only limit is your limit, what you are willing to pay for. And when you hire an advocate to be on your side, it might be the advocate who knows how to squeeze an extra 15 minutes out of the doctor appointment or the extra few days out of your hospital stay.
The whole point is to improve the quality of your care by having an expert on your side who is solely devoted to that improvement in the quality of your care.
Look at it another way: The reason you hire a real estate broker to help you buy or sell a home is that he or she is the expert. Sure – you could buy a “for sale by owner” without a broker — but what if something went wrong? You don’t know what you don’t know — but brokers do know because they deal in real estate every day. So it’s worth the extra expense.
The reason you hire a CPA is that you want an expert to help you with your taxes. Sure, you could use tax software, or a pencil and a calculator, and do it yourself. But what if you missed a deduction? Or what if you don’t understand a form? Again — you don’t know what you don’t know — but a CPA does know because that’s her area of expertise. It’s worth the extra expense.
Those examples address your home and your taxes. And neither is nearly as important as your health, or your life. So spending the money on a professional advocate is worth it – because you don’t know what you don’t know.
How the Cost of Advocacy Services is Determined
The cost to hire a private advocate will depend on a few things:
1. The types of services and complexity of your need.
There are perhaps dozens of services health advocates might provide to you. These range from explaining your treatment options to reviewing your hospital bills, from uncovering clinical trials appropriate to your need to getting your insurance company to pay a claim you think should be covered. Each service will cost something different to accomplish, mostly as a function of the time it takes to achieve it.
2. The background and expertise of the person you will hire.
Just as would be true in any service business, the more credentials an advocate has achieved, the more it will cost to hire that person. A physician who has gone into private advocacy practice will charge more for her services than someone whose expertise has only been developed by helping his wife through her cancer diagnosis. The person who has worked in health insurance claims for ten years will charge more than the person who just finished taking a weekend course in how to get the insurer to pay up.
Further, some advocates have developed specific niches to their work which becomes a benefit to you, and will be worth a higher price. It could end up costing you less in the long run because that person is so good at what he or she does.
If you need to determine your next steps after a devastating cancer diagnosis, then working with an expert in Shared Decision Making may cost you less and provide more quality of life. Decision aids are pre-developed by experts. You will save over hiring an advocate who would have to research your options on her own, then walk you through the pros and cons, and would charge you for the time it took her to do all that research.
It’s important for you to establish and understand the credentials of any advocate you hire. That’s one of the recommendations in a list of questions that help you choose the right advocate for you.
3. Your geographic location.
Just as there are variations in cost for almost anything we buy based on where we live, the same goes for health advocacy services. A medical/navigational advocate with a nursing background in San Francisco or Boston or New York City will command a higher hourly rate than someone with the same experience who practices in Boise, Syracuse or Amarillo.
How Much Will You Have to Spend for Private Advocacy Services?
Because there are so many variables, it’s impossible to put an accurate price tag on the cost of advocacy services, and it’s even harder to assign them a value.
The value point is important. For example you might pay a lawyer $500 to draw up your will, which you could have done yourself, online for $50. Or you might pay a lawyer $500 to keep you out of jail because you didn’t pay for your speeding ticket. There’s a lot of value in that $500 that kept you out of jail!
That’s the kind of value you can get from a private advocate. Spending a few thousand dollars doesn’t sound like so much if you know your life will last longer, or your quality of life will improve, or your pain may go away.
Please don’t translate that to mean that an advocate will cost you a few thousand dollars. Her services might – and even so, that might be a bargain. Or, it could be that your needs require only an hours’ worth of work, ranging from $75 to $500, depending on those variables described previously, or a month’s worth of work that may reach into the many thousands.
Interview Advocates to Determine Costs
Interviewing advocates cost nothing. Interview them, ask questions about how they can help you, their qualifications, and what they charge. Many suggest you pay them to don an assessment of your situation and possibilities. Even that cost will be worthwhile to learn more about what you don’t even know to ask about. That’s the reason you’ve gotten in touch with a professional to begin with.