In the complex and often bewildering world of health care, many individuals feel the need for additional advice or help, which is the primary role of a patient advocate. But understanding what these advocates do for those in their care is crucial, both to assist those who choose this career path and to inform individuals who may need to call for their assistance. Below, we’ve compiled a list of the five primary responsibilities advocates fulfill.
1. Powerful Company
One of the simplest but most important aspects of an patient advocate’s position is that of a companion. While they are also educated to offer advice and negotiate with third parties, patient advocacy’s priority is the comfort and peace of the patient. Many people who undergo procedures, fall ill or grow old are alone. Without the support network of a family or a community of friends, the experience can be frightening and disorienting. That can represent a host of complications, from stress or panic to impaired decision-making skills.
Advocates are compassionate, but they also have the advantage of being removed from the direct emotional repercussions of medical choices. That means they can accompany you to the doctor’s office and ask difficult questions while you are absorbing a diagnosis. They can help you seek a second opinion, or they can accompany you during your time in the hospital. These specialists can also visit you in your home during convalescence to ensure that you are recovering as you should be. Ultimately, they act as an interlocutor between patients and the medical or insurance businesses, using their skills to ensure that patients are not taken advantage of or abused.
2. For Purposes of Insurance
Navigating the maze of insurance claims, payments, and correspondence can be mind-boggling on the best of days. Especially if patients are undergoing stressful procedures, have suffered injuries or are having trouble coping with the myriad details of illness, injury, recuperation, and therapy, the intricacies of insurance policies are the last thing on their minds.
Patient advocates assist individuals with selecting the insurance plan that is appropriate for their needs in both short and long-term perspectives. They may also assist in the interpretation of policies, track and respond to communications from the insurance provider, and mediate any disputes related to coverage of essential procedures or care.
3. Medical Billing and Integrity
There are numerous cases in which accidental oversight or intentional padding of medical bills lead to fraudulent charges against a patient. Many advocates are trained to interpret billing language. They help patients keep track of medical visits and procedures. In the event of a disagreement or an unclear transaction, these individuals will contact and effectively negotiate a clear understanding with the health care provider. Should clarity not be attained, they may also enter more complex negotiations to reconcile disputes or incorrect billing for services and treatments.
4. Interpretation and Exploration of Patient Options
In cases that warrant the consideration of End of Life options—whether that includes hospice care, pain management regimens, or grief counseling—advocates are trained to offer support, active care, and advisement. They can also provide rigorously researched options for assisted living care or in-home treatments and rehabilitation. For individuals who are considering options for elderly relations or parents, this skill set is invaluable because it applies a focused and educated opinion or appropriate skill sets to the many options for care.
5. A Healthy Start
There are also advocates for expectant parents. In the U.S., the infant mortality rate has fallen drastically in the past few decades. However, the maternal mortality rate is the highest in the developed world. This is mainly due to a healthcare system that does not include the mother-to-be in her care and treatment. What advocates of expecting patients can do are asserting the right of the mother to be a participant in these decisions. They can provide advice about prenatal care. If the mother wishes, they offer suggestions and recommendations for in-home birthing, including doula services and water birth preparations. Their sole concern is to ensure the safest possible experience for mother and child before, during, and after birth.
The labyrinthine structure of the healthcare system—from insurance policies to appointments with specialists and surgeries—can be baffling. Patients who feel they are unsupported can wind up making poor choices or being taken advantage of by these vast and impersonal systems. This is why the patient advocate exists, to communicate with health care personnel and insurance providers, dispute unclear or fraudulent billing, negotiate existing bills, ask difficult questions at the moment, and provide companionship, consultation or both to patients.
See also: What is a Nurse Advocate?