Guide to Hiring an Advocate

You may not really know what services you need, but you no doubt know the problem or challenge you’re experiencing. Is your situation related to financial issues, including health insurance and/or medical bills? Or clinical issues, such as your diagnosis, treatment, healthcare providers, or a healthcare facility? Or both?

Sometimes the line isn’t completely clear between financial and clinical issues, like when your health insurance denies a request for a certain rehab facility or medication and you have to choose an alternate treatment or place to get care.

Don’t worry! We’ll help you sort out what’s really going on and how to get resolution.

Many advocates focus on either financial or clinical issues. Some work on both. Make sure whomever you hire works on the types of issues you have.

Some advocates have clinical training and experience, like nurses and doctors. If you have a complicated health condition or need an expert to review your medical records to help you determine the best treatment plan, you may want to hire an advocate with clinical training.

Some advocates used to work in healthcare provider organizations or health insurers, so they know how the system works from the inside. If you’re fighting a medical bill or an insurance decision that didn’t go your way, you may want to hire an advocate who has experience from working in these types of organizations.

Other advocates turn their personal experiences navigating care for themselves or a loved one into their career. These advocates have been in your shoes and can be great guides through the system.

Whatever your need or your preference, there are advocates who are equipped to help you.

Most of the work an advocate does can be done remotely. If your situation can be supported from a distance, that opens up your choice of advocates.

If you need someone with specific knowledge of a local healthcare provider or insurer, you may want someone who has worked in your area, whether or not they are based there.

But if you need someone to go to medical appointments with you or a loved one or to check in on you or a loved one in a hospital or other facility, obviously location matters. If that’s the case, filter advocates by location AND make sure they provide in-person services.

It’s important that you feel a connection with your advocate. Do you feel heard and understood? Do they give you confidence and comfort? Is it easy for you to communicate with them? These are some things you can only get by meeting someone.

Many advocates offer a free meeting that you can use to get a feel for the advocate’s style and how they might be able to help you.

At Umbra Health Advocacy, we offer free 15-minute consultations for just this purpose. Schedule your free consultation here.

Any interview or even a brief consultation may be helpful to point you in the right direction, but don’t expect an advocate to solve your issue or answer all your questions in 15 minutes. Any complex situation will probably require more time. See Umbra Health Advocacy service packages here if you want to jump right into the help you need.

Fifteen minutes can go by fast. Plan ahead to get the most out of that time. See our Advocate Interview Guide below for specific questions you can use, but here are the types of things you may want to find out:

a. What are their credentials?

There’s no one right profile or credential for an advocate. Great advocates can have a wide range of credentials or backgrounds. That said, it’s fair to ask an advocate about their background, training, and experience providing services like the ones you need. It’s also fair to ask how long they’ve been practicing as an advocate. Don’t necessarily rule out advocates who are newer to advocacy practice; many advocates come from long careers in other parts of healthcare and can draw on that extremely valuable expertise to work on your behalf.

There are currently no specific licensing requirements to practice as an advocate, but there is a Board certification and a range of certifications that advocates can pursue.

b. How does their expertise match your needs?

It’s important that you explain your situation at least briefly. Ask the advocate if they have experience with similar cases. Were they trained in this type of situation? Have they worked with other clients with similar issues?

c. How do they work with clients?

Do they have a set process for gathering all your information? What will they need from you and how will they ask you for it? How do they communicate their progress to you? What will they do if they bump into obstacles to getting resolution for you? When are they available to speak with you? Will you set meeting times or can you call them whenever you want?

These questions will give you a good sense of what to expect when working with this advocate. Make sure it feels like their approach will work for you.

d. What do they charge?

Independent advocacy services are usually services you have to pay for. Costs can vary depending on the advocate (their expertise, location, and level of experience) and on your situation (how complex or straightforward it is). Rates range from $100 per hour to $450 per hour. Much like other professionals like accountants or attorneys, advocates have varying rates as well.

Advocates may set an hourly rate or a project or service fee. Sometimes, advocates will charge you based on their success, such as a percentage of a medical bill savings they’re able to achieve. But often, advocates charge for their time.

Advocates can’t always predict exactly how long your situation will take to resolve, but professional advocates will probably be able to give a good estimate or range of time they will need. Ask for that estimate so you know what to expect. Can you afford this advocate? Does it feel worth it to get the help you need? Only you can decide that. But you should feel comfortable discussing fees with professional advocates.

Are the fees you pay to them their only payment? It’s important to know if a healthcare provider, insurer, or other organization pays all or part of their fee. That’s not necessarily a problem (it would help offset the costs), but it does introduce potential conflicts of interest. You deserve and need to know if the advocate is working solely for you or if they answer to anyone else as well.

Independent advocates are bound by an allegiance factor, which means that they work only for the patient and in the patient’s best interest.

e. What are their terms

Most advocates will ask you to sign a contract and agree to certain terms and conditions. Review those terms carefully and make sure you understand them and feel comfortable with them. If you have questions, ask the advocate.

If you hire an advocate through Umbra Health Advocacy, you can read our terms and conditions here. If you have questions, get in touch! Email us at admin@umbrahealthadvocacy.com.

f. Do they have time to help you?

What is the advocate’s current caseload? Do they have time to work with you and give you the attention you need? It’s fair to ask.

We collect client reviews of our member advocates. Read what others have to say about working with the advocate/s you’re considering. Advocates may also be able to offer references (other clients they have helped who are willing to share their experience). But keep in mind, advocates will protect their clients’ privacy and may not be able to share client contacts with you for that reason.

Do you like what you read and hear? Does your gut say this is someone you want by your side as you navigate your healthcare challenges? If so, go ahead and sign up with the advocate. Get the help you need and deserve.