How Patient
Advocates Help
Patient Advocates Work for You
Healthcare is hard. It’s complicated. Confusing. And expensive. No one teaches you how to deal with it.
If you feel frustrated or overwhelmed by your healthcare situation, you may need a healthcare expert – or patient advocate – on your side.
Patient advocates have different training, certifications and specialties. There’s an expert for almost every healthcare situation.
They can help with financial matters like medical bills or insurance claim denials. Others have clinical training and can help you navigate a new diagnosis to make sure you get the best treatment possible.
If you are feeling stuck in the health system, consider hiring a patient advocate.
Here are just some of their specialties:
Care Coordination
- Managing your healthcare needs by coordinating appointments and services as well as doing research into options
- Attending doctors' appointments remotely or in person to communicate your needs and help advocate for the best care
- Making sure your doctors and specialists communicate well with each other and know all of your diagnoses and medications
- Supporting a loved one when they have a health crisis and you can't be there in person like emergency room visits, hospitalizations or mental health crises
- Managing medications
Clinical and Mental Health Navigation
- Finding doctors, hospitals, or specialists
- Researching and securing mental health providers for you or a loved one
- Finding and selecting facilities such as hospitals, skilled nursing facilities (SNF), rehabilitation hospitals, surgical centers or mental health treatment facilities
- Explaining to you what to expect at each stage of your healthcare journey such as substance abuse treatment or a hospital discharge
- Helping you prepare for doctor's appointments so you can ask the right questions
- Providing support in understanding and treating your new diagnosis or chronic condition
- Reviewing your treatment plan and arming you with questions to ask or researching other options
- Finding second opinions
Senior Care Navigation
- Supporting seniors or their families to manage their healthcare
- Coordinating and making doctors' appointments
- Attending doctors' appointments to ensure your senior gets the best care
- Providing support in person for hospitalizations or long term care stays when family cannot be there
- Overseeing compliance with providers' treatment plans including medication management or wound care
- Researching and helping select the best independent living, assisted living, nursing home or dementia care facilities for your needs
- Serving as the main contact with your senior's providers reporting back to family members
- Researching and securing home health services like home health aids, physical therapy, companion care, or assistance with activities of daily life
- Providing senior care coordination of all of your senior's services including in-home services, transportation, meal prep, doctors, specialists, pharmacists, and nursing homes
Medical Advocacy and Complex Care Management
Get help navigating complex diagnoses and medical situations, working with an MD, PhD, specialized RN, or other credentialed professional
- Navigating complex diagnoses like breast cancer or multiple chronic illnesses such as COPD, diabetes, and hypertension.
- Managing a medical or mental health crisis
- Navigating end-of-life care
Medical Billing
- Compiling or organizing medical bills
- Reviewing medical bills to find errors
- Negotiating medical bill adjustments
- Researching and applying for financial assistance
Insurance Navigation
- Understanding the Explanation of Benefits (EOB) for your health plan
- Working with your doctors to submit pre-authorizations
- Fighting insurance claim denials
- Arguing for out-of-network coverage
- Reviewing insurance options with you so you can decide on coverage between your employer plan or Medicaid or Medicare
- Supporting Medicare Advantage Plan selection
- Researching health insurance options on the Affordable Care Act marketplaces and helping you select the right plan
You might encounter a patient advocate, care manager or case manager at a hospital, clinic, or health plan. They work for the provider, not you. Only a private independent advocate works for YOU.
Search for a patient advocate in our national directory or let us help you find an advocate by submitting a Help Request or calling the number below.