Navigating the health system in the United States is hard. As if being sick wasn’t bad enough, you also frequently have to deal with complicated administrative issues, difficulties scheduling appointments, health insurance complications, working with different doctors for different things (and making sure all of them are up to date on everything the other doctors are doing and saying), and a confusing medical billing process.
Dealing with health care in this country could be a full time job, but most people have to manage it on top of a number of other life responsibilities and without the skill sets really needed to handle it all effectively. Fortunately, there’s an industry of people who have those skill sets and are willing to do the work of managing the health system for you.
What is a Patient Advocate?
A patient advocate is someone whose job it is to help people navigate the health care system. Some of them are specialists – you can find patient advocates that focus on helping people with specific illnesses like cancer and Alzheimer’s, and those that focus on medical billing. Others aim to more generally help with whatever needs and questions you have that arise while dealing with doctors, hospitals, and health insurance companies.
Patient advocates have a better idea than most patients do of the right questions to ask, the right steps to follow when you have a need, and how to read medical bills and insurance paperwork. Often, they’re people who have worked in the health care industry before so are familiar with the inner workings of it all. They can recognize medical lingo and do the research necessary to understand and explain treatment options. Some of them join patients in the room with the doctor (but only if you want them to); others provide their help in between or after appointments.
Across the board, patient advocates bring their skills and knowledge of how things work to helping improve your experience of dealing with your health care needs.
When Patient Advocates Are Worth It
Some employers provide patient advocates as a benefit to employees and some hospitals may offer patient advocates to help their patients out, but for most people, hiring a patient advocate can get costly. If you’re paying out of pocket, you should expect fees that range from $100-$200 an hour or a flat fee for specific services.
Being that the cost is significant, how can you determine if a patient advocate is worth it for you or a family member?
There are a number of factors and questions to consider to make a decision:
- In your experiences navigating hospitals and the health insurance system before, did you find it especially difficult? Can you remember how much time you spent on phone calls, going over paperwork, or doing research?
- If not, do you have a close family member who’s better at dealing with these things and who has the time and willingness to help out?
- Do you have a serious illness that will require frequent doctors’ visits, a complicated mix of medications, and a number of treatment options?
- Does the nature of your illness make it difficult to stay on top of things like appointments, bills, and health recommendations? For example, if you have an Alzheimer’s diagnosis or any illness that causes fatigue, you’d likely fall in this category.
- Have you received medical bills that seem disproportionate to the treatment you received, but don’t know how to contest them?
In some cases, the cost of a patient advocate will pay for itself in money saved in medical bills. And in some cases, it could literally save your life by helping you make sure you get in to see the right doctors and pursue the best treatments.
If you can afford it and find a skilled, trustworthy patient advocate, usually hiring one will be worth it.
How to Find a Patient Advocate
If you’re currently employed, then your first step should be to ask your HR department. If you can use a patient advocate that’s provided by your employer, then you’ll save a lot of money.
If you’re not employed or your employer doesn’t provide a patient advocate as a benefit, then you have a few main options for seeking out an independent patient advocate to hire:
- Google. Search for “patient advocates <your city>” to see your local options. If you’re struggling with a specific type of illness or specifically want someone to help with medical billing, then add those terms to your search.
- Advoconnection. This websites provides a directory of patient advocates and patient advocacy companies around the country.
- National Association of Healthcare Advocacy Consultants. This organization also provides a listing of patient advocates for you to search.
Before hiring anyone, ask questions about their background and experience and look for any reviews you can find.
It’s ok to ask for help, especially with something as difficult and high stakes as pursuing health care in the United States. If you can manage the cost, hiring someone to take charge of the process for you can pay off in better care and more reasonable costs.