Living with and managing complex medical issues can be frightening. Add to that fear the frustration of feeling as though no one is listening to you. A patient advocate is there to listen to your concerns and to assist you in setting priorities based on what you want and need, not what others may perceive that you want or need. When a patient is being confronted with multiple healthcare providers, from multiple specialties, they can feel as those they have lost control. To make matters worse, those providers are usually speaking in a different language. A patient advocate will help you take back control of your own healthcare.
For all healthcare professionals, they begin their education by learning Medical Terminology 101. It is a distinct language in which they learn to communicate with one another. It is not designed for communicating with patients, who are the object of their ministrations. A patient advocate is there to act as your interpreter, and to help you understand the significance of what is being discussed regarding your health status. Sometimes the terminology being used can be very confusing to an already concerned patient and can add to an already stressful situation. This lack of understanding contributes to the fear.
Combine with the hazy medical terminology, the jargon of the third-party payers, and it begins to sound like the floor of the United Nations. Insurance terms like “medical necessity”, “observation status”, and “coverage limits” are just of few of the obstacles patients face when trying to access appropriate care. A patient advocate is there to unravel the mystery and to advocate for the patient when a payment decision needs to be appealed. Rarely will a payer administrator go out of their way to explain in common language why a bill is not being covered. It can be something as simple as an incorrect procedure code being applied to a bill, or as complex as incorrect bill type. The patient advocate can spot these issues and act for you in defense of an adverse claim determination.
All of this culminates in thousands of pages of documents, both electronic and paper. Trying to organize and manage all of this documentation is daunting to a perfectly healthy individual, and is downright overwhelming to someone in the mist of illness who is trying to heal and recover. A patient advocate is there to help you aggregate, index and manage the documents in easy to access, and easy to share formats. In today’s complex healthcare environment, more and more of your personal health information is in some form of digital electronic format, but there is not yet a standard format from one provider to the next. The patient advocate can unify all these diverse electronic documents.
Your patient advocate can help ease the fear, interpret and explain the medical terms, demystify insurance barriers, and organize your important personal health information. The patient advocate is there to ease the burden of coordinating all the administrative and medical instructions being thrown upon the patient’s already full plate. These are not all the services a patient advocate can provide, but a place to begin in the journey to take back control over your personal healthcare experience. These are the essential tasks provided to clients that enable them to focus on their own healthcare priorities.