Do You Need a Patient Advocate?

7 years ago

It seems as if not a day goes by that we don't hear about another medical horror story. With the health care system being in various degrees of disrepair, it is even more important for patients to get the support they need to navigate complex diagnoses and treatment. Even if you are a savvy patient, when you are ill, you are at your most vulnerable. A medical maze that was already overwhelming is exponentially more frightening and confusing. It's not uncommon for regularly strong, empowered people to go into "helpless patient mode" when faced with a health challenge as Gloria Feldt shares in this article.

So what can you do?

The New York Times article "After Diagnosis, Someone to Help Point the Way" tackles the subject of hiring a professional patient advocate to help you navigate your way through the complex medical maze. You may have heard the title patient advocate when you or a loved one has been admitted to a hospital, but his is not the same as hiring your own, independent patient advocate:

Just bear in mind, Ms. Weil cautioned, that an advocate paid by your company or employed by a hospital may have to represent competing objectives. "Know the agenda of the person who is helping you," she said. A hospital’s own advocate, for instance, may not be allowed to suggest another institution or physician where you might find better expertise for your particular medical condition.

If you want to be certain that an advocate has your best interests in mind, be prepared to hire one independently - and to pay out of pocket for their services. Expect to pay either an hourly rate of $150 to $200 or a flat fee for a specific service.

This added expense is typically not covered nor reimbursed by Medicare of insurance plans. Yet it may be a financial investment well worth making, a matter of life and death. Unfortunately, for those with low or no income entertaining the idea of hiring an advocate is not even an option.

So what can a patient advocate help you with?

Walletpop has an excellent article on avoiding medical nightmares and lays out the following ways an advocate might help:

According to Elisabeth Russell, founder and president of Patient Navigator LLC and vice-president of the National Association of Healthcare Advocacy Consultants, an advocate can, among other things,

  • deal with the paperwork to make sure you pay only what you owe
  • coordinate medical care, setting up appointments, arranging transportation
  • tap into community social services
  • negotiate with medical providers and insurance companies
  • coordinate home care with friends and professionals
  • assure communications among health care providers, insurers and the patients
  • explore alternative therapies

A misstep in treatment or communication can result in injuries or even death. You owe it to yourself to get support. Trisha Torrey of Every Patient's Advocate offers a number of articles and her book, The 10 Mistakes Every Patient Makes, to help you sort through the maze before you find yourself ill.

One of the challenges in hiring a patient advocate is the lack of a credentialing or licensing body. One of the best ways to find one is through a referral from a friend or trusted colleague. Otherwise, you need to evaluate an advocate's credentials and ability to help you on your own. Some things you want to check include:

  • What is this person's background? Do they have formal medical training? What level of medical understanding do they possess?
  • Is it easy to communicate with this person?
  • Are they good negotiators?
  • Are they persistent?
  • Do they guarantee confidentiality?
  • Do they possess a solid understanding of medical claims processing?
  • Are they experienced with various aspects of of hospital claims administration, diagnoses, and the language of medicine?
  • Are they empathic and caring?
  • Are they persuasive?

Here are some additional resources to find the help you need:

Do you have a health care horror story to share? Have you ever hired a patient advocate? If so, what was your experience?

Paula Gregorowicz, owner of The Paula G. Company, helps people make wiser decisions through the power of Intuitive Intelligence(tm). She helps people break free from the tyranny of their own minds that hold them back from their greatest success and best lives. If you are searching for a way out of of feeling confined, restricted, and frustrated and are ready to breakthrough these limitations you can learn more about how Life Alchemy(tm) can benefit you and get the free eCourse "5 Steps to Move from Fear to Freedom" at

This is an article written by a member of the SheKnows Community. The SheKnows editorial team has not edited, vetted or endorsed the content of this post. Want to join our amazing community and share your own story? Sign up here.

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