Everyone Needs An Advocate When They Enter the Healthcare System

Everyone Needs An Advocate When They Enter the Healthcare System
| by Anne Llewellyn

By Anne Llewellyn, MS, BHSA, RN, CCM, CRRN, CMGT-BC, BCPA, FCM. Follow Anne's weekly blog, Nurse Advocate, where she shares stories and events that help people be better prepared when they enter the healthcare system. You can find Anne at www.nursesadvocates.com

Patient/Health Advocacy is an emerging practice in today's healthcare system. As most know, the healthcare system is complex, fragmented, costly, and sometimes dangerous. People, Patients and cargivers realize they need help when they enter the complex healthcare system and interact with their insurance companies.

What is a Professional Healthcare Advocate?

Professional Health Care Advocates assist you and your family members in understanding the plan of care your healthcare team put together. As an objective member of your team, healthcare advocates can do research to help you find resources to meet your needs. They help you to understand the workings of the healthcare system so you and your family can make decisions that are right for you. They work with your healthcare team to coordinate care, improve communications, help you transition safely through the complex healthcare system, question medical bills, and help resolve conflicts.

Healthcare advocates go by many names. They are called patient advocates, health advocates, nurse advocates, navigators, lay advocates, and professional or independent patient advocates.

A lay advocate is someone you know personally who you ask to assist you with your care. A lay advocate is usually a family member or someone you know from your social network.

An independent healthcare advocate is a professional who specialize in this area of work. They charge for their services and work directly for you as an objective member of your healthcare team. They have your best interests in mind and work with payers and providers to ensure you have a voice and say in your care. The most important consideration in choosing any advocate is to select someone you respect and trust to be discreet and caring.

Here are some tips for working with a professional independent healthcare advocate:

  • The best advocates are calm, organized, assertive, and comfortable asking questions.
  • A healthcare advocate should be able to clearly explain the kind of help you need and your concerns and communicate your heath history to your healthcare providers.
  • Provide your advocate access to your electronic health portal so they can refer to test results or notes, ask for refills on prescription medication, and even email questions or concerns to the physician. Most patient portals have a way to give proxy access to your advocate.
  • It is essential to sign a form that gives your doctor and other healthcare professionals permission to share information about your protected health information (PHI) with your advocate.

Some healthcare advocates will attend doctor appointments with you and meet with you at the hospital. They’ll take notes or may even record conversations with healthcare professionals during visits. If you choose to record a conversation with your doctor or other team members, alert them that you will be recording the conversation and get their permission. It is against the law in many states to record a person without their permission.

Many hospitals and insurance companies provide patient advocates or case managers to assist with questions or concerns. These advocates are good and should be utilized whenever possible. Please keep in mind these advocates work for the hospital and/or the insurance company and must follow the policies and procedures of the organizations that employ them. That allegiance may create a conflict of interest or limit the options and support they can provide to you.

An independent healthcare advocate is objective and has an allegiance to YOU. This direct and unbiased relationship allows the advocate to be transparent with you about how the healthcare system works and all your options. An independent advocate will conduct research, so you have the information necessary to make informed decisions and works with your healthcare team and your insurance company to ensure your voice is heard, that relevant questions are raised and answered, and help you maximize your healthcare insurance dollars to meet your needs.

How to Find an Advocate?

Many people find advocates through a Google search and calling those who reside in their areas. Doing this type of search can be very time consuming, especially if an advocate is urgently needed.

To narrow down the search many people search for patient advocates through professional organizations’ websites. Most healthcare advocates associations have searchable databases that can be used to find an advocates by zip codes or by need. In addition, advocates who belong to national organizations have a code of ethics that guides their work. There is also a national certification for patient advocates that also holds them accountable to standards that guide the practice. When searching for an independent professional healthcare advocate, look for the designation BCPA (Board Certified Patient Advocate).

The tips above are helpful whether you are looking for a professional advocate or a family member or friend to be your advocate. If you are considering hiring an independent professional advocate, schedule an initial consultation to ensure the advocate has the qualifications and skills to do the work you need done. Verify the healthcare advocate has the necessary education and expertise and ask how they charge for their services. Do your due diligence just as you hire any other contractor or specialist.

Here is a list of the professional organizations you can use to find an independent patient/healthcare advocate:

You can also search for healthcare advocates on these marketplace platforms:

To learn about the history of Patient/Health Advocacy visit this link: aphadvocates.org/assets/History-Trends-CSA-Schuler-12.21.pdf

Anne Llewellyn, MS, BHSA, RN, CCM, CRRN, CMGT-BC, BCPA, FCM is a registered nurse with 40 + years of experience in critical care, risk management, case management, patient advocacy, healthcare publications, and training and development. Anne is a leader in case management and patient advocacy. Anne is one of the three founding members of Healthcare Advocates of Florida. Anne speaks and writes frequently on topics for consumers, caregivers, and all members of the healthcare team to encourage all parties to come together to improve each person’s healthcare experience. Follow her in her weekly blog, Nurse Advocate, where she shares stories and events that help people be better prepared when they enter the healthcare system. You can find Anne at www.nursesadvocates.com