Healthcare Uncomplicated with Emily Egley - How to Advocate for Yourself and Take Control of Your Ca
Board Certified Patient Advocate Emily Egley shares the deeply personal journey that led her into healthcare advocacy. After developing a life-altering medical condition in 2008, Emily spent years learning to navigate the healthcare system as a patient herself. That experience took on new meaning when her husband, Jared, was diagnosed with colorectal cancer at just 35. For seven years, Emily managed virtually every aspect of his care, from appointments and insurance to billing and treatment coordination. Before his death in 2023, Jared encouraged Emily to use what she had learned to help others, ultimately inspiring her to create Healthcare Uncomplicated and become a Board Certified Patient Advocate.
Emily breaks effective healthcare advocacy into four practical pillars: understanding your insurance coverage, verifying every financial step, controlling communication, and navigating strategically. She explains how patients can catch billing errors, understand explanations of benefits, document conversations with insurance companies, and communicate confidently without alienating the medical professionals they depend on. Her goal is not to navigate the system for patients, but to teach new patients and first-time caregivers how to move from fear and confusion to confidence, clear next steps, and the feeling that when a healthcare problem arises, “I’ve got this.”
TRANSCRIPT:
Host
I'm here with Emily Egley. Thank you so much for being on the podcast.
Emily Egley, BCPA
Thank you so much for having me. I'm excited to be here.
Host
So, Emily, I want to get into a little bit about how, as I like to do with everybody who's in the advocacy space, how you came into the advocacy space and you have your own personal journey. you don't have to give us all the details, but kind of the high level, what got you into the space?
Emily Egley, BCPA
So a little background on me. I it's important to know I went to Tulane University. I in New Orleans, part of my heart is still there. I met my husband at Tulane. It was not a love at first sight story. we know that we met at least four times in small groups of people for extended periods of time, like Super Bowl parties and things like that. There is actual photographic what?
Host
So love at love at fifth sight. Love at fifth sight.
Emily Egley, BCPA
Exactly. So we have actually a photograph where he is standing directly behind me and we have no recollection of meeting each other. None. So clearly God was not ready for us to meet. Our official meeting was Mardi Gras night of our senior year.
And we had a whirlwind romance. and after graduation, I followed him to Southern California. I love being just a few miles from the beach. I don't get there as often as I would like. but we got married in 2007. In 2008, I was diagnosed with a life-altering medical condition.
And I was no longer able to work full-time. I tried to do part-time a couple of times and I was not successful. So I spent the next decade really being a professional patient. I was a full-time patient and learning how to navigate the healthcare system so that I could get the best care possible. And that's really where my expertise comes from, in terms of from a patient perspective.
So and the other part of that story is that eventually I did apply for permanent federal disability, and I was awarded that in 2018. The other part of my expertise in how I got into this, my husband Jared was diagnosed with colorectal cancer in 2017 at the age of 35.
I will get more into his story, but I want to stop for a moment and say how important it is if you are 45 or older or know someone who is 45 or older, get the colonoscopy. Because colorectal cancer caught in stage one, the survival rate is over 90%. If it's caught in stage four, that goes down to 12 to 18%. So it is absolutely essential for people to get.
Emily Egley, BCPA
Their colonoscopies. I want to talk a little bit about the things that happened within the time of Jared's cancer journey that is separate from his cancer journey. And I'll get back to his cancer journey in a minute. because there's a lot of life that was lived during that time. And
So we love to travel, especially we had some favorite places in Mexico. We loved Mayan Ruins and going to Vegas a couple times a year and pretending that we had all the money in the world, art galleries for him, jewelry stores for me. And one thing that I really want to say is that my Christian faith is really at the core of everything that I do. It is where I
Host
Ha.
Emily Egley, BCPA
have drawn my strength from for my own personal healthcare journey as well as during Jared's and then after as well. My heart and soul is with underserved and marginalized communities. So communities of people of color and the LGBTQIA plus community. And the first tangible step that I took was joining the NAACP in 2020. And the NAACP is the National Association for the Advancement of Colored People.
And their mission is to achieve equity, political rights, and social inclusion for all marginalized communities. Why is this important? Because one of my core goals is to pursue health equity, which is different from health equality. Health equality is everyone gets the same access.
Health equity is everyone gets the opportunity to have the best health care possible for themselves. So that involves potentially additional resources or reducing barriers and discrimination. So that's why I kind of talk about this of how important this is to me. And I started out as a general member and then went to the events committee, and now I'm at the I'm I'm on the health committee. We've done a lot of really great things.
Free mental health symposiums, men's mental health event. So we do a lot of really great work. me as just a person, I love speaking in Spanish. I'm fluent in Spanish. I have an amazing family. I have two incredible sisters. I'm very close with my in-laws, and I have 10 nieces and nephews between my side of the family and Jared's. So I do want to talk a bit about Jared's cancer journey and want to come back to that.
Host
Yeah, sure.
Emily Egley, BCPA
Because Jared was diagnosed, as I said, in 2017. He did radiation and then surgery and ended up with a colostomy bag. He then did chemotherapy and we thought we got it. Scans in 2018 showed that it had metastasized to his lungs. So he was now stage four. So from that point on he did
Host
What stage what stage was he at when they caught it for the first time?
Emily Egley, BCPA
So it was diagnosed as stage three. But when we got a second opinion, when it was stage four, he was able to trace back the actual, like where the cancer, where the tumors were. And the tumors were actually there from the beginning, but they were the size of a pinprick, which is smaller than.
scars from bronchitis. So it would have never been caught at stage four, but it always was stage four. Does that make sense? Okay. So he did every treatment possible. He did chemotherapy, radiation, he did a clinical trial that included immunotherapy, and did multiple types of chemotherapy and radiation. And
Host
Got it. Yes.
Emily Egley, BCPA
I wasn't just there for the appointments and the hard decisions. For seven years, I used my expertise that I had gained from my healthcare journey, and I managed every single aspect of his health care. I from appointments to coordination of care to insurance, billing.
Every single aspect so that he could focus on fighting cancer and living life to the fullest. And as I said before, we lived life to the absolute fullest. I was a full-time caregiver, so that is where my expertise comes from as being a caregiver. So I have this expertise from being a patient as well as being a caregiver, which provides different perspectives.
And at the end of Jared's life, he it had metastasized everywhere, including his bones, his brain, everywhere. And at the end of his life, he said that I should do for others what I had done for him. By navigating the healthcare system for him, I gave him time and energy. And he wanted me to do that for other people.
So he passed away December 21st, 2023, darkest day of the year, because of course that makes sense. and from his wish, this business, healthcare uncomplicated, really was born. And March of 2025, I got my
I became a board certified patient advocate. And it's kind of funny the way that I got there because I was starting this business and looking at logos. And every website that I went to, it said board certified patient advocate, board certified patient advocate. So I was like, well, what is that? And so I went to the PAC board website, which is where they have all the information for the board exam. And it had this 31 question quiz.
Emily Egley, BCPA
And it said very clearly, this is not an indication of how well you will do on the exam. It's an indication of how ready you are for the exam. I took the quiz and I got 30 out of 31 right just by happening upon the page. So the exam was six weeks later. So I crammed for the exam and I I passed with flying colors.
Host
Well.
Well
Emily Egley, BCPA
And I tell this because I was able to do that because of all of my lived experience. So I was able to have this perspective because I had been a caregiver. And with Jared, we had a very clear rule of your body, your choice. And so as a patient advocate, it's really important to make sure that the other person, that you're not making decisions for them, that you're empowering them to make their own decisions.
providing the education and then they can make their own decisions. And that was really something that I learned how to do being a caregiver for Jared.
Host
Your company, you said the name of it, say it again for me.
Emily Egley, BCPA
Healthcare uncomplicated.
Host
Healthcare uncomplicated. So the kind of advocacy you do, you have decided to go more into the education self-empowerment space as opposed to doing more one on one, like a lot of people who who are BCPAs. and I think a lot of the lessons you've learned, what one of the things that attracted us to having you on the podcast is you've breaken down you've broken down a lot of complicated.
things in the healthcare space into chunks, into different categories that people need to know. And it helps organize the process so that that people can wrap their head around. I was wondering if you wouldn't mind sharing what those categories are and kind of how you've arrived to them.
Emily Egley, BCPA
Absolutely. So I am building an education platform. I am finalizing that. And so there are four pillars of the program. So it's broken up into four different pillars. The first is understanding your insurance coverage.
You cannot navigate the healthcare system unless you understand your insurance coverage. Now, what do I mean by that? So you need to know the type. So how you get your insurance. So is it from your job? Is it from Medicaid, Medicare? Is it from the ACA market place where you buy your own? And also known as Obamacare. And an example of that, why that's so important, I had a client who
Her mom qualified for Medicare and Medicaid. So she had to realize that okay, I I need to navigate with both. And how do I how do I sign up for both and how do I navigate with both? So it was really essential for her to really know what her mother qualified for and where that insurance was going to be coming from. The other thing that I go over, I go over all the differences of be between a premium and a deductible.
co-pay and co-insurance. And then network types. This is something that we're most familiar with HMO and PPO. There are a couple others, but those are the main ones. And another term that is important also as well is the out-of-pocket maximum. And the reason that I bring that up is I got a bill for $3,000. I didn't panic.
Because I knew for a fact that I did not owe that bill. I knew that on that date for that procedure, I had already met my out-of-pocket maximum. Now, what is an out-of-pocket maximum? It is the maximum amount that you spend for your health care before the insurance company pays for your care at 100% for the calendar year.
Emily Egley, BCPA
So I knew that by that date I had already met my out-of-pocket maximum. So I didn't have to be afraid of it. But if I had not known what an out-of-pocket maximum was or what mine was, receiving a $3,000 bill would be absolutely horrible and terrifying. So that's why that first one is so important.
Host
And I'm sure there are people that get eighty thousand dollar and two hundred thousand dollar bills where they're like, What am I are do you want my house? What's gonna happen?
Emily Egley, BCPA
Exactly, exactly. So it's so important to know each of these things, deductibles, copies, what counts toward what. so that's essential. The next pillar is verifying every financial step. So what this looks like is learning to read the explanation of benefits, which is the confusing document that the insurance company sends you that details.
How much was billed, how much was paid, and what you might owe. The other important thing is learning how to read a medical bill so that you can compare the explanation of benefits and the medical bill to make sure that you are being billed for the correct amount. So let me give you an example of this. A very dear loved one of mine who is in the medical field had some treatment recently.
And I was talking to her and I said, Are you comparing your explanation of benefits with your medical bill? And she said, Well, no, the the bill seems really reasonable for the amount. And I said, just because it's reasonable doesn't mean that you owe it. And so that was a conversation that we had in June. I saw her in July and she said, You know what, Emily, you saved me money.
Host
Mm-hmm.
Emily Egley, BCPA
And I was kind of caught off guard because I had forgotten about this conversation. And she said, No, I started checking my explanation of benefits against my bill. And for one of my treatments, the explanation of benefits and the bill matched exactly to the scent. And then there was another treatment where the explanation of benefits had one number, and the bill.
Host
Mm-hmm.
Emily Egley, BCPA
was significantly higher than what the explanation of benefits said that she owed. So she was able to call the billing department and say, hey, there's a discrepancy here. There's these don't match up. It needs to be reprocessed. And so I ended up saving her money. Now, not everybody is going to save money. I want to put that out there very clear. But by being able to do this, you will be able to ensure that you never overpay a medical bill.
Host
Right. Which happens all the time.
Emily Egley, BCPA
It happens so often. And and I look back and I probably have two, if I'm honest, because I didn't always do this. I didn't always check this. So another example that that I really want to share is a couple of months ago, I received a bill for $500, over $500. And I looked at it and I said, I don't, I don't know this bill.
And I called the billing department and they said, no, you don't. That bill was sent to you by mistake.
Emily Egley, BCPA
And if I didn't know to check the explanation benefits against the bill, I would not have known that I didn't know that and I would have just like that, I would have paid the five hundred dollars.
And the thing is that that that no one is going to catch it except for you. There's no incentive for the doctor to double check things. There's no incentive for the insurance company to double check things. So it's really on the patient to make sure that they're vi verifying every financial step. So the third pillar is controlling communication. What is this? Yes.
Host
Sure.
Host
Great example.
Host
So let's review real quick. So the first the first pillar was understanding your insurance. The second one was understanding your financial obligations. Is that how you okay. And then the third and the third one
Emily Egley, BCPA
Yes, exactly. Verifying every financial step. Now we're into controlling communication. So learning how to speak confidently with the medical team, with the insurance company, and with the billing department. And medical staff etiquette. We will get to that one in a minute. I want to get back to that $3,000 bill that I received.
Host
Okay.
Emily Egley, BCPA
Because I knew how to speak confidently with the insurance company, I was able to call the insurance company and say, look, I've checked this against my explanation of benefits. This needs to be reprocessed. And I had that confidence to talk to them about that. I wasn't, I wasn't hemming and hawing. I wasn't like, I'm sorry, I don't know. It was, this is wrong. I need you to do this.
Host
Mm-hmm. Right.
Emily Egley, BCPA
And one thing that I want to tell everyone is whenever you are speaking with the insurance company or billing department, I want you to write down four things. The first is who, who you spoke with. The next thing is when. What is the date and time that the conversation started? And then write down the what. What was discussed.
And finally, and most importantly, is to ask for a reference number. A lot of people don't know that they can ask for a reference number, but when you have a reference number, if you need to call back, you can say, this is my reference number, and they can pull up the entire previous conversation and you don't have to repeat yourself.
Host
So who, what, when, and the reference number?
Emily Egley, BCPA
Correct. Exactly. So I want to I want to explain this. I want to give an example of this because it's so important because controlling communication can be so powerful powerful and can change things. So if you do write down the who, what, when, and reference number, you can call back and say
Host
Okay. Very hopeful.
Emily Egley, BCPA
On November 2nd at 215, I spoke with Sarah. She said that please see reference number 4488. Do you see how that changes the tone of the conversation? It changes things because you're actually speaking from a pa place of like in control of what is happening. And the next part is medical staff etiquette.
Host
Yeah, sound like an expert.
Emily Egley, BCPA
How do you get your needs met while being respectful to the medical team and medical staff?
Host
And this is part of the communication pillar.
Emily Egley, BCPA
It is part of the communication pillar. A lot
Host
Right, 'cause it is it is tempting, especially if you're armed with that kind of authority and information, to kind of get angry if people aren't stepping in line. And that that can backfire, can't it?
Emily Egley, BCPA
Absolutely.
Emily Egley, BCPA
Absolutely. And it has backfired in my life. So let me tell you a quick story about that. I I have yelled at more people than I would like to admit. I have I've gotten much better about it. it has been a learning curve. But I at one time I was just I was trying to get Jared the care that he needed at the time that he needed it.
Host
Okay. Fair enough. Fair enough.
Emily Egley, BCPA
And I yelled at the his oncologist, his cancer doctor, his oncologist's medical assistant. And the next day I called back and apologized. But from that point on, I was Mrs. Egley. I was no longer Emily. So it changed the relationship and there was nothing I could do to fix it.
And an important thing to know is that the medical staff are the gatekeepers to your provider. They are they have conversations with them. The your providers know if you yell at the medical staff. So people here advocating for themselves.
And people think that there are only two options. At least I used to think there were only two options. One was to sit quietly and hope and pray that my medical needs got met. And the other one was to raise my voice to make sure that my medical needs got met. An analogy I like to use about that is: imagine that you get home and you have to really, you really have to go to the bathroom.
Host
Mm-hmm.
Emily Egley, BCPA
Do you think your only choices are to stand in front of the door and hope and pray that it opens? Or to kick the door in and go to the bathroom? In the first scenario, you may end up wetting your pants. In the second scenario, you get to go to the bathroom, but you have you no longer have a working door. So it's important to understand that there's a third option, which is using the key.
I want to share an experience that I had that really illustrates what using the key is. For one of my providers, the office manager was always short with me. And one day I called and I said, Sarah, how are you doing today? And I genuinely meant it. And she answered how she was doing.
And from that point on
My messages got to my provider more quickly. My insurance issues were handled more quickly. Now the question is, did I manipulate the system? No. I led with intentional kindness and communicated strategically.
So there is, when there is respect, you gain leverage with the medical staff. You actually have people working for you. You get a positive response from the medical team and from the medical staff when you communicate strategically and lead with kindness. So the fourth pillar, the last one, so we have understanding your insurance coverage, verifying every financial step, and controlling communication.
Host
Mm-hmm.
Host
Mm-hmm.
Emily Egley, BCPA
The last pillar is navigating strategically. It's taking the first three pillars, bringing them all together, and using that to leverage your situation. What does that look like? Let's go back to that $3,000 bill. Because I was able to catch that I didn't owe it because I understood my coverage.
I was able to read my explanation of benefits and my bill and compare it so that I could see where the error occurred. I was then able to call the insurance company and confidently say, This is what's going on. I know that I don't owe this. This is where the error occurred. It needs to be reprocessed. So I was able to take all of that, put it all together.
Host
Mm-hmm.
Emily Egley, BCPA
And have this conversation with the insurance company and get it reprocessed and resolved so that I didn't have that bill for $3,000. Another example was a client that I had. Her mother needed to sign up for Medicare and Medicaid. And so as we worked through it, it was she needed to understand all of the different options for Medicare and Medicaid.
And then learn how to read those explanation of benefits. And then how to speak confidently because she needed to call Social Security, the Social Security Administration to get her mom signed up for Medicare. So she had to make these phone calls and gain the confidence to understand what was going on enough in her situation to be able to do that. Once she was able to do those things, she had clear next steps.
She was able to do it from she went from a place of fear and uncertainty and just complete doubt about herself. And then also guilt that she hadn't done it sooner and exhaustion because she was caring for a mother with dementia all while doing this. So she was feeling all of those emotions, and we were able to take her from that place to a place of calm and confidence.
Host
Uh-huh.
Emily Egley, BCPA
and clear next steps. So the goal of the entire program is for you to be able to go through all of these steps and at the end be able to say, when any medical situation arises, I've got this.
Host
Sounds like a pretty comprehensive way to kinda look at the healthcare system. Who's it designed for and when will it be available? How do people actually access it?
Emily Egley, BCPA
That is excellent because it is not for everyone. I want to be very clear this is not for everyone. If you are looking for someone to do this for you, that is not what I do. If you are looking for someone who is going to take all the steps and just make sure that you don't have to do anything, that is not what this is for. This is for new patients.
And first-time caregivers who are unfamiliar with the healthcare system to go through and learn all of these things so that they can have a solid foundation to be able to navigate the healthcare system strategically. So this is really for people who haven't had interactions with the healthcare system. So this isn't for people who are veterans of the system, but they're just overwhelmed.
Host
Mm-hmm.
Emily Egley, BCPA
That is a different definitely a subset that needs assistance, but that's not what this particular program is for. So the program is going to be going live in October. And you can currently sign up for the wait list, and you can go to my website, www.healthcareuncomplicated.com.
And on the navigation bar, you can just click on the word wait list and it will take you right to the page to sign up for that wait list. And then as soon as the program goes live, you'll be the first to know about it.
Host
So we went over the who it's for, what it is, when it's gonna happen. I feel like I need a reference number now just to kind of follow up on on what's on on the on the teachings. Well, this has been really great. and and to and to get in touch with you, I assume if they have detailed questions or anything more, they can also go to healthcare uncomplicated dot com. There's some kind of contact form there if they need to reach out to you. Is that right?
Emily Egley, BCPA
Ha
Emily Egley, BCPA
Yes.
Absolutely, absolutely. And right now, as I am finalizing the program, I am on a limited basis, on a very limited basis, doing one on one guidance sessions. So if you are interested in that, please go to my website and you can sign up for a free 15 minute consultation and we can evaluate.
whether you're a good fit, whether we together are a good fit, and I'll ask you some questions, I'll answer your questions, and then when you leave the call, you will have clear next steps for what to do. So
There are some limited spots available for this one-on-one guidance to just kind of finalize and tweak the last pieces of the program. So please go to my website, healthcareuncomplicated.com, and there is a button there to sign up for the free consult.
Host
All right, Emily, thank you so much. I was incredibly insightful. I love how simple you broke down the four different pillars and you had examples for every one of them. I can't wait to see it go live in October. And I wish you the best of luck. Thanks for being on the podcast.
Emily Egley, BCPA
Thank you so much for having me. It's been an absolute joy. Thank you.
