August 19th, 2010 at 2:12 am
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Feel Like There Is No One on Your Side? Try a Patient Advocate!

by Sue Lanza

Do you have the same stacks of papers that I do cluttering up my kitchen table and many other flat surfaces? I’m sure you do. I’m not talking about the routine bills (they take up plenty of their own space) or the pictures of the grandkids, I mean the annoying piles of things erroneously called “explanation of benefits”, “this is not a bill” or “your easy-to- read provider statement”.

I know that your head is spinning right now just thinking of those pesky papers. You and the rest of the world! Right now I have a folder devoted to mail order medications that my health plan secretly (they said they clearly notified us) made us switch to after the third refill of routine medications. I keep adding papers to this folder almost daily as the prescription vendor has me on a delightful mailing schedule so I don’t forget about them. I can’t understand half of the papers because they say things like “mail this form to us with payment” but I don’t know what it costs and it asks for numbers on a member card I don’t have. Help!!!

There is an answer for people like us who are running like gerbils through the labyrinth of medical care: hire a patient advocate! I can probably screw my head on straight one day and figure out my gobs of prescription papers but what about those folks who are dealing with volumes of important papers streaming in daily due to complex medical issues or a terminal diagnosis?

Patient advocates are professionals who can navigate through much of the “red tape” to accomplish tasks that are very complicated or ones that a patient can’t do because of illness. Here are just a few of the items that a patient advocate may be able to assist with:

  • Coordinate multiple appointments, including those with impossible-to-schedule physicians
  • Helping to find suitable health care providers within your health plan
  • Fighting with insurance companies on your behalf when services are denied
  • Assisting in plotting a plan of care after receiving a diagnosis of a progressive disease
  • Explaining clearly the treatment options that have been presented so decisions can be made
  • Sorting through mounds of insurance claims to determine what has been covered and what you may owe

Patient advocate fees may vary widely, starting with a low of $35 per hour. Since there aren’t clear regulatory guidelines as yet on the profession, be sure to check credentials so the person you select to help you has the right skill set for your needs. There are some organizations in your state that maybe able to offer services for free so check with your state health department first. Remember that you are sharing your very personal data and medical information with someone so be cautious. A good starting place for more information including some self-help tips is the Patient Advocacy Foundation website at www.patientadvocate.org. Good luck with your piles of papers!!!

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