Living with Chronic Pain

When to Involve a Professional Health Care Advocate


What is health care advocacy?

Health care advocates provide assistance to individuals as they navigate the health care system. This can include health insurance benefits, medications, physician appointments, hospital stays, etc. They may also help with specific situations, such as the diagnosis and treatment of cancer. Health care advocates are especially beneficial to the elderly population.

When to involve a professional health care advocate

Many individuals can advocate for themselves, or family members, friends, and nurses can advocate on their behalf. There may also be times when it becomes necessary to involve a professional health care advocate. This may occur when an individual is facing a serious diagnosis, an extended hospital stay, or a condition requiring the collaboration of care from several health care offices or facilities.

When receiving a serious diagnosis, (e.g., cancer, life-threatening conditions, debilitating illness, long-term health issues, etc.), a professional health care advocate should be considered. The professional advocate can help coordinate care, identify challenges, brainstorm solutions, and help implement the best solutions. They can also help individuals understand their diagnosis and treatment options.

Individuals having problems with billing or insurance claims may also benefit from a professional health care advocate. Certain professional health care advocates specialize in medical insurance and insurance claims. They can help with acquiring insurance, obtaining preapprovals, explaining coverage, and requesting an appeal if a treatment or claim is denied. They may also negotiate payment plans with billing offices or identify potential sources of financial support.

If a person is unable to accurately process information to make informed medical decisions, and a family member or friend is not willing or able to assist, it might become necessary to involve a professional health care advocate. This can occur due to a variety of reasons, such as the aging process or having an intellectual disability. In these cases, a professional health care advocate can gather information, help make decisions that are in the best interest of the individual, and ensure decisions are executed as planned.

In general, whenever an individual is experiencing difficulty navigating aspects of the health care system, they may benefit from a professional health care advocate.

Additional sources: Own Your Health and The Healthy

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