Don’t Walk Alone: How A Patient Advocate Can Support Your Healthcare Journey

According to TIME Magazine, over 705% of adults in the U.S. are dissatisfied with the healthcare system. For older adults with complex health needs, this dissatisfaction can be even more pronounced. The American Psychological Association notes that distress often follows a diagnosis, and those with additional stressful life events or a history of depression experience even higher levels of distress. When faced with a diagnosis or managing a chronic condition, patients often find themselves juggling care from multiple providers while dealing with insurance companies. It’s essential for patients to be their own advocates. Being your own advocate means taking proactive steps to manage your healthcare. This can include:

• Preparing for Appointments: Bring a list of questions and current medications.
• Handling Paperwork: Complete necessary forms in advance.
• Understanding Insurance: Know what your insurance covers to avoid surprises.

However, these tasks can be challenging, particularly if you’re dealing with a new diagnosis or a condition that affects your cognitive abilities, such as dementia. In this post, we’ll explain how a patient advocate can help ease this burden and ensure you receive the care you deserve. 

What is a Patient Advocate?

A patient advocate, as defined by the Patient Advocate Certification Board (PACB)  is a professional who assists patients and their supporters in understanding and managing the healthcare system. These advocates work directly with clients or their legal representatives to ensure they have a voice in their care and access to information that promotes informed decision-making. They may operate independently or within medical or other organizational settings, serving individuals, communities, disease-specific populations, and family caregivers.

A patient advocate acts as a crucial intermediary between you and the complex healthcare system, ensuring your needs and rights are prioritized. These professionals assist in various aspects of medical care, from setting up medical appointments to negotiating medical bills and resolving disputes with insurance companies .They champion the patient’s best interests, ensuring they receive the appropriate care. Advocates can be family members, friends, or hired professionals with backgrounds in healthcare, social work, or nursing. Many hospitals also have on-staff patient advocates to assist patients.

Situations Requiring a Patient Advocate

Patient advocates are important in several scenarios. But what exactly do they do, and when might you need one?

• When faced with a diagnosis or managing a chronic condition, patients often find themselves juggling care from multiple providers while dealing with insurance companies. Patient advocates guide patients through these stages, ensuring clear communication between patients and healthcare providers. They help with setting up appointments, accessing financial, legal, and social support, and liaising with insurance companies, employers, case managers, and lawyers. This support ensures that patients receive the necessary information to make informed healthcare decisions.
• An advocate can guide you throughout the healthcare process. This includes managing medical appointments, finding second opinions, and supporting patients in understanding their treatment and care options. Their duties also involve negotiating medical bills, resolving disputes with insurance companies, and ensuring that medical documentation is accurate and reflective of the patient’s needs and wishes.
• Advocates can also help patients understand clinical research opportunities and evaluate whether to participate in experimental treatments. Some research programs include patient advocates to guide participants through the process.

So, when should you consider getting a patient advocate? If you or a loved one is overwhelmed by the healthcare system, managing multiple providers, or facing a serious diagnosis, a patient advocate can provide much-needed support. They help ensure your healthcare journey is as smooth and stress-free as possible, allowing you to focus on your health and well-being.

How Can a Patient Advocate Help You?

Patient advocates can provide valuable support in various ways:

• Explaining medical terms: They can help you understand complex medical jargon and procedures. According to the Ohio Revised Code (Section 5122.29), patients have the right to be informed about their treatment and prognosis in understandable terms, which advocates can help facilitate​.
• Coordinating care: Advocates can help manage appointments with different specialists and ensure all your healthcare providers are on the same page.
• Reviewing bills: They can check for errors in medical bills and help you understand your financial responsibilities.
• Resolving disputes: If issues arise with your healthcare provider or insurance company, an advocate can help mediate and find solutions.
• Researching treatment options: They can help you explore different treatment possibilities and understand their pros and cons.
• Emotional support: Sometimes, just having someone to talk to about your health concerns can be incredibly helpful.

Finding and Evaluating Patient Advocates

Though a relative or friend can often serve as a patient advocate, there are times when no one is available. In such situations, how can you ensure you’re selecting a reliable advocate? If you’re looking for a patient advocate, here are some steps you can take:

• Check with your hospital: Many hospitals have patient advocates on staff, so contacting your hospital can be a good starting point. In Ohio, hospitals such as Cleveland Clinic and University Hospitals have patient advocacy departments. VA health facilities also have advocates on staff to assist veterans.
• Contact local non-profits: You can also reach out to patient advocacy groups, organizations such as Patient Advocate Foundation, or networks relevant to your health condition. In Ohio, the Ohio Patient Safety Institute can provide resources and support.
• Social media, online platforms, and newsletters are also valuable tools for finding advocates who are actively engaged in areas pertinent to your healthcare requirements.
• Look for professional advocates: The Alliance of Professional Health Advocates has a directory of independent advocates, including those in Ohio.
• Consult with an elder law attorney: If you’re dealing with complex healthcare issues, an elder law attorney can provide legal advice and may be able to recommend patient advocates.

When looking for a patient advocate, be cautious of scammers. Be wary of people who seem to be making unrealistic promises or pressuring you to make quick decisions. A reputable advocate should be transparent about their services and fees.

Consider Working with An Elder Law Attorney

While patient advocates can assist with the basic tasks of managing the healthcare system, an elder law attorney can address specific legal issues that may arise during your healthcare journey.

For example, a qualified Cleveland elder law attorney can help manage communications with a private insurance company or Medicare in case of disputes. Attorneys whose practice focuses on elder law and estate planning can also assist in creating an estate plan, including future healthcare decisions. This might involve drafting advance directives such as a living will or healthcare power of attorney, as outlined in the Ohio Revised Code.

If your health care provider makes a mistake in your care, an attorney can work to protect your rights and help you understand your options for recourse. They can guide you through the process of filing a complaint or, if necessary, pursuing legal action. Having an attorney, in addition to a patient advocate, can provide an extra layer of support and protection. This dual approach ensures that both your immediate healthcare needs and your long-term legal interests are protected.

Don’t wait until a crisis occurs to start planning. Contact Rhodium Law today to schedule a complimentary initial consultation discuss how we can help safeguard your health and legal interests.