Tuesday, August 6, 2013

Patient Advocacy: Healthcare on your side

Patient Advocacy: Healthcare on your side

   by Martine G. Brousse
Healthcare Specialist, Patient Advocate, Certified Mediator

Five (more) Good Reasons

 to Hire a Patient Advocate

My previous expose on this subject highlighted the financial, billing-related and administrative support an advocate could provide patients with. Auditing claims and statements, negotiating reduced fees, appealing with insurance carriers, helping navigate a complex system and helping find assistance are some of the more common skills available to patients. 
Let us focus this week on other more practical aspects.

1. I am confused about my treatment options

The news of any diagnosis requiring a surgical intervention, an invasive or difficult treatment, an inpatient stay or the loss, temporary or not, of the use of a limb or organ can be daunting and overwhelming. Managing a chronic illness or condition will almost certainly require a change of mind, a lifestyle adjustment, the need for educational resources and a bit of support. 
An advocate specializing in the condition you face will research your clinical, pharmaceutical and treatment options. This will ensure that the prescribed course of active meets FDA guidelines, is covered by your insurance, and that you have all the  necessary information you need to make an informed decision. It will allow you to prepare yourself, your caregiver and loved ones to the upcoming adjustments and changes in your life. 
While only a medical doctor can and should advise you on your medical needs and status, your advocate can translate new requirements into concrete steps. Nutritional musts can be turned into recipes and menus, treatment side effects can be eased, preparation can lower anxiety and bring back a sense of control, education will empower.
An advocate can help find specialists, centers of treatment, or necessary equipment. She/he will help you schedule the second opinion appointment you are entitled to. Some advocates will suggest or investigate alternative therapies, and keep you informed on nutritional supplementation.
2. I cannot care for my loved one.

The last decades have seen innumerable changes in our society, yet one that is becoming more and more challenging, especially as the American population ages, is that of  family members unable to care for others, due to work obligations, geographical distance or responsibilities their own family. 
Advocates are then hired to step in and act as the main caregiver, their eyes and ears. Accompanying the patient to appointments, monitoring their prescription schedule, assisting with daily logistics at home, acting as their liaison with medical office staff and insurance carriers, handling communications with clinicians, being at their bedside while inpatient or in another facility, are all part of this service. The advocate reports findings, changes and progress in a status report to the person(s) who has hired them. She/he can also organize other supportive care, supervise activities,  monitor visits and communicate to you your loved oneʻs mental and emotional state of mind.  

3. I need someone to coordinate my care at home or in rehab facility

The logistics of dealing with a serious diagnosis or condition are often obscure and unknown at first glance. In case of injury or accidents, seemingly simple activities can become frustrating and complicated. If a patient needs to stay in a rehab facility or is unable to return home after an inpatient stay, an advocate may be the helping hand you need to reach to. From finding a neighbor to feed Fluffy, to making sure the wheelchair is delivered to the right address, to updating and communicating the patientʻs medication list to all clinicians involved, to checking insurance coverage for all services, to driving a spouse to visit you, the advocate can help coordinate your care, and help with the day-to-day management of your affairs until you are back to normal. He/she will collect discharge instructions and make sure they are implemented and followed. If you are at home, he/she will arrange for and supervise treatments and therapies given there. He/she will also make sure your safety and well-being are given the utmost priority.
4. I need help dealing with legal and social paperwork.

Some advocates specialize in  services that are more on the regulations and legal side. A patient is given a difficult dx, needs to start treatment or schedule surgery that same week, and must deal with 1,001 details while sinking into the unknown and having to find immediate solutions to countless problems. How does one get about filing for disability? What about job security and duties? How to sign up for financial support programs such as SNAP (food stamps), or MediAid as 2ndary coverage? If someone has a incurable condition, can they get permanent disability and Medicare?
If a patient faces a shortened life expectancy, or may be incapacitated to make decisions, what discussion should we have? Who with? What are the necessary forms to fill out? Where should these be filed?  
While you should seek legal, financial and accounting advise from a specialized professional, an advocate can help answer many of these questions, provide you with forms and assist you with applications. They can educate you on your basic rights and direct you to more appropriate or specialized organizations and agencies

5. I need other services

Advocates are sometimes known to carry other hats: life coach, stress-management advisor, interpreter, mediator, medical literature researcher, alternative modalities consultant, mentor, moral supporter. 
Trust your advocate to locate national support organizations, local resources, free or low cost services. Let your advocate be the impartial and trustworthy manager of your fundraising efforts. 
Join with other patients and hire an advocate as a group, for an educational informative session based on your specific clinical circumstance, or ask your Dr to provide one. Join your senior friends and neighbors for a presentation on upcoming healthcare changes. Ask your employer for a stress management office-wide consultation. 

I, for example, can assist you in preparing, concretizing and implementing a plan of action based on your oncology-related diagnosis and regimen. My background as a billing manager enables me to offer you expert administrative and claim-related auditing services, as well as other financial skills. My degree in metaphysics and extensive knowledge of alternative therapies are perfect foundations for a range of other modalities you may find of interest: strategy for stress management and for keeping focus on wellness goals, body/mind/spirit protocols, family healing mediations, local resources and addresses. 

©  [2016] Advimedpro.
©  [2016] Martine G. Brousse.
All rights reserved.

My objective is to offer you, the patient, concrete and beneficial information, useful tips, proven and efficient tools as well as trustworthy supportive advice as you deal with a system in the midst of sweeping adjustments, widespread misunderstandings and complex requirements

AdvimedPro        (424) 999 4705 or (877) 658 9446       fax (424) 226 1330
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