What is a patient advocate & what do they do?

Nicole Broadhurst |

Patient advocacy is a little-known field with the potential to make a big impact on the patient experience. Patient advocates assist patients in navigating our incredibly confusing healthcare system across all areas of the industry. Assistance ranges from finding and vetting the right provider of services, to understanding and maximizing your health insurance benefits. As healthcare costs continue to rise, accessing and affording care is becoming more challenging. Patient advocates can offset many of these challenges. In this article, we’ll explain the field of patient advocacy and review the many available specialties so you can identify the best option for you and your family.

What is a patient advocate?

An advocate is someone who defends or maintains, supports, promotes or pleads the cause of another. A patient advocate performs these functions on behalf of the patient. Patient advocacy has been around for as long as there have been patients. Mothers advocate for their children, children advocate for their parents, and spouses advocate for spouses. We all advocate for those we love when they become patients and need medical care.

Patient advocacy as a profession

Patient advocacy emerged in recent years as an independent profession. Patients increasingly need assistance navigating their healthcare journey, and individuals have stepped into new roles to provide skilled assistance to patients navigating our challenging system.

Who becomes a patient advocate

Patient advocates come from a wide range of backgrounds. Many transition from backgrounds within the healthcare system and bring years of experience and knowledge about the intricacies of our complex healthcare system. These professionals include doctors, nurses, clinical social workers, therapists, and even healthcare administrators who are excited about creating an overall better and safer patient experience.

What do patient advocates do?

There are many areas in which patient advocates provide assistance. Areas of specialty within patient advocacy include:

1. Clinical Navigation

Patient advocates specializing in clinical navigation typically assist patients with locating the right doctor, lab, surgeon, hospital, and or treatment clinic for the right treatment at the right time. They may also assist patients with transitions from one medical setting to another. For example, a patient advocate could help when a patient is transitioning from the hospital to a skilled nursing facility, rehabilitation center, and home. Transition of care is considered a high risk moment for medical error. Having a patient advocate monitoring and coordinating transitions of care and providing an added layer of support and security to the transition increases the likelihood of a successful transition.

2. Clinical Coordination

Patient advocates specializing in clinical coordination typically assist patients with coordinating their care among many providers. They may assist patients with communication between one medical provider and another. For example when a patient is being seen by a cardiologist, neurologist and a primary care physician, the advocate may coordinate the communication between all involved parties to ensure a cohesive effort is utilized to care for the patient.

3. Medication Review

Some patient advocates specialize in reviewing medication records to ensure they are accurate and are not creating unnecessary side effects for patients. Many of these advocates are trained pharmacists and are well-versed in how medications can affect patients and interact with other medications.

4. Medical Billing and Coding

Medical billing and coding is also a specialty within patient advocacy. These advocates are experienced in the medical billing and coding processes (link to previous article?). They are skilled in reviewing, auditing, identifying, and correcting medical billing and coding errors, which could cost patients hundreds or thousands of dollars.

5. Health Insurance and Benefits

Health insurance and benefits can be very confusing. It’s no surprise that there are patient advocates who specialize in reading and understanding benefits, and holding providers and insurance companies accountable to the benefits they provide. These advocates can also assist patients in reviewing their health insurance options and ensure patients are able to make the right choice for their coverage and benefits based on their individual needs and use of healthcare services.

Finding the Right Advocate

Finding the right advocate for your situation will ensure you reach the best possible outcome to your situation. There are several national directories to locate patient advocates by specialty and location including AdvoConnection, the National Association for Healthcare Advocacy, and Greater National Advocates. If your employer offers Thatch as a benefit, you have access to our team of advocates who specialize in medical billing and coding as well as health benefits navigation. Get in touch with our advocacy team at support@thatch.ai.

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