“When the world is silent, even one voice becomes powerful.”- Malala Yousafzai
When your loved one is getting medical attention, you want them to be taken care of by the healthcare system quickly, efficiently, and accurately. Whether it’s an insurance question or a response from a medical professional, it should be easy to get answers to questions. Know when a patient advocate is working for you and when the patient advocate is working for someone else.
Patient Advocates in Hospital Settings
Let’s take a look at this from a patient advocacy standpoint.
Hospitals in the United States are accredited by the Joint Commission. The Joint Commission requires hospitals to have “complaint resolution process” information available at all times. This is typically handled by the hospital patient advocate. It’s the job of the hospital patient advocate to resolve any concerns a patient may have about their hospital stay.
So that’s great, right? There’s already an advocate for patient in the hospital. And it’s their job to solve patient problems regarding hospital stays.
Well, that is great and those people can be very helpful. Their goal is, in fact, to inform and find solutions to problems and frustrations with care at the hospital. They can explain hospital insurance billing or arrange for transportation home from the hospital.
But let’s dig a little deeper, OK? Ask yourself this question: “Who does the hospital patient advocate work for? Do they work for the patient? Do they work for the patient’s family? No. Hospital patient advocates work for the hospital.
Now, I’m not disparaging hospital patient advocates. They can be very helpful. What I AM pointing out is that, for most people, their allegiance is to who signs their paycheck. In the case of a hospital patient advocate, that would be the hospital.
In fact, hospital patient advocates (or liasons/case managers/ombudsman – whatever title the particular facility selects) often work for the hospital Risk Management Department. If this is the case, their job, first and foremost, is to mitigate risk for the hospital.
Patient Advocates in Insurance Company Settings
The same points can be made for insurance companies. Their patient advocacy services can be very helpful as well. However, keep in mind that their job is to save the insurance company money. Wise consumers know to ask good questions.
The point here is to ALWAYS KNOW WHERE THE PATIENT ADVOCATE’S ALLEGIANCE IS.
Use this information as a starting point. Wise consumers know to ask good questions. When working with the healthcare system, keep in mind that the patient is your primary concern. Don’t let insurance or medical facility professionals distract you from your goal of getting the best result for your loved one, the patient. Bring the conversation back to the main point, over and over if necessary. Request (and follow up if you don’t receive) documentation. Take names and phone numbers. Use a log to record your conversations with dates, times, and names. Summarize discussions for later reference.
Information is Power
Information is power. If you are not receiving the information you need, ask to speak to a supervisor. Go up the chain of command until you are satisfied with the result. Be pleasant, patient, and persistent with everyone to whom you speak.
Hospital and insurance patient advocates have the tools to help you. Let them help. But also, be aware that you may have to go further to resolve a problem to you and your loved one’s satisfaction.
Learning how to advocate for your loved one may be invaluable them when they need help the most. You don’t need a degree in medicine to understand how to get what your loved one needs or to get answers to questions.
“No voice is too soft when that voice speaks for others.”- Janna Cachola
How Can You Advocate for Your Loved One?
Do you want to advocate for your loved one? The How to Advocate for Your Loved One digital course gives you the information and tools you need to begin advocating for your loved one today. Learn more about the course HERE.
Recent Comments