A medical issue can come up without warning, and even savvy patients can find themselves overwhelmed when trying to navigate care and insurance. Private health-care advocates can help you and fight the outrageous bills, typically for a fee.
They help resolve medical-billing problems, fight insurance-coverage denials, aid in complex medical decision-making, and find the right specialist or hospital for a particular condition.
Many health-care advocates charge individuals a flat fee, an hourly rate or take a percentage of whatever money is recovered. But some perform the work for free or on a sliding scale or reserve a portion of their workload for such cases.
Advocates typically charge $50 to $200 an hour, says Joanna Smith, president of the National Association of Healthcare Advocacy Consultants, a professional group in Berkeley, Calif. Consumers looking to hire one can search online directories run by the NAHAC and a company called AdvoConnection.
Advocates are often nurses, social workers or people who've navigated their own challenges with the medical system. No license is needed to practice, but there are several credentialing programs. And the NAHAC has designed a code of ethics. So be sure to ask about those when interviewing an advocate.
Elisabeth Russell, founder of Patient Navigator (PatientNavigator.com) in Vienna, Va., says people looking to hire a health-care advocate should expect a written estimate of costs and services and feel comfortable with the advocate's style, experience and expertise before signing on. Patient Navigator charges an hourly fee, typically $125.
The bulk of cases at Philadelphia-based HealthCare Advocates (HealthCareAdvocates.com) are insurance disputes, decisions about medical treatment and billing snafus. A lot of people are too busy to handle all the paperwork that comes in and they don't know what to do with it. Most cases cost consumers $300 to $400 and last a few weeks or months, depending on the problem.
The Patient Advocate Foundation of Hampton, Va., (patientadvocate.org) offers free help to patients whether or not they have health insurance.
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