Working with a Patient Advocate on a Budget
Patient advocacy can be life-changing for people. You get one-on-one support from an expert in navigating the medical system. Your advocate works for you, not a medical provider or facility. The resources, skills, and unmatched support that a good advocate can offer is as good as gold. There are folks that desire patient advocacy, but find the cost to be prohibitive, so they don’t reach out. Patient Advocacy is an investment, and a good advocate will help you budget your time and resources effectively. Here’s how to make it work:
First, let your Advocate know that you are on a budget before you hire them. This can be discussed in a consultation, or via phone and/or email communications. The business I work with, Lost Coast Advocacy, offers free hour-long consultations. It’s okay to have consultations with multiple advocates to find the right fit for your needs and your budget! Don’t be afraid to shop around. Don’t be shy about asking questions. The Patient Advocate should help you determine how many hours they can offer based on their rate and your budget.
Determine what you are looking to get out of working with an Advocate. A focused, clear objective is always useful. Your advocate can help you decide what your most important needs are, should you require support with that.
Next, create a game plan. What steps need to be taken to get your needs met? What is your role and what is your Advocate’s role in this? Do they anticipate being able to fulfill your desires within the limited timeframe?
Ask for resources! Your Advocate may have an abundance of pertinent resources at their fingertips. Since time is limited, it is crucial to have tools to continue advocating for yourself once you part ways with your Advocate. You can also ask them to help you strategize next steps to take for when you are no longer working together.
As an example, let’s talk through a fictitious scenario. Carmen has a medical history of years of back and shoulder pain from the weight of her breasts. She suffers through the days, despite taking an excess of over-the-counter pain medications and trying remedies like heat, massage, and a myriad of different supportive garments. Carmen has done some research and is interested in a breast reduction to ease her pain and take some stress off her chest and back. She had a consultation with the only plastic surgeon in her area. A pre-authorization was filed with her insurance, Medi-Cal, but was denied on the basis of deeming this breast reduction cosmetic instead of medically necessary.
Carmen does not know what to do next and her plastic surgeon is so overwhelmed with patients that they are neglecting to help her appeal this. She reaches out to a Patient Advocate for help but is worried because she her budget is tight. After discussion with her Advocate of choice, she determines she can afford to pay for 2 hours. She is worried this will not be enough. The Advocate reassures her that they can make this work. They determine that the primary objective is to file an appeal, and get her insurance to pay for the breast reduction.
The Advocate follows through with filing the appeal. They learn that there was insufficient documentation to prove the procedure is medically necessary. The Advocate assists in getting the clinic to take and submit photos to the insurance- it takes 3 phone calls to make this happen! The Advocate also gets medical records that support the claims of years of pain related to the size of Carmen’s breasts. Eventually, the claim is approved and Carmen gets scheduled for surgery!
Carmen’s Advocate sends her resources to prepare for surgery and recovery. Her Advocate also checks in on her after the surgery. Their time together is complete. Carmen got her surgery, and resources to help her now that her time with the Advocate is up. She is relieved and feeling so much better now. The investment and leap of faith was worth it!
In summary: A good Advocate will be honest about what they can realistically support you with in the timeframe that works with your budget. They will provide resources to help you along the way, and for once you are no longer working together. They will help you meet your needs!
Please reach out if you have any questions about Patient Advocacy. We want to help nonjudgmentally, and to support you as best we can. Our role is to help you, and we are happy to do it! Take care.