BILLING & CLAIMS
Review of medical billing and charges to ensure accuracy in billing.
- Seek billing reduction and/or negotiation
- Resolve billing errors
CANCER
Some advocates specialize in navigating in cancer, cancer-related issues, specific cancer types (like brain cancer) and/or helping clients find and participate in cancer research.
END OF LIFE / LIFE CARE PLANNING
- Helping clients understand and plan for transitions and end of life
- Advanced care directives
- Burial/cremation
- Hospice services
HEALTH COACHING / PREVENTION SERVICES
Assisting clients in ways that further personal health goals and ensure better health outcomes through preventative measures.
HEALTH INSURANCE
- Identify sources of coverage for people without insurance
- Confirm and decipher coverage for those with insurance coverage, including
- Medical Benefits
- Pharmacy Benefits
- Vision Benefits
- Medicare Benefits and Supplements
- Home Health and Rehabilitation Coverage
- Social Security
- Veterans Benefits
- Explain patient costs such as co-pays and coinsurance
- Facilitate research for appropriate in-network providers and clarify out-of-network options and costs
- Advise on denials and appeals processes
- Help with choosing health plans, Long Term Care plan or COBRA (continuation of benefits)
- Investigate additional benefits available such as private or employer-provided disability or long-term care insurance
- Exploring appropriate Wellness benefits:
- Preventive Care
- Alternative Care
- Member Discounts
- Use of Advice Lines
- Hearing Aids and Screening
HEALTH CARE PROXY
An advocate can serve as a health care proxy (medical decision-making surrogate) to make decisions for when someone is unable to make decisions for themselves; a health care proxy is named in a durable power of attorney for healthcare and needs to be evaluated whether the person can serve in that role.
MEDICAL / NAVIGATIONAL
Typically includes interacting with healthcare professionals, attending appointments, medical translation, appointment setting and coordination, asserting client’s patient rights, communication, identification of medical/health resources, etc.
- Help patients understand their diagnosis and learn more about their condition
- Translate complicated medical information for family members
- Research treatment options
- Coordinate care between various physicians
- Provide regular contact with patient to evaluate condition and advocate for appropriate care with providers
- Assist with transitions including hospital admissions, stay and discharge; transfer to another facility, care center or home
- Coordinate outpatient care
- Help with understanding and managing chronic disease
- Establish contact with Social Service Programs and Eldercare
- Act as liaison between patient and with providers regarding wishes for hospice
- Referrals to appropriate resources as needed
- Assist with communications with providers, family members at client’s patient’s direction
MENTAL / BEHAVIORAL HEALTH & SOCIAL WORK
- Managing stressful, serious, and/or chronic health conditions
- Issues related to controlled substances
- Working with behavior health challenges that make communication difficult
OLDER ADULT SERVICES
- Housing
- Home care or support
- Transport
- Meals/nutrition
- Treatment plan assistance i.e. medications, lifestyle changes
- Financial
PAIN MANAGEMENT / PALLIATIVE CARE
Helping clients ensure that their pain is managed appropriately, whether short-term, long-term, and at the end of life.
PEDIATRIC CARE
Working with families whose children need support in navigating various aspects of the health care system.
TRANSITIONS / HOUSING PLACEMENT
- Transitions in/out of hospital, assisted living, skilled nursing, nursing home, adult family home, or other placement, including home with or without care