FAQ: Patients and Family

Why do I need a patient advocate?
Our healthcare system is complex. We represent you, ask questions and have your best interest in mind. We attend medical appointments with you, ask questions, take notes, and coordinate logistics with providers and caregivers.

What is an insurance consultant?
A licensed insurance consultant is a licensed individual who does not sell any insurance or financial products but is trained and knowledgeable about insurance products and issues. We help find health insurance coverage, appeal denied insurance claims, transition to Medicare, navigate complicated health related insurance products, coordinate benefits, and review and reconcile explanation of benefits

What is healthcare advocacy?
A healthcare advocate is a person who can help individuals access, understand, and navigate the healthcare system, especially when ill, frightened, or vulnerable.

What’s the difference between you and a health plan/hospital assigned case manager or social worker?
We are independent and unbiased with a vested interest in the patient. We charge a fee for our services but work for you—not a clinic, hospital or medical entity. We stay with the patient regardless of your setting. Other facility representatives may only be available while the patients are under their care and receiving services in their facility

How can I help my family long distance?
You can hire us to check on your loved one in any setting and ensure they are well cared for. We will stay through transitions, attend appointments, ask pertinent questions and follow up. We can also facilitate conference calls with the entire family.

What resources are available for….

Respite care? Depending on the situation, we will consider in-home, adult day care, independent/assisted living and hospice options.

Understanding my insurance to fight denied claims? As licensed insurance consultants, we review insurance with you and answer any questions. We have years of experience appealing and winning denied insurance claims.

Reducing out-of-pocket costs? Our goal is to maximize coverage and minimize variable out-of-pocket costs. We routinely prepare cost/benefit analyses for each option available to you so that you may make an informed decision.

Reviewing Medicare options? When initially eligible for Medicare, we look at the situation and customize options so patients can make an educated decision.

Reviewing Part D prescription coverage? We encourage clients to review their Medicare Part D prescription drug plans annually during open enrollment (October 15-December 7). Plans change and a beneficiaries medications/health may also change.

Reviewing a long-term care policy? We recommend reviewing policies every two years. Personal and policy premium changes should be addressed as well.

Transitioning from one level of care to another or one facility to another? When? Where? Why? An advocate can help research relevant options. We will coordinate with healthcare professionals, movers, etc. to ensure a seamless transition and maintain continuity of care as required.

What if my loved one has to go to the Emergency Room before I get to town?
An advocate can meet your loved one in the ER to represent him/her, ask questions and take pertinent notes. Once a family member or caretaker arrives, we debrief and stay through the process.

What if my family needs help outside regular office hours?
We are not on call 24/7 (at this time) but can be available as needed on a case-by-case basis.

I need to move my loved one closer to me. Can you help with an out of state move?
Yes, we can assist in finding the appropriate resources to assist with the move.

Click the links below for other FAQs

General FAQ

What is a Patient Advocate?

What is an Insurance Consultant?

FAQ: New to Medicare

FAQ: Healthcare Professionals

FAQ: Businesses

FAQ: Prescription Drug Assistance

 

 

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