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Advocate and Care Manager Best Practices
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Advocate and Care Manager Business Management
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APHA offers many CEs free or at a discount for certified members.
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Courses and Tips to help you find practice success.
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APHA’s Mentor Program – Information and Application
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Find events of interest to advocates and care managers.
Certification
Keep up with certification for Patient Advocates.
COVID-19 / Coronavirus Resources
From business maintenance, to client service, to marketing during a pandemic.
Information Specific to Canada
Case #Patient LocationPatient GenderAdditional Information
CA-21-0921La Mesa, CAfemaleClient and family not honest when hired regarding clients medical diagnosis and that she had checked out AMA from previous SNF. Client and family wanted to find another SNF with long-term custodial beds in a very specific geographical area. SNF’s that had openings declined to accept due to AMA and other medical conditions. Client called frequently about getting increased dosages of narcotics, and even called 911 from the SNF to go to the ED for additional narcotics. Clients primary complaint is getting more meds, when she is already at a high-dose. Family expects additional pain management above what is being prescribed. Client refuses other pain management alternatives, only wants narcotics.
NY-21-16Wading River, NYfemaleThe client has many health issues (physical and mental). She does not comply with doctors recommendations, and by doing so compounds her health issues and is in a constant cycle in and out of the hospital and various specialists. I have provided her with summaries of her doctors visits and critical next steps to improve her condition which she ignores until she is in another health crisis. She is angry, very unpleasant and passive aggressive making it impossible to rationally communicate with. When she doesn’t like what she is told she threatens to retaliate with negative google reviews and lawsuits.
CA-20-0819Palm Desert, CAfemaleClient has complicated health issues, tends to be irrational, emotional and angry. Client was not honest during our initial consultation, and did not fully disclose all health issues and challenges with local providers. She was not compliant with doctors treatments and therefore her condition got worse. Local doctors have declined to treat her. I was able to get her an expedited appointment at a university hospital, however she was not satisfied with the date and time. She does not work well with people, and tends to blame providers for her current situation. Her behavior can be demanding with calls, texts, emails, evening hours and weekends, and expects that time to be at no charge.
CA-20-0210Los Angeles, CAfemaleThis client is very high maintenance and will tend to not respect the amount of time it takes to complete tasks that have been identified in the client contract, to include the time estimates. Additionally, she has a difficult time allowing the Advocate to advocate for her. She is extremely intelligent and well versed in her condition. So much so, she speaks over you during conversations and disregards previously established boundaries. While my efforts were successful and I provided the services requested, for these reasons, It became increasingly difficult to manage her as a client. Most importantly, she began to request things that would alienate providers that were willing to work with her.
CA-18-0120Oakland, CAmaleOn a national holiday, I traveled to visit a couple, in Oakland, CA that I had good reason to believe had converted from prospect to client. The husband is ill; his wife, apparently, runs interference for him but they don’t seem to communicate their intentions to or plans with each other. Two days prior to my visit, I had sent them my contract, intake form, and an authorization for release of protected health information after speaking with the wife for a 25-minute complimentary consultation and brief intake. I had also cleared the path for a sub-specialty referral, since their visit at Mayo had not gone as they had hoped. When I arrived at the couple’s apartment (after traveling for 1.5 hours from San Francisco), they summarily dismissed me, ordering me to leave their apartment in a threatening tone without so much as a thank you or willingness to pay for my travel time.

Should they contact you, I encourage you to think twice about working with them. They are very young (the husband is age 31) and immature, disrespectful of professionals whose services they wish to engage, and poor communicators. In all likelihood, they will waste your time, as they did mine.

In addition to this red flag, I have notified all Bay Area advocates whose contact information I can find about my experience with this couple, as I anticipate they will, at some point, seek out another health advocate.

N.B.: Upon returning from my thwarted visit, I learned from another advocate that, on the previous day, she had had a lengthy telephone consultation with the wife. Furthermore, she had reviewed the husband’s records from Mayo and believed SHE had been retained for advocacy services.

Request more information.
CA-18-0115Menlo Park, CaliforniafemaleClient is clearly intelligent and in need of assistance but is extremely angry at the “medical establishment” and unwilling to consider what might be the truth because she is afraid of it. She proclaims that she is “blacklisted” from a couple of very prominent hospitals in the country. I am not the right advocate for her simply because I am unwilling to work on a 24/7 “on call” basis but I’m also not prepared for (or willing to take on) the emotional abuse that will likely come from working with this client.

Request more information.
TX-17-1111Frisco, TexasmaleThe client attempted to not fulfill the payment terms of the contract. This, despite, ultimately saving him the entirety of a bill–$33,000.

He is aggressive, rude, disrespectful and not trustworthy.

We were the second advocate he approached. The first one never consummated a contract because he said she had no follow through. I now believe he misrepresented the situation.

I only wish our success had benefited someone more worthy.

Request more information.
MD-17-0523Las Vegas, NV and Los Angeles, CAfemalePt’s wife hired me, misrepresenting the situation and lying repeatedly about certain facts. She soon became reluctant to pay my invoices due to lack of results, although work was performed. Anticipated results (refunds) could not be achieved as she lied about having paid the providers. Other work (auditing EOBs, filing appeals…) was performed.

I terminated her but agreed to finish the work (and adding more) after she paid me in advance. Eventually I filed appeals for almost 100 underpaid claims, which resulted in no liability vs. thousands of $ being billed to her. Yet she kept complaining of the lack of “refunds”.

I terminated her for good after two months of work went unpaid.

I now have received a letter from her daughter, an attorney, stating I am owed nothing as the work was not performed and as I did not know that the patient had passed away (after all communication was severed!). She threatens me with malpractice unless I write off the balance. I have little choice but doing so.

As she was demanding from the start, I undercharged her, and spent countless hours being a friend when she needed support (without charge). I see now what a mistake I made by being too helpful and caring when all early signs pointed to a lack of integrity and little intention of paying me on her part. I should have trusted my gut feeling and stayed away the first time she disputed my bill and questioned my professional integrity.

Request more information.
MD-17-0330Hagerstown, MDfemaleClient has very complicated health issues, including chronic pain, Lyme disease, and adrenal crises. After many phone calls and cancelled intake evaluation appointments, I agreed to work for her. Once I started work, her priorities changed daily, making it difficult to focus on any single issue effectively. Client’s almost daily phone calls were often 60+ minutes long, full of rambling anecdotes, despite my best efforts to get her to focus. Client used up her initial retainer quickly because of the phone calls and the amount of work needed to pursue her changing priorities. When it came time to ask for an addition to her retainer, I discovered that she thought I worked like a malpractice attorney, and would only get paid when I achieved results. I then realized she had never read the contract or proposed plan for services. She became angry and verbally abusive when I explained how the account was charged and that all those policies were included in the contract. She threatened me with legal action. The account has been terminated and the balance of her retainer refunded.

Lessons learned: No matter how much you’d like to help some folks, trust your gut! When the client cancels the intake eval two times, don’t make a third appointment. Fortunately I took great notes. I’m frankly relieved to be terminated, although I was just beginning to make progress. I still think I could have helped her a lot, which is disappointing.

Request more information.
NY-16-1218Queens, NYfemale and her fatherThese clients worked with two APHA members. They withheld/misrepresented their case and became threatening.

Request more information.
CA-16-0819Los Altos, CA or Carson City, NVmaleClient got into my Pay Pal account terminating some of the invoices I sent him, he also wanted a full time person handling all of his medical issues, appts, etc. He was very upset and angry when I terminated him. I did his Disability Appeal and won but that was not enough.

Request more information.
TX-16-0727Little Elm, TexasmaleBailed before offering a contract to represent him and his company in a dispute with Cigna. Problem was full disclosure – did not find him forthright in conveying essential information to me.

Request more information.
NV-16-0224Las Vegas, NVfemaleI went against my lawyer’s advice to help this patient’s daughter with trying to getting billing issues resolved with Medicare, after my lawyer researched the patient’s daughter he discovered that she is sue happy.  She turned around and sued everyone who has tried to help her including the lawyers that helped. The patient’s daughter at first was okay with the way I was handling the case then she started falsely saying that her boyfriend and then her mother were sending emails of complaint on me. Ultimately she wants to sue for $400 which I already refunded.

Request more information.
FL-15-0627Melbourne, FLmaleMy lesson learned is ask the patient “if he has had another Advocate assist him in the past.” Nicholas remains focused upon his legal needs making it very difficult to direct his attention to his health needs. The client understandably wants to be kept informed but his telephone calls were lengthy due to repeated and repeated issues that were focused upon his perceived illegal issues regarding the client’s cardiologist. My presenting choices to help the client keep directed on health concerns were basically not of interest to the client. This termination of service is very difficult for me as he also has a wife who is diagnosed with Pancreatic Cancer. The client wants to make his wife his primary concern. Yet in speaking with the client a couple of times I introduced the topic of temporary household assistance. as with other potential new Client goals the dismissed subject,due to what this Navigator opines as illogical reasoning on the part of the Client. Telephone calls became somewhat abusive toward me so I resorted to email.

Request more information.
MD-14-101Silver Spring, MDfemaleClient asked Advocate to help with Appeal to get Denial of Psychiatric Benefit coverage overturned. Client did not provide complete information, did not provide data requested, provided documents but gave Advocate only 4 days to complete filing for “review” of actions taken by insurance company & kept changing the explanations she was originally denied coverage. She later said she had $7700 worth of bills for counseling she had after insurer denied 2 internal & 1 external appeal that she wanted insurer to pay her for. She was honest but purposely omitted critical information until the last minute. I cannot present a brief to Maximus with her story continually changing & the data missing.

Request more information.
Medical Information Resources
Request CodeState / ProvinceDescription of Need
1122-1633WAI am a single mom with low-income status. I have upcoming knee surgery that involves ACL and Meniscus repair. With my insurance and the estimate, I received it cost me around $2500. However, it seems too much for 2 procedures at the same time. I would like someone review on this.

How Can an Advocate Help You?: Reviewing the estimate and help with financing.

Request submitted on: 11/21/22

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1122-1632MOI am 57 with history of back issues. I have gotten rear-ended last night and went to the hospital and was given nothing for pain

A MRI states severe spinal stenosis with out contrast.

The hospital refused to give me anything for pain because of the fentanyl issue around our area?

Why am I being victimized??

Request submitted on: 11/17/22

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)

1122-1631CAI am being denied access to understanding my blood test results in writing formated as Purpose, Doctor’s recommendations, consistent with analysis consistent with the test data. I need an advocate who can help me obtain what I know is medically necessary and is inconsistently provided.

How Can an Advocate Help You?: Is a real leader who can provide me with access to diagnostic blood test data purpose, recommendation analysis data that my doctor withheld since my March 03, 2022 25 blood tests. He handed me 15 pages I could not read telling me the printer ran out of ink. Help?

Request submitted on: 11/16/22

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1122-1630CT I am inquiring on behalf of my parents who are both 85. They live outside of New Haven, Connecticut and could use a patient advocate to help find and coordinate various doctors.

Request submitted on: 11/16/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1122-1629MII’m in need of a Private Patient Advocate
How Can an Advocate Help You?: Need help with understanding new diagnosis and treatment options.

Request submitted on: 11/15/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1122-1628FLMy mother is 94. She lives alone. She has multiple medical problems. She thinks clearly. Right now she has sores on her foot which haven’t healed. It’s been recommended that she have vascular surgery to improve the circulation in her legs. She is scared to have it.
How Can an Advocate Help You?: By evaluating her medical needs, arranging for second opinions, driving her to appointments, providing knowledgeable support including note taking and advocating for her.

Request submitted on: 11/16/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1122-1627AZThe date for an informal conference was set , postponed,and then my appeal was dropped the day before the postponed informal conference. 3 letters written by the same person who blamed me for not showing to the original informal conference she postponed and I made a complaint about postponing
How Can an Advocate Help You?: I have referrals to surgeons on my ears since April 19 2021 and referrals to infectious disease since Aug 2021 do to infections caused by not having the surgeries. I have lost my home and living in my car because of this I need help

Request submitted on: 11/14/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1122-1626KYIndividual is in need of health care services. She indicate that she has spinal stenosis, sciatica, neuropathy, scoliosis, and her doctor has cut off the only medication that has helped her. She expressed that she has so much medically wrong with her.

Request submitted on: 11/14/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1122-1625FLPatient medical advocate, support advocate
How Can an Advocate Help You?: Guidance, decision making, medical and community resource support, medical wellness, accessing medical care.
Executive function skills-someone to help with cognition based daily activities

Request submitted on: 11/13/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1122-1624MNNeed urgent help. Vaccine injured. Covid long haul, heart issues , cancer spreading all over. Nurse myself 22 years. Harmed locally need to get to Mayo in Rochester MN urgently I can get there need help tgere. An advocate very sick can explain more. Very urgent in nature
How Can an Advocate Help You?: Need help someone in Rochester MN area Mayo Clinic or can meet me there I’m from kc can explain more send pictures. Desperately need help

Request submitted on: 11/10/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1122-1623MOHomeless man with mental illness is in need of an advocate who can help him with navigating care. This is a pro-bono case. If you’re interested in helping this person, we can share his emails with you that outline his situation.

Request submitted on: 11/3/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1122-1622OHI cannot get a medical statement from my doctor. I think that I am paying more out of pocket fees than Cigna, my Medicare supplementary has stated. I can’t check to see what Medicare, Cigna, and myself are paying without a medical statement.
How Can an Advocate Help You?: I need to know how to get a medical statement when the billing office refuses to give me one.

Request submitted on: 11/3/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1122-1621LAOwing a bill for years. Really stressing me out. Can not afford it.
How Can an Advocate Help You?: Lead me in the right direction

Request submitted on: 11/1/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1620SCAdult daughter (located in Florida) needs an advocate to accompany her 94-year old mother to doctor visits, etc. Mother has a range of health issues (heart, blood pressure, kidneys, plus anxiety).

Request submitted on: 10/31/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1619CABeing forced to taper off of opiod prescription for chronic pain due to severe neuropathy pain. Having anxiety/panic from situation. Blood pressure highly elevated from pain and constant stress. I am in no condition to have to fight for medical care that could save my life. No family left. Help
How Can an Advocate Help You?: Getting medical attention and treatment that prevents me from having a stroke or heart attack. My health issues require a team of specialists and I am unable to orchestrate this feat on my own. Please, need help now.

Request submitted on: 10/29/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1618WAThis is a dental issue regarding hybrid arches I had in stalled two years ago in Denver, CO. Teeth have broken out and one of the arches has broken. They have offered to replace it all brand new. Based on the previous work they did, I am not confident.
How Can an Advocate Help You?: I want someone knowledgeable who can help me make sure the work gets done right.

Request submitted on: 10/27/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1617CASevere back issues, he has anthem blue shield and recommendations for shots etc by pain clinic and doctor keep getting denied. He needs help
How Can an Advocate Help You?: Assist in getting procedures done.

Request submitted on: 10/27/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1615IAMy life partner of 15+ years has been subjected to no care or treatments for life-threatening issues with overload of fluids in her body/abdomen/legs/lungs/heart.
No doctors seem to know what to do or
try to find someone who knows what to do.

Request submitted on: 10/20/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1614MIPatient is homeless, jobless and can’t get proper medical care. Is on Medicaid. Broke her back in 2005 and 2017. Prior to COVID, patient was being treated every six months for 8 years for back pain. She would like to continue to maintain treatment and needs assistance in obtaining a diagnosis for another injury. Pro bono case.

Request submitted on: 10/12/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1613TXA woman is looking for insurance options for her adult daughter who was in a serious hiking accident while in between jobs. Her daughter had a major head injury and is missing part of her skull. Her mother is concerned about the long term care plan as well. She is nervous about her budget for an advocate and is also looking at pro bono options.

Request submitted on: 10/11/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1612D.C./VAI am looking for a patient advocate in the Washington DC/Arlington, va area for my sister who was recently diagnosed with liver cancer.

Request submitted on: 10/6/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1611TNI am a 35 yr retired ER /RN under mysterious circumstances, my physiatrist was taken from me. It had nothing to do with my Dr I believe, lots of problems in my chart I requested. I have not been given the whole chart. excuses don’t hold water. I am a nurse, and this is violation of procedure if nothing else but there is more. Can you help with this in any way? thank you. No one will tell me who. No one. I am not stupid but they sure think I am…..breaking HIPAA laws as though they dont exsist.

Request submitted on: 10/4/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1610GAMy mother was arrested and is awaiting charges due to an extreme mental health episode. She is in desperate need of a Legal Advocate, she is going to attempt to represent herself in court, but she is not mentally competent.
How Can an Advocate Help You?: I was hoping a legal mental health Advocate could be of support to her during her court trail with multiple felonies, she is attempting to represent herself in court, she is nowhere mentally competent.

Request submitted on: 10/4/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1608MOMisinformation in record. Told I wasn’t sick and that the hospital was for sick people.
How Can an Advocate Help You?: Expunge record. Make sure I am not unfairly expelled from the hospital, or services.

Request submitted on: 10/3/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
1022-1607KYBilling dispute that I can’t get resolved.
How Can an Advocate Help You?: Would like someone to resolve a billing issue with hospital.

Request submitted on: 10/1/2022

APHA Premium +ADL Members: Link here to help this person (You must be logged in to the myAPHA membership site.)
Other
Premium Announcements
Getting Started with Your Premium Membership
A step-by-step guide to uncovering some of the resources you’ll find at APHA.
Free Gifts!
We’re pleased you joined APHA.
Here are the gifts we promised you.
What Do You Need to Know?
Find articles, podcasts, tools, tips, and more in the ORB, the Online Resource Bank.
APHA Academy
Learn to start and grow your practice.
CEs for Certifications
APHA offers many CEs free or at a discount for certified members.
PracticeUP! Online Courses
Courses and Tips to help you find practice success.
Need a Mentor?
APHA’s Mentor Program, General Mentoring Information, and List of Mentors
Calendar
Find events of interest to advocates and care managers.
Certification
Keep up with certification for Patient Advocates.
COVID-19 / Coronavirus Resources
From business maintenance, to client service, to marketing during a pandemic.
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