Insurance Reimbursements for Patient Advocates?

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Insurance Reimbursements for Patient Advocates?

This is one of those questions I’m asked frequently which recently popped up again: When will private patient advocates be reimbursed by insurance? In fairness, the question is usually asked by either those who either aren’t advocates, or are in the very early stages of thinking about patient advocacy as a living. They haven’t been exposed to the issues involved on a regular basis, so the obvious answers aren’t so readily apparent. But whether you’re a total newbie, or you’ve been dancing in advocacy circles for awhile, there are two answers, at least for now: •  probably never •  hopefully never If those answers surprise you, then you don’t know enough about health insurance and/or you don’t understand one of the most important attributes of private, independent advocacy. Health insurer reimbursement for private, independent advocates would not only create a conflict of interest, but would drive most advocates out of business. In any case, reimbursed advocates would no longer be private NOR independent. Let’s break it down. Among the most important attributes of private, independent, professional patient advocates is that they are… independent. Independent of what?  Independent of the payment system that has created most of the hurdles patients encounter with the system, for which they seek solutions. Being outside the payment system is precisely what creates the advocate’s objectivity. When it comes to guiding patients and supporting patients’ decision-making, advocates don’t profit based on the choice the patient makes. Their only goal is to achieve the best outcome for their client, without regard to how much money any provider or facility will profit from, or save. Their allegiance is solely to their clients; they are beholden to no one else. That’s the major reason they can be so effective. But health insurers are quite the opposite. Within the system, health insurers control the flow of time, information, and payment, because their primary goal is to save money. Health insurers actually go to great expense to limit their expense. Here are a few examples: insurance won’t pay for time doctors spend with their patients, which means patients don’t hear about…


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