The Question of Patient Advocacy Services Covered by Health Insurance

Posted on September 20, 2023

The often-raised question revolves around whether insurance provides or should provide reimbursement for the vital services offered by these advocates. The unequivocal answer is a resounding “No,” here’s why. . .

In the dynamic landscape of healthcare, the role of the Independent Credentialed Patient Advocate has emerged as a beacon of hope for patients and families navigating the intricate nuances of the healthcare system. An often-raised question revolves around whether insurance provides or should provide reimbursement for the vital services offered by these advocates. The unequivocal answer is a resounding “No,” here’s why.

As independent and professional (board certification) patient advocates, our unwavering commitment is to our clients – patients and their families. This dedication places their needs and priorities at the forefront, ensuring they receive optimal care and favorable outcomes. Unlike being aligned with insurance companies, our focus remains solely on the well-being and empowerment of our clients.

We are all aware of the concerning decline in personalized patient care at the bedside that has been experienced or observed. Physicians, once known for genuine patient interactions (I will always particularly remember one surgeon in the early 1980s, beloved by patients, operating room staff, and floor nurses, who rounded each early evening on his post-operative patients, frequently observed checking in while sitting on the edge of their bed, even helping himself to one of their chocolates if a box happened to be nearby). Now, face time constraints and the many administrative tasks – result in a rushed healthcare experience, where the patient is fortunate to be acknowledged.

This shift stems from a compensation model where doctors are paid based on the volume of patients seen rather than the time spent with each patient.

In contrast, the physician, nurse, technician, or therapist who can’t get out of the room fast enough due to the number of patients they are expected to see or care for during any given shift, to the Independent Patient Advocate. Our approach is rooted in the strength of relationships and tailored support. We stand independent of the healthcare system, equipped with extensive knowledge of its inner workings following years of professional experience. Our value lies in being able to devote the necessary time, care, and attention to addressing the unique needs of each client, equipping them with what they need to make informed decisions that align with their needs.

Seeking insurance reimbursement for our services would inadvertently align us with their directives, limiting our ability to offer personalized guidance and support on their time, not someone else. It would also hinder our capacity to navigate the maze that is our healthcare system in a manner that best suits their individual circumstances.

While the financial landscape of healthcare is constantly evolving, the role of the Independent Professional Patient Advocate remains steadfast in our dedication to the well-being (including safety) and advocacy of and for clients to have all the information needed to make informed choices and decisions that align with their needs. We stand by our principles, putting our clients first and ensuring they receive the best care and support throughout their healthcare journey.

For additional information, visit: https://patientadvocatesofswfl.com