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Today we are taking a look at the front end of patient advocacy – the finding, interviewing, and selection of your Patient Advocate. I’ll bet you have some questions.
Why are we even talking about this?
Why do you need to interview?
Is this gonna be hard?
In a word, no. This should be an exchange.
This early communication is when you gain a sense of whether this person can help you. You are looking for (and so are we) “The Fit.” You need a window into the possibilities, the process, what may occur, and of course, the cost of services.
Many an Advocate or entity has written this kind of article, but I have never assigned commentary. Finding, interviewing, and then selecting a Patient Advocate is the lead domino to much of what may follow, so let’s spend some time on the front end.
As you open your inquiry it’s important that you explain your situation, at least briefly. Here is where both you and the Advocate begin to establish and gain clarity as to the work that will be needed. You are each coming to understand what is required and when from each party.
You may be asked what has been tried so far or if there are any deadlines coming up for decision or action. The Advocate will explain how they normally work, and you may ask questions to gain a sense of how things will flow.
Use the questions that follow, or choose a few that seem important to you. Read the commentary and decide whether that helps. Most of all, let’s get you where you need to be in terms of understanding and in terms of The Fit.
The goal here is to gain clarity – about the person, how they deliver services, and how to engage them, along with the pertinent points of what the business relationship will look like.
It’s true: “We make the best decisions with the most information.”
You will no doubt wish to look and listen for experience working in the healthcare system, evidence of strong listening and communication skills, solid knowledge of the complexities involved, and an ability to offer emotional support and resources. Listen for passion for the well-being of patients and for doing the job.
You may wish to refer to the Code of Ethics for Patient and Healthcare Advocates and also to understand that we are guided internally by something called The Allegiance Factor. I cite it often. The Allegiance Factor means that “I work in direct service to patients and their loved ones – not for hospitals, not for insurance. I work for you.”
And so we begin with:
- The Advocate
- Engaging for Services
- Links to locate Patient Advocates
The Advocate: Basics, credentials, and experience
How long have you been an independent Advocate?
This may or may not be important to you, as an Advocate’s credentials, work experience, or education may be more important than when they entered our industry.
Where are you located?
Does that matter in your case? Read on. In these post-pandemic cases, it has become more of a norm for Patient Advocates to coach and steer cases remotely. It can save you money as it can be more efficient. And yes, there are times when boots-on-ground are definitely called for, and your Advocate is listening for that. The Advocate is determining if they can be the “Best Fit” or can “Best Serve.” If they are not the ideal Advocate for your situation, I believe that I am safe in vouching for all when I say that we will refer you on and likely assist you in finding the best fit. That is paramount to us.
What are your credentials/your education/experience/certifications/licensures?
I am here to say (and it is an opinion, and one drawn from years of observation in this field) that one credential may not be superior to another as far as your remedy goes. Degrees or licenses can be trumped by relevant experience, for example. Always listen for ‘Best Fit, Best Serve.’ Your internal compass will likely tell you if you have found the fit.
Have you completed any patient advocacy certifications or coursework?
This can be their opportunity to tell you about specific coursework certifications that may be relevant to your situation or to offer that they became a BCPA – Board Certified Patient Advocate. Your Advocate may have certain training and education that will have them stand out as the right candidate for your situation.
What work did you do before going into advocacy practice?
Gain a window into your Advocate-candidate’s career path, or hear how some of their previous work history (or life experiences) might directly apply and can have a positive bearing on your outcome.
What is your work approach?
Do you have a set process for how we would work together? If so, please describe how this works.
What will you need from me? Do I provide information, history, contacts, get documentation to you? Sign any consents?
What happens if there are obstacles encountered while getting the work done?
Things change, circumstances change, and people certainly do. The key here is open and continual communication. Are you hearing that message of commitment (and can you have the same)?
How will we communicate?
How and when is best? Will you set meeting times, or can I call or email you as needed? How will you communicate your progress to me? What are your normal business hours for responses?
Do you have the time in your current workload?
It’s a fair question, and you will want to listen for their tone in honest reply. In my case, if I knew I could not be available to you to help walk you through a loved one’s impending and tricky discharge then I would tell you that. Then I would go about the business of helping you find the right fit, absolutely! Most times, we can be of service however there are times when we may be at caseload capacity. Therefore I will make it my business to know other Advocates that can be contacted toward your need.
The Advocate: Service offerings and fees
What services do you provide that will help my situation?
What is your experience handling cases similar to mine? If you have handled cases similar to mine, how did they turn out (or how do they typically turn out)? An Advocate, upon hearing your need, will be able to match their proposed activity to your needs. Expect them to discuss relevant services they provide.
What do you charge? How do you charge?
Meaning how will the Advocate be billing: by the hour, month, and encounter? Increment of time? Package/blocks of time purchased? A flat rate for a project with an agreed-upon scope of work?
Independent advocacy services are considered “Fee For Service,” meaning we are not covered by insurance. (That is actually to your benefit, in that our voices will not be squelched nor our work curtailed because insurance is our employer, or the hospital is our employer. We work for you).
Advocates may set an hourly rate or a project or service fee. Sometimes Medical Billing Advocates will charge you based on success, such as a percentage of a medical bill savings or funds they are able to recover. Most often, Advocates charge for their time by the hour or by offering packages (blocks of time for services and other features).
Costs can vary depending on the Advocate (their expertise, location, and level of experience) and on your situation (how complex or straightforward it is). Rates range from $100 per hour to $400 per hour.
How long will it take you to perform the services needed? How long will it take?
While this seems a fair question, and we know that you are anxious for resolution, Advocates cannot always predict exactly how long your situation will take to resolve. Professional Advocates can, however, speak from their experience to provide a loose timeline of how things might go.
Be aware that any case likely has moving parts:
→ multiple parties and providers involved
→ “the human condition” as a large variable
→ systems-related challenges
→ holidays, hurricanes, you name it!
Savvy Advocates can effect change much faster than the average consumer due to our knowledge of how things work, our expertise, and our experience serving folks with similar circumstances.
Do you have any references?
Since our work relies heavily upon confidentiality the answer here may be a No, as we protect the confidentiality of our clientele. You could certainly ask, “Do you have testimonials?” In addition, expect to read testimonials within directory profiles, and bios, on their websites or other social media.
Ask the Advocate to “tell you about a time when they…” or “How have you handled similar cases?” We want you to feel confident in your selection.
Pause and assess. So far,
- How does their expertise match your needs?
- Do they seem knowledgeable about your situation and solutions?
- Are you becoming comfortable with how they work?
Time to move on to the business end of things. Gain clarity on engagement for services.
Engagement for Services
What will you require of me/us as the guarantor?
Contract or Service Agreement? Consents for release of information? Copies of our legal documents, such as a Healthcare Power of Attorney document with designations or insurance policies?
What are the service fees and payment options?
Is there a down payment?
What kinds of payments do you accept (Cash, check, credit card)?
Are refunds available, and under what circumstances?
What are the terms of the agreement or contract?
Most advocates will ask you to sign a contract and agree to certain terms and conditions. Review those terms carefully and make sure you understand them and feel comfortable with them. If you have questions, ask. (Personally, I will often offer to go ahead and send my Agreement For Services for their review to ensure their understanding and to allow for questions).
In closing, all that I have just shared with you is merely a guide. My list of topics and questions is not exhaustive, and you may find other questions of value to you when searching the internet. For example, a list of interview questions may be located on the websites of our professional organizations, too. I have placed some links for you below that will help you find them and ultimately locate us.
As with many things in life, simply “Take what you need and leave the rest.”
Today’s segment should provide a good sense of what to expect when working with your Advocate-candidate, and it’s important that you make sure it feels like their approach will work for you. We are all about The Fit, and we want you to be, too.
I hope that something covered today provokes thought or helps you in some way on your own journey or when helping someone you may encounter.
Be well, everyone!
Nancy Ruffner is a consultant, speaker and coach, consulting with clients in telehealth fashion and working to advance consumer knowledge of their options. Healthcare navigation, eldercare matters and solo aging are focuses. Offering Complimentary Consultations toward engagement. nancyruffner.com.
Professional Organizations and Directories
Umbra Health Advocacy, Formerly the Advoconnection Directory
GNA – Greater National Advocates (Directory & info, a good locator)
Solace (Directory only, a growing locator)
Patient Advocacy Certification Board (A credentialing body, but will have names of folks who have passed a certification exam, by state)