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" Recognize your needs before you call us. Some patient advocates specialize in navigating you through the maze of medical bills and insurance; others focus on advising patients through (or even overseeing) treatments for a chronic condition or illness. The trick, says Ken Farbstein, a patient advocate and author of Getting Your Best Health Care, is trying to identify what you need. For support specific to one ailment (e.g., choosing a breast cancer treatment, handling an employer who doesn&amp;#039;t understand lupus), contact an association that focuses on that ailment. Many of these groups have free or low-cost patient advocates, often available by phone. To see someone in your home, search the directory at AdvoConnection.com, clicking on the options you need (legal help? bedside care?). Be sure to get references! Prices range from $40 to $200 an hour. If an insurance company won&amp;#039;t pay for a treatment, appeal. &amp;quot;The last thing you should do is pay out of pocket,&amp;quot; says Barby Ingle, a patient advocate and executive director of the Power of Pain Foundation, which supports neuropathy patients. &amp;quot;Most insurance companies will deny a first-time or nonstandard service-it&amp;#039;s a money-saving tactic, because most patients don&amp;#039;t appeal.&amp;quot; Fill out an appeal form on the company&amp;#039;s website as soon as your claim is denied, and cite sections in your insurance plan that show the treatment qualifies under its benefits and rules. Submit copies of your medical records documenting both the ailment and related treatments you may have tried, as well as a letter from your doctor and copies of any bills. Also include information such as studies showing that the service has worked in similar cases. Follow up weekly. Pharmacists are a great resource. Not only can they look over your medication lists and help pinpoint any side effects you may be experiencing, but they&amp;#039;re also great at referring you to area specialists (they know a lot of them, and can tell you which offices run smoothly), and can give you questions to ask your doctor. Your pharmacist can even sign appeal letters to your insurance company stating that yours is a known and necessary treatment, and list other medications you have unsuccessfully tried. If you have a chronic illness, choose a practice with a dedicated staff registered nurse (RN). Whether you choose to go to a traditional family practice physician or a larger group practice, make sure the staff includes an RN whose role specifically includes dealing with patients who have a chronic condition, say Farbstein. That way, if the doctor is unavailable, the nurse can help with any problems or answer questions. You also want a practice with an organized office staff since you&amp;#039;ll be working with them to arrange prescriptions, appointments and treatments. Need helpful statistics? We&amp;#039;ve got them. Say you&amp;#039;re deciding where to have surgery. You need to choose which hospital is best. What&amp;#039;s the hospital infection rate? How many times has the surgeon done this procedure? What are his outcome rates compared with other surgeons&amp;#039;? Advocates who specialize in medical research can provide those statistics. It may be worth it to hire an advocate for a few hours to help you make the best decision, says Farbstein. We know how to get your doctor to call you back. Frustrated that your doctor won&amp;#039;t return calls? At your next appointment, ask him what the protocol is for getting a call back-and politely express your concerns about past difficulties. &amp;quot;Keep in mind that most questions can be answered by the nurse practitioner, physician&amp;#039;s assistant or a pharmacist,&amp;quot; says Ingle. If you really need attention (say, you&amp;#039;re not sure which medication to take), go in person. &amp;quot;The nurse will get the doctor for you if needed,&amp;quot; she says. In off-hours emergencies, call the office message service every 30 minutes until you get a response. ARIANNE COHEN is a contributing editor to Woman&amp;#039;s Day and the author of Help, It&amp;#039;s Broken: A Fix-It Bible for the Repair-Impaired. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.womansday.com/health-fitness/womens-health/advice/a6408/patient-advocate/>