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5 Steps to Becoming Your Own Health Advocate

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As someone who’s been on both “sides of the coin” as a patient and as a past hospital employee, I’ve learned over the years how to be my own health advocate so my medical appointments would run smoothly, especially in case of an emergency where my medical history would be vital so the ER team can make a decision regarding my care.

Here are some simple tips that patients can use to make it easier for them during their medical visits.

1. It’s very important to understand how your insurance plan coverage works. Make sure your physicians are within network. There is usually a deductible, the amount one has to pay before the plan begins to pay for health care costs. Then you either have to pay a copay, a flat dollar amount for a covered service, or a coinsurance, which is a percentage of the charges for medical care, such as the plan pays 80 percent and you would be responsible for 20 percent.

2. Once the medical bills come in, go over them to make sure the “amount due by patient” matches the EOB (explanation of benefits). If the amount doesn’t match, call the insurance company and take down the name, date and time you called and ask questions. If it was processed incorrectly by the insurance company, call the billing department to put the account on a 30-day hold until the issue is resolved. If the billing office coded the bill incorrectly, contact them and let them know of the error and ask them to re-bill and tell them you will contact them after 14 business days to see if the insurance has paid the claim.

3. During medical appointments, always provide an updated list of current doctors, medications you take along with the dosage and time they’re taken as well as any new drug allergies. Also attach a list of hospitalizations which show the date you were seen, the name of the procedure and reason it was done. This makes it easier for any medical professional to know your case history at a glance if you are seriously ill and need help stat.

4. Don’t be afraid to ask questions. In fact, most physicians want their patients to take an active role in their care by inquiring about things such as test procedures: “What is it for?” and “When will I get the results?” and “Why do I need this treatment?” and “Are there any interactions with what I’m already taking?”

5. Adopt healthy habits so your symptoms aren’t exacerbated to the point where you’re in pain. Be sure to eat right and exercise regularly. Avoid unhealthy habits such as smoking and excessive drinking of alcohol because both can do damage to your body and interact with the treatments you are on.

butterfly on a flower

Your health care team is only part of the equation. Patients need to be vigilant with knowing how their insurance plan works, educated about their illnesses and ask the important questions about their care plan. By taking charge, you are not only in control of yourself but your future as well.

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Originally published: October 5, 2017
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