What is a Healthcare Advisor?

Claire Thevenot

Claire Thevenot

August 28, 2020

The role of a Healthcare Advisor emerged from the need to provide support and guidance to patients and their families. They help patients navigate the complex and confusing healthcare system in a variety of ways, like by reviewing medical bills, coordinating second opinions, negotiating with insurance providers, managing medical records, and much more. In other words, a Healthcare Advisor has become the go-to person for anything healthcare-related. 

The role of a Healthcare Advisor (also called a patient advocate or health advocate) is to educate and assist patients so they can make informed medical decisions for themselves. They are there to advocate for your health and consider options that you didn’t know you had.

Why Healthcare Advisors Exist

The need for Healthcare Advisors has continued to grow as the cost of care increases and the healthcare system becomes more challenging to navigate. The reasons for considering seeking assistance from a Healthcare Advisor are compelling: 

1. They provide peace of mind for out-of-state family members

For family members who live far from one another, hiring a Healthcare Advisor can bring peace of mind to the entire family, knowing that the health of their loved ones’ is taken care of. 

When living in a different city, it can be challenging to play an active role in the care of other family members. A Healthcare Advisor can still be in a different state than the patient, but can have more oversight of the patient’s situation by virtually accompanying them to their medical appointments, managing their medical records, and ensuring that all family members have a full understanding of the diagnosis and treatment plan.  

2. They help reduce the financial burden of healthcare 

Up to 80% of all US hospital bills include errors, which could be costing patients thousands of dollars. Healthcare Advisors can help reduce the financial burden of any condition or disease as they are very knowledgeable on the medical bill system. 

They can help you avoid overpaying by spotting mistakes in medical bills, determining the best insurance plan for your specific situation, researching resources to help with payment issues and reducing your out-of-pocket costs with tips and tricks. 

3. They make sure you have all the information you need 

It is very easy to become overwhelmed with the amount of information given to you by your doctor. A Healthcare Advisor can help make sense of things you might be unfamiliar with or have difficulty understanding.

They can explain your diagnosis, treatment options, and the medications being prescribed to you. Additionally, a Healthcare Advisor can help you prepare questions to ask your doctor and do supplemental research to make sure you have a thorough understanding of your needs and condition. 

What Healthcare Advisors do

Every patient will have different healthcare needs. Although a Healthcare Advisor offers multiple services, they will focus on your specific situation and tailor their services to your needs. Here are just a few examples of what a Healthcare Advisors can do:

  • Research and explain your diagnosis and treatment plan

  • Review and negotiate your hospital medical bills 

  • Appeal insurance denials or help you switch plans

  • Ask questions to your doctor or healthcare team to get the necessary information you need to make appropriate healthcare decisions

  • Prepare you for appointments, and attend them with you (virtually or in-person)

  • Coordinate second opinions 

  • Review your prescribed medication

  • Speak to your employers as it relates to your healthcare 

Why Do I Need a Healthcare Advisor?

How do I get information about my treatment? 

How do I make medical decisions based on just online information?  

What if I need care outside of my insurance network?

How do I tell my doctor I want to seek a second opinion? 

These are just some of the difficult questions patients face. Navigating the healthcare system is a daunting task, and it’s easy to get lost. That's why having a health advisor on your side is always a helpful thing.

Having a strong understanding of your diagnosis and treatment can be incredibly empowering during a time when you feel overwhelmed with information. But it’s common to refrain from asking for help because we either don’t know how to ask or want to avoid tension with the healthcare team. 

This is where a Healthcare Advisor steps in. 

Qualifications & Role of Health care Advisors 

Healthcare Advisors need to have a deep understanding of the health care system, knowledge of medical terms and treatment plans, and have strong research and communication skills. They typically have a background within the medical industry, such as a registered nurse or physician,  but can also come from very different backgrounds. They might, through their own experience, have seen the difference patient advocacy can make, drawing them to this profession. In all cases, they are professionals with a passion for helping people gain access to the best healthcare they can get. 

The primary responsibility of a Healthcare Advisor is to look out for your best interests and help you overcome any challenges or obstacles related to the healthcare system.