Road to health care advocacy.
Individual do not always realize their options when it comes to health care insurance. He often encounters that weren't anticipated, especially since payments were made regularly and on time. A health care insurance company may deny your claim and leave you financially devastated. That is where health insurance advocate enters the picture; she will help you sort out the problem. The advocate studies polices, legislature and contacts petitions for the fair treatment of consumers; she fights for the patient.
Instructions
1. Learn principles of advocacy.
Learn what an advocate does in general. Find out the common duties of the advocate, and how she operates her business, bills for services, handles clients and deal with insurance companies. Also, learn about advocacy and privacy policies.
2. Know health insurance.
Find out everything you can about health insurance and how they bill, deny claims and limit payments. If the consumer is overcharged or his health insurance claim is denied, you must know if the insurance is acting rightly. Read health insurance policies until understanding them is second nature.
3. Know medical terms.
Learn medical terminology and insurance terms. Knowing the language of medical staff and insurance agents affords you the ability to read the patient's medical records, understand the procedures and fees for a procedure.
4. Get a mentor.
Talk to other reputable advocates. Men and women who put in lots of hours and know steer you in the right direction. For instance, if you sense something is amiss with a case, but can't put your finger on it, a seasoned professional can help.
5. Understand medical billing.
Know the cost of medical procedures and how they're coded for payment. If the hospital and/or insurance company doesn't provide or volunteer the needed information, your investigative skills must be top notch to help your client.
6. Attend advocacy classes.
Seek out and attend workshops and seminars tailored for health care advocates. After the class, listen and talk with other students. These students will give you information that isn't in books or wasn't covered during the seminar or workshop. Exchange business cards and get together after the seminar.
7. Coding books help.
Buy books that aid the health care insurance advocate in understandi g how medical procedures, medicines, diseases and/or conditions are coded and assigned for payment by insurance companies. The following books are published by the American Medical Association (AMA). One or more can help in your practice.
The CPT4 (Current Procedural Terminology 4E) This text provides information on classifying and ascertaining the payment or fee for a medical procedures and services; it has coding statutes and principles.
HCPC (Healthcare Common Procedure Coding). This book is primarily concerned with coding and payment of a medical procedure.
DSM-IV (Diagnostic Statistical Manual 4E) learn about how psychiatric disorders are classified and coded.
ICD-9 (International Classification of Diseases, 9th Revision). This text outline the theories of the classification system to help you understand why a medical procedure is classified with a particular code.
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