Health Advocate

Health Advocacy About Health Advocate

Our Health Advocacy program, centered around our team of Personal Health Advocates, offers a comprehensive spectrum of programs that help employees navigate the complex healthcare and insurance systems. Our team assists employees and their families with clinical and administrative issues involving their medical, hospital, dental, pharmacy and other healthcare needs.

How Health Advocate Works

Participants who call our toll-free number are assigned their own Personal Health Advocate, typically a registered nurse, who is supported by a team of medical directors, benefits and claims specialists. Health Advocate keeps all calls strictly confidential in compliance with the privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA), freeing plan sponsors of the financial and legal liability.

Our highly personalized assistance, which addresses a range of sometimes challenging and sensitive health issues, helps ensure that employees receive the quality care—and the correct answers—they need, when they need it. This one-on-one support frees employees of worry and time lost seeking solutions, and enables them to remain fully productive on the job.

For employers, this means reduced healthcare costs and greater savings.

We effectively help reduce your HR staff’s workload and offer considerable savings in medical costs and productivity.

Key Benefits:

  • Independent and objective service
  • Increases productivity and reduces claims costs
  • Eases burden on Human Resources staff
  • Helps support consumer-driven health programs
  • Increases employee satisfaction and retention
  • Improves quality of care
  • Helps employees better balance work and family health concerns
  • Professional, non-adversarial approach to finding the right answer
  • Complies with HIPAA privacy and confidentiality requirements

Administrative Support

Health Advocate helps sort out and resolve claims and related paperwork problems. We work on coverage issues and help members understand the coding and payment rules that apply to their circumstances.

For example, we help:

  • Resolve insurance claims
  • Save money on healthcare bills
  • Navigate within an insurance company
  • Assist with correcting billing errors

Clinical Support

Our Personal Health Advocates help members find the clinical help they need, and will also assist with coordinating their care.

For example, they can help:

  • Find the right doctors and hospitals
  • Assist with a complex medical condition
  • Locate and research treatments for a medical condition
  • Secure second opinions
  • Schedule appointments with hard-to-reach specialists
  • Identify “best-in-class” medical institutions

Healthcare Coaching

Our Personal Health Advocates provide members with the information they need to help them become active participants in the management of their health.

For example, we can:

  • Help prepare members for visits with their physicians and other healthcare providers
  • Help members better understand their serious or chronic conditions
  • Answer questions and provide information about medical terms, tests, medications and treatments

Information & Resource Support

Health Advocate helps locate and make arrangements for members’ special services needs.

For example, we can help:

  • Assist with eldercare issues
  • Obtain health information to help members make informed decisions
  • Complete qualification applications
  • Identify and coordinate/arrange for wellness services
  • Research transportation

Health Advocacy