How to Become a Patient Advocate

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OVERVIEW

What is a Patient Advocate?

Patient advocates work with healthcare patients on their behalf. Patient advocates work alongside insurance companies and healthcare workers to ensure that their clients make the best information-based decisions regarding their health. They work in several different roles as well. Some patient advocates specialize in one particular area such as insurance, medical literacy, or other high-need areas while others provide multiple advocacy services. Largely, a patient advocate serves as the liaison between patients, healthcare staff, and insurance companies.

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RESPONSIBILITIES

What Does aPatient Advocate Do?

As mentioned above, the role of one patient advocate may vary greatly from the role of another. One patient advocate may focus their services entirely on nursing advocacy while others may provide advocacy services in a number of areas. The exact day-to-day of a patient advocate will vary greatly depending on the expectations agreed upon between involved parties. Below is a list of different generalized tasks that patient advocates are often responsible for:

Healthcare visit support: Patient advocates help patients get the most out of their healthcare visits. Caregivers and clinical environments can be intimidating to many patients, and a patient advocate can help by preparing patients beforehand or even attending an appointment with a patient. This helps to ensure that they are getting all of the answers to their questions and that they are asking all of the questions that should be asked.
Insurance support: Patient advocates often help their patients understand everything that they need to know about their insurance coverage. They will help patients understand what their insurance covers vs. what it doesn’t, premiums, co-pays, payer reimbursem*nts, deductibles, and any other health insurance-related support. They also work with healthcare financial departments to bill their patient's insurance for care.
Financial support: Patient advocates specialize in healthcare financial support. They work alongside healthcare billing and financial departments to monitor different financial processes like billing the insurance provider, negotiating treatment or care costs, and identifying any medical bill errors. They also help patients understand treatment costs, payment plans, and what is covered by insurance vs. out-of-pocket costs. They can also help patients locate different financial support programs and organizations that help offset the cost of healthcare.
Healthcare literacy: Doctors are busy and may accidentally skip over certain pieces of information that they think are common knowledge or understood (for example, the severity of a diagnosis). Patient advocates can help by making sure that both patients and their loved ones understand the diagnosis, prognosis, treatment options, costs, and any other information that may not be clear after a visit.
Patient rights: Patient advocates help their clients navigate their rights as a patient to ensure that healthcare workers and insurers are providing proper care according to the book. They will help patients understand both local and federal patient rights laws. Patient advocates can help identify any care gaps or concerns and make suggestions or take action accordingly—in some cases they may help with seeking out legal representation. Some scenarios that may require a patient advocate to include do not resuscitate orders (DNR) or refusal of services.

EDUCATION & BEST DEGREES

How to Become a Patient Advocate?

The route to becoming a patient advocate isn’t as uniformly defined as other certified or licensed careers like becoming anurseorteacher. Many careers—especiallyhealthcare careers—require some combination of formal education and certification, but as is, there are no national or state standards required for patient advocates. However, just because there aren’t any definitive universal standards doesn’t mean that you automatically have the credentials to become a patient advocate. Below are some methods for obtaining the necessary skills for a career as a patient advocate.

Although there are no formal education requirements necessary for a career in patient advocacy, there are severaldegree programsthat can help you get the relevant healthcare experience necessary for success in the role. Some examples of degree programs that translate well into patient advocacy include:

Social work
Nursing
Healthcare management
Health information management

There are alsoonline degree programsthat are designed to be flexible to help working individuals attend school. Additional schooling can help you stand out to employers, so consider taking advantage of master’s programs like anMBA in healthcare managementor anMSN in leadership and management. For those who have earned their master's degree, apost-master's certificate in nursing leadership & managementcan be beneficial.

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SKILLS

What Skills Does a Patient Advocate Need?

If you are working towards a career in patient advocacy, there are some skills that you should have currently or should work towards. The exact skills needed to be effective within the role can vary depending on the nature and specific responsibilities of the role, but the following are some general skills that are indicative of a successful patient advocate:

Advocacy skills: Advocacy skills are an obvious necessity. You need to be able to effectively communicate, negotiate, plan, research, and act in the best interest of an individual patient or multiple patients.
Communication skills: You need to have both strong verbal and written communication. You need to take complex healthcare information (insurance forms, medical diagnoses, treatment plans, etc.) and put it into terms that are easily understood by your patients. An effective patient advocate should also be skilled in reading non-verbal cues such as confusion, anger, frustration, or being overwhelmed.
Negotiation skills: Effective advocating requires a great deal of negotiation. You will need both written and oral negotiation skills to create a solid case for the patients that you advocate for.
Attention to detail: A primary aspect of patient advocacy is reading through all of the documentation and making sure that all information is accurate and complete. Successful patient advocates should be able to identify any errors and take action accordingly—especially since proper documentation is so critical for quality care.
Organizational skills: When you advocate on behalf of someone else, it is important to keep everything in order. Patient advocates often advocate for multiple patients, so it is important to be able to keep each respective patients’ files organized and free of clutter. This role requires both mental and physical organization.

Interpersonal skills: Patient advocates are in constant communication with patients, healthcare professionals, and insurance companies. To nurture those relationships and collaborate successfully, you need to have important interpersonal skills like positivity, listening skills, and empathy. It’s also important to be able to read social cues so that you can better align with the expectations of the parties involved in your role.
Problem-solving skills: Medical-related decisions and processes are not always straightforward for everyone. Patients may need help with insurance denials or disputes, billing issues, miscommunications, or misunderstandings that create the need for problem-solving skills.
Financial skills: Another primary aspect of patient advocacy surrounds finances. You will need to be able to make financial recommendations, understand different financial assistance programs (local, state, and federal programs), and you need to be able to answer specific financial questions that may arise at any point.
Caregiver skills: Patient advocacy requires a combination of empathy and some comfort and familiarity with the modern healthcare system. This makes it particularly helpful for advocates to have some experience working as caregivers—especially doctors or nurses—to help prepare them for guiding patients through the system. Caregivers often require many of the same skills as patient advocates, including problem-solving, communication, organizational, and interpersonal skills—in addition to clinical training and knowledge.

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How to Become a Patient Advocate | WGU (2024)