• Government
• Profession
• Business
• Opinion
• Health

• Health reform
• H1N1
• P4P
• EMRs
• Medicare
• Liability
• AMA House
• » More

• Book Excerpt
• Business Pitch
• Meetings
• » More

• Contract Language
• Ethics Forum
• In the Courts
• Practice Management
• Technically Speaking
• » More

• Issue dates
• Regions
• Health plans
• Sections
• News briefs
• Columns
• Editorials
• Letters
• Writers
• Other years

• Search tips
• E-mail alert
• Radio
• RSS
• Mobile
• Subscribe
• Institutions
• Staff directory
• Advertising
• Permissions
• Reprints
• News media
• Site guide
• Useful links
• About
• Premium
• Contact

Advocates for hire: Getting paid for helping patients fight insurers

Two-thirds of doctors are already coping with insurers on behalf of patients to resolve claim disputes, a study says. Now a small number are doing this and more as part of a growing niche of health care advocate companies.

By Myrle Croasdale, amednews staff. June 3, 2002.

• PRINT|
• E-MAIL|
• RESPOND|
• REPRINTS|
• SHARE

A handful of doctors are doing, for a fee, what many practicing physicians don't have time for -- guiding consumers through the U.S. health care system.

Products range from an Internet site for appealing denied claims to one-on-one help for any number of tasks, such as finding an affordable nursing home for an aging parent. Fees run the gamut of monthly memberships to flat rates per service.

Many physicians are already involved in helping patients cope with the demands of their health plans. According to a 1999 Kaiser Family Foundation and Harvard University School of Public Health Survey of Physicians and Nurses, 66% of respondents had contacted a health plan on behalf of patients outside of routine requests for referrals.

Making money at this rubs some the wrong way. Part of being a doctor is being an advocate for patients, they say.

"I've spoken to physicians who've become defensive about this, saying, 'That's what I do,' " says Stanley Stier, MD, a medical management specialist and board chair for Patient Care, a fee-based patient advocate product of New Orleans-based Labyrinth HealthCare Group. "We see it as something to supplement what doctors do. We deal with the mundane, the unexplained bill. Members can call us anytime issues come up."

William Rees, MD, a pediatrician in private practice and an adviser for Healthcare Advocates Inc., located in Philadelphia, says doctors with a busy practice aren't able to fill the demands of an advocate.

"It takes a lot of time and concerted effort to get results," Dr. Rees says. "Writing letters goes nowhere. You have to be on top of it, and most doctors don't have the time. It's very difficult for doctors with their own practice to do this." [...]