How to Choose the Best Health Insurance Plan for Your Business
There are some days where business simply can’t be business as usual. One of these events is when an employee receives a serious diagnosis. An event like this can cause extreme distress about work and home life, leaving an employee wondering how to juggle it all.
A serious diagnosis may also result in extra medical trips which can place work and finances under severe strain. Employers aren’t always equipped to deal with these types of events and may not be able to provide effective support with the needed finesse or experience, which is where healthcare advocates can make a difference.
What is a Healthcare Advocate?
Studies show that only 70% of patients have a healthcare advocate, including a family member or friend. A healthcare advocate is there to provide support, an extra pair of ears, and help manage appointments.
From an employer’s perspective, the healthcare advocate bridges the gap between the company and the employee by providing support where needed. This alleviates work stress and ensures that the employer has insight into the happenings, without infringing on the employee’s privacy.
How Can Healthcare Advocates Help?
A healthcare advocate provides much-needed assistance in terms of navigating options for employees diagnosed with a serious condition.
Discuss Options Provided by Current Medical Cover Provider
Not all health insurance plans are the same, even within the same company, as there are different plan types and levels of coverage. A healthcare advocate will discuss the options the employee has through their current plan, such as specialists that are in-network, the number of appointments available, and the extent of treatment options offered.
Coordinate Initial Doctor and Specialist Appointments
Before a plan of treatment starts, it’s best to receive a second opinion and also meet with a specialist in the field to discuss treatment options. The healthcare advocate can arrange these appointments and find doctors and specialists who are preferred by the health insurance plan if the plan requires members to use a specific network of providers.
Strategize a Treatment Plan
When confronting a serious diagnosis, it's essential to strategize a treatment plan. For instance, cancer requires a treatment plan and may jump from one treatment option to another. A patient may need to move from radiation treatment to chemotherapy to improve their chances of stopping the spread or even allowing cancer to go into remission. A proper treatment plan allows the healthcare advocate to liaise with the employer to create a work schedule that will allow the employee to undergo treatment and have the needed time for recuperation.
Work Through the Claims Process
Endless tests and procedures can quickly deplete available funds, Healthcare advocates can help employees navigate all the payments. They may also be able to provide a list of cheaper alternatives that still form part of the accepted medical network. For instance, the advocate may suggest getting blood tests at certain laboratories, which might be more cost-effective than at a hospital.
Routine tests and ongoing therapy can also quickly erode medical savings or benefits, and savvy healthcare advocates might pick up on the varying costs of these procedures and refer patients accordingly. For instance, radiotherapy can cost anywhere from $5,270 to $14,155 and knowing which procedure and center offer the best rates can save patients thousands of dollars. They may also assist with denied claims, providing guidance to appeal these decisions.
Another feather in a healthcare advocate's cap is their ability to scrutinize statements and refer errors back for correction, which can add hundreds if not thousands back into the patient's account.
Coordinate the Care Plan
Some diagnoses require more than medication; for instance, support equipment such as oxygen tanks, monitors, and emergency buttons may be prescribed. Healthcare advocates can help employees source these, find out which of these are covered by their medical insurance, and process the claims.
End of Treatment
At the end of the treatment process, the employee may be fit to return to their normal work duties. If not, they may require remote work access or to be medically boarded. A healthcare advocate can help navigate this process, working with the employer to find the best possible solution.
Families are often at a loss on how to support a family member working through a tough medical diagnosis. With the help of a healthcare advocate, family members can be let in on the treatment plan, what to expect after treatment sessions, the effect of medication, and the road to recovery.
The Importance of Working With a Healthcare Advocate for Your Business
A healthcare advocate is a wellness benefit that allows you to take care of your employees with the right knowledge and level of finesse needed to deal with a serious diagnosis. Not only does it foster a good relationship with your employee, but it ensures that they’re taken care of -- helping you demonstrate empathy to your team.
Healthcare Advocates are Trained
These are professionals within their field, knowing how to provide the best support to employees affected by terminal or serious diagnoses. It’s not easy to guide staff through the steps needed to work through the medical insurance providers, even if this is a company benefit. That’s why this service is often taken on by a professional.
There are Legal Reasons to Use Healthcare Advocates
It’s important that employees know what their options are in terms of their sick leave, working through medical-legal jargon, and setting up legal documents prior to serious procedures. Employers are not always equipped to help employees navigate these legal procedures and could cause a liability issue if incorrect advice is given.
Other Employees Still Need You To Operate 100%
While the business comes to a halt when one of its own undergoes a traumatic experience such as this, it’s essential that the rest of your employees still receive the care and attention they need to provide for their families. Healthcare advocates free up an employer’s hands to still carry on with business operations to ensure that the business keeps going. They can also provide a group session that educates the team on how to care and support for their colleague during this period.
Healthcare Advocates Help Navigate an Employee’s Serious Diagnosis
As an employer, you want the best for your employees. This means supporting them in the most optimal ways when they navigate life’s toughest journeys. When it comes to a medical diagnosis, it’s important to have the right team by your side to help you help your employee make important decisions about their care and support system.
If you have any questions about OPOC.us or how we can help you CARE for your employees through a serious diagnosis, please give us a call at 800.724.8802.