A nurse at high risk for breast cancer called to make an appointment for her annual preventive mammogram. During the phone call, the appointment scheduler asked the nurse if she was experiencing any symptoms. She told the scheduler that her skin was itchy, including her breasts, but she was pretty sure the itching was caused by the new soap she was using. Unbeknownst to the nurse, the scheduler noted “itching breasts” in her chart, and instead of scheduling her for a PREVENTIVE mammogram, which was 100% covered by her insurance, she was scheduled for a DIAGNOSTIC mammogram, which was only partially covered. The nurse was never informed of the change, and she had no idea that she was not getting the test she wanted. A couple of months later, when the nurse got a bill for over $400, she was sure there was some mistake. She called the billing department, where she learned that she received a diagnostic test because of itchy breasts. When the nurse tried to protest, the billing clerk scolded her, saying it was her own responsibility to know what tests were being performed and what the costs would be.
If medical people have problems like these when they themselves are the patients, is it any wonder that our patients become frustrated and worried as they try to make their way through the system?
Patient advocates (or health advocates) represent those who need assistance with their medical care. When people are sick and don’t know where to turn for help, professional patient advocates can act on their behalf by helping them “navigate” through the health care system.
For people with cardiopulmonary disorders, Select Respiratory Services provides patient advocacy as an important element of our case management services. We strive to ensure that our patients receive the very best of care and are well-informed every step of the way.