The Secret’s Out: It’s Possible to Privately Negotiate Care and Prices
A patient advocate who isn’t afraid to negotiate on behalf of a client is likely to be an advocate in demand. Everywhere an advocate turns, opportunities to negotiate are plentiful: Inflated medical bills, premature hospital discharges, discontinuation of physical therapy sessions, procedures deemed medically unnecessary by insurance companies – yet desired by a specialty physician. The list is endless and will likely grow as healthcare benefits continue to narrow for subscribers nationwide.
Negotiation doesn’t have to mean arguing, arm twisting, or threatening. Those tactics are bound to result in worsening your client’s situation. Negotiation can mean knowing what rights your client has, the ability to identify and document when those rights are and aren’t being respected, and the follow-through to professionally, politely, yet firmly place a healthcare provider or insurer on notice that the treatment your client may be experiencing may not be acceptable.
Documenting a client’s patient rights and citing how those rights are being accidentally overlooked (or deliberately ignored) can be an effective way to begin knowing where an advocate can begin negotiating on a client’s behalf. This method tends to keep emotions in check and allows an advocate to work calmly, systematically, and deliberately. The chances of negotiations resulting in a favorable outcome for your client will likely improve if you don’t allow the frustrating feeling of unfairness to sidetrack your professional efforts.
There are times when an advocate can become overwhelmed at the magnitude of a task that presents itself: You see a client with pneumonia who is too sick to leave the hospital but being pressured to return home. You hear a client who is disoriented because the after-effects of anesthesia haven’t yet ended his hospital delirium. You feel the trembling in an elderly client’s voice because she is uncertain whether to treat her newly diagnosed cancer with chemotherapy or simply live out the rest of her life at home, with as much quality and comfort as possible.
It is easy to slip into ineffectiveness when witnessing distressing situations like these. That makes it all the more important to remember you are a professional who can perform the greatest service to your client by remembering your primary goal as an advocate is to ensure your client has the best options available to choose from moving forward. Those best options, sadly, are no longer guaranteed to any patient. Those best options usually have to be negotiated with a steady hand and focused mind.
One of the ironies of serving as a competent patient advocate is you feel empathy toward a vulnerable person in the midst of an unfolding medical crisis. Yet the danger of feeling too much usually ends up compromising an advocate’s ability to work effectively and negotiate a fair option for a client. Fair options can be tricky to define, as each person’s definition of fairness can differ. Where one client may consider fairness to mean not being overcharged, another’s may consist of wanting to return home at any cost. A key component to effective patient advocacy often begins by understanding what is of primary importance to a client, and negotiating for that specific goal a particular client desires.
Given the business that healthcare has become in the United States, a savvy patient advocate can enhance his/her practice by responding in kind. What was once a given in healthcare — reasonable care at fair and customary prices — is no longer the norm. More than ever, obtaining that norm will require the assistance of a skilled patient advocate. An advocate who possesses the ability to negotiate effectively will likely result in an advocate performing valuable work with a thriving practice.