Health Advocate

From Wikipedia, the free encyclopedia
Jump to: navigation, search
Health Advocate
Type Private
Industry Health care
Founded 2001 (2001)
Founder(s) Michael Cardillo
Arthur "Abbie" Leibowitz, M.D.
Thomas Masci, Jr.
David Rocchino
Martin Rosen
Headquarters Plymouth Meeting, Pennsylvania, USA
Services Health advocacy
Employees 640
Website healthadvocate.com

Health Advocate, Inc. is a US national health advocacy, patient advocacy and assistance company, serving more than 12,800 clients and 40+ million people and offering a spectrum of services to help employers, employees and consumers navigate the healthcare system and facilitate members’ interactions with insurers and providers.[1] The privately held company was founded in 2001 by former Aetna executives[2] and is headquartered in Plymouth Meeting, Pennsylvania. The company employs registered nurses, medical directors and benefits specialists[3][4] who address a range of health care and health insurance issues.[5] Personal Health Advocates can help members locate providers, address errors on medical bills, answer questions about coverage denials and assist with insurance appeals.[6]

The company's products include Wellness Advocate, Benefits Gateway+Health Information Dashboards, EAP and Worklife, Pricing Decision Support, Personalized Health Communications, Chronic Care Management, and HR solutions. The company offers a direct-to-consumer advocacy service, called Health Proponent to individuals who are not part of groups.

Products and services[edit]

Core advocacy

  • Clinical Assistance – medical and pharmaceutical advice and research.[7]

Clinical Assistance helps members understand tests, treatments, and medications recommended or prescribed by physicians, facilitating the transfer of medical records, X-rays, and lab results before a scheduled appointment with a new physician, arranging for home-care equipment after discharge from a hospital, facilitating review of test results with another physician for confirmation of diagnosis, consolidating a multiple-day testing schedule for members with special needs, arranging hospice and other services for the terminally ill, facilitating transfer from a community hospital to a tertiary care facility.[8]

  • Administrative Assistance helps resolve claims and benefits issues, and helps find assistance outside the health plan.[9]

For example: Researching a member’s outstanding out-of-pocket responsibilities and resolving errors with providers and/or the member’s health plan, correcting balance-billing problems, correcting charges incorrectly applied to the member’s deductible, resolving eligibility problems and benefit and claim denials, coordinating benefits between dental, medical, worker’s compensation, and disability carriers, assuring correct application of provider network status, correcting errors in processing of “blind” network provider discounts, resolving coordination-of-benefits disputes between carriers, satisfying plan requests for copies of referrals, providing correct member insurance information to providers.[10]

Complementaty solutions

  • Wellness Advocate provides employers and other plan sponsors with wellness solutions that help employees lose weight, get fit and make other lifestyle changes. The program is designed to reduce risks of diseases, prompt employees to take a role in their healthcare and make informed decisions about their healthcare. The program features access to live Wellness Coaches coupled with health and wellness information.[11]
  • Employee Assistance Program (EAP)/ WorkLife provides counseling and work/life services to resolve healthcare and insurance-related issues.
  • Enrollment Advocate answers employees’ questions about health plan options and features during an organization’s annual open enrollment period.[12]
  • Medical Bill Saver helps negotiate discounts on non-covered or out-of-network medical claims.[13]
  • Benefits Gateway+Health Information Dashboards offers a service that gets employees to the right benefit, through a single toll-free number. The dashboard uses algorithms to interpret data from multiple sources and provide a snapshot of member information about benefits use and health indicators.[14]

Coverage[edit]

Employers generally offer the service to their employees as a benefit and extension to their healthcare insurance plans. The employee’s immediate family is also covered. This includes spouses, dependent children, parents and parents-in-law.[15] According to one client, Wawa Food Market's director of compensation and benefits, "As an employer there's a limit to what we can do for our employees. For us it made sense to have this service available, where our associates can reach out to somebody who knows the ins and outs of the health-care business."[16] The company's services are available 24 hours a day, 7 days a week.[17]

Those whose employers do not offer the service can purchase it from Health Advocate's direct-to-consumer arm Health Proponent.

Awards[edit]

Published Works[edit]

  • Rosen, Martin B. & Leibowitz, Abbie. “Health Advocacy Programs Help Employers and Employees Navigate Health Care and Insurance Systems.” Employee Benefit Plan Review Volume 57, Number 4, October 2002
  • Rosen, Martin B. & Leibowitz, Abbie. “Health Advocacy Helps Employers and Employees Cope with Health Care and Insurance Systems.” HIU Health Insurance Underwriter November 2002
  • Leibowitz, M.D., Abbie. “What Do Patient Advocates Do?” National Underwriter Vol. 3, No. 2, December 2003
  • Cardillo, Michael & Rosen, Martin. “Benefits, Challenges of Consumer-Driven Healthcare.” Human Capital January/ February 2004
  • Rosen, Martin B. & Leibowitz, M.D., Abbie. “Health Advocacy Helps Employers and Employees Cope with Healthcare and Insurance Systems.” Philadelphia SHRM Chapter News February 2004
  • Rosen, Martin B. & Leibowitz, M.D., Abbie. “Health Advocacy: Saving Time and Money for Employers and Employees.” Employee Benefits August 2004
  • Leibowitz, M.D., Abbie. “Health advocacy: Strategic complement to consumer-directed Healthcare.” Inside HR/NY September 2004
  • Leibowitz, M.D., F.A.A.P., Abbie. “The Role of Health Advocacy in Disease Management.” Disease Management Volume 8, Number 3 2005
  • Rosen, Martin. “Health Advocacy: A New resource for Employers.” Pension & Benefits Update Vol. 16, No. 3, March/ April 2005
  • Rosen, Martin B. “Health Advocacy: Saving Time and Money for Employers and Employees.” The Healthcare Savings Chronicle Volume 3 August 2005
  • Martin B. Rosen and Arthur “Abbie” Leibowitz, M.D. coauthored The Healthcare Survival Guide: Cost-Saving Options for the Suddenly Unemployed
  • Rosen, Martin B. “Simple Ways to Organize Your Older Relatives.” Buttoned Up 6 January 2010
  • Rosen, Martin B. “Top 10 Ways to manage Eldercare.” S.I. Parent March 2010
  • Chiaro MSW, LSW, Michelle. "The Role of Social Work in Health Advocacy." Social Work Today Newsletter August 2010

External links[edit]

References[edit]

  1. ^ Dorschner, John. “Healthcare advocacy experts aid workers.” Miami Herald 31 August 2010
  2. ^ Young, Lauren. “Advocates WhoHelp You Negotiate Healthcare.” BusinessWeek 22 October 2007
  3. ^ George, John (2–8 October 2009). "Health Advocate has the answers to health questions". Philadelphia Business Journal. Retrieved February 15, 2010. 
  4. ^ Heubeck, Elizabeth (30 November 2007). "Personal health care advocates sell benefits expertise to firms". Baltimore Business Journal. Retrieved February 15, 2010. 
  5. ^ Wells, Susan J. (1 August 2006). "Independent experts can help employees conquer mountains of medical paperwork, freeing HR to focus on other core concerns". SHRM HR Magazine. Retrieved February 15, 2010. 
  6. ^ Guterl, Gail O. “Advocating for clients.” Advance for Nurses 9 June 2003
  7. ^ Silverman, Ed. “Healthy Backing,” Human Resource Executive May 2003
  8. ^ Diamond, Frank. “Plan Lets Ombudsman Go To Bat for Members,” Managed Care October 2004
  9. ^ “Former Aetna Execs See Growth in New Patient Advocacy Company.” Managed Care Week 29 July 2002
  10. ^ Diamond, Frank. “Plan Lets Ombudsman Go To Bat for Members,” Managed Care October 2004
  11. ^ Cranshaw, Dave. “Gen Plumbing institutes long-term wellness plan.” Providence Business News 2–8 January 2006
  12. ^ George, John. “Health Advocate has the answers to health questions.” The Philadelphia Business Journal 2–8 October 2009.
  13. ^ George, John. “Health Advocate has the answers to health questions.” The Philadelphia Business Journal 2–8 October 2009.
  14. ^ George, John (2–8 October 2009). "Health Advocate has the answers to health questions". Philadelphia Business Journal. http://philadelphia.bizjournals.com/philadelphia/stories/2009/10/05/focus2.html. Retrieved February 15, 2010.
  15. ^ Rotenberg, Carl. “Health move,” The Times Herald 14 May 2003
  16. ^ George, John (2–8 October 2009). "Health Advocate has the answers to health questions". Philadelphia Business Journal. http://philadelphia.bizjournals.com/philadelphia/stories/2009/10/05/focus2.html. Retrieved February 15, 2010.
  17. ^ Burgess, Dave “Dealers sign with health advocacy service,” Western Business News November 2003
  18. ^ http://www.inc.com/inc5000/2007/lists/top100-industry-health.html?o=0&c=200701140
  19. ^ http://www.inc.com/inc5000/2007/lists/top100-metro-regions-Philadelphia-Camden-Wilmington-PA-NJ-DE.html?o=0&c=200701140
  20. ^ http://www.inc.com/inc5000/2008/company-profile.html?id=200809840
  21. ^ http://www.inc.com/inc5000/2009/company-profile.html?id=200912210
  22. ^ http://whartonsbdc.wharton.upenn.edu/philadelphia100/philadelphia100_2006.pdf
  23. ^ http://www.phillymag.com/articles/features_the_20_best_companies/page2
  24. ^ "CFO of the Year Awards". 
  25. ^ "Medium Company". 13 July 2009. 
  26. ^ "Philadelphia Business Journal names 2009 Best Places to Work winners". 16 October 2009. 
  27. ^ http://www.easterntechnologycouncil.org/ea/winners.aspx
  28. ^ http://ibpabenjaminfranklinawards.com/archives/