advocacy and the Affordable Care Act

Open Enrollment – Confusion Spells Opportunity

What a MESS Open Enrollment is this year! No matter where your health insurance comes from – an employer, the Obamacare exchanges, or Medicare – it’s changed up, switched up, and more confusing than it has ever been. YOU, as an independent health or patient advocate or care manager live (and fight) in this world of “let’s make money from patients even if we have to deny the services they need” world. You know what it’s like having to get a treatment, or claim, or hospitalization approved for someone who has inadequate insurance coverage. You know what it’s like when …

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The Advice That May Tick You Off

In 2012, I blogged about this very topic. One ticked-off reader then attacked me on Twitter. A day later, both she and another member of The Alliance of Professional Health Advocates left the organization, both citing the post. Ouch. But it was good advice then, and it’s still good advice today. So at the risk of provoking additional readers, I’m going to wade into those waters again. Since most of us are self-employed, in the process of either starting or growing a professional practice, you’ll find that this advice will serve you very well, even if it IS maddening or …

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Sorry. That’s Not Good Enough

One of the most visible changes in the new health insurance reality are the medical bill surprises people are receiving that they never received before, for services covered previously as a matter of course. You know – whereas their insurance automatically approved a CT scan for purpose X in the past, now patients need pre-approval. Without that pre-approval, payment for that CT scan comes out of their own pockets – totally unexpected and usually very expensive. Most of us learn the hard way that we need to get permission for many of the services that used to be automatically approved. …

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The More Things Change, The More They…

… seem to change. Yes – I know that’s not the way that saying is supposed to go, but in this case, it’s true. Healthcare – and the pursuit if its best outcomes – changes constantly. Just think about the changes over the past few years! I suggest to you that all the changes in healthcare, ranging from the ACA, to updated research results, to use of the internet, to changes in DRGs and CPTs, to outright FRAUD – all create opportunities for advocates to market themselves and their services. All these changes have been on my mind in a …

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The Affordable Care Act / Obamacare Defines Perfect Roles for Private Professional Patient Advocates

The healthcare reform law called the Affordable Care Act (ACA) – or Obamacare if you prefer the moniker (preferences seem to run about 50/50) – is being implemented over time. Of course, as most of us realize, the major portion described as the individual mandate, kicks in January 1, 2014 – only a few months from now. No matter how you feel about the legislation for your personal situation, you owe it to yourself to become familiar with the aspects of the law that define excellent roles for health advocates, no matter what type of advocacy they practice – medical …

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Sharing Healthcare’s Dirty Little Secrets

I’ve just written a post at About.com about my recent mammogram experience where the breast center I’ve gone to for more than a decade managed to dissolve my trust of their service in the span of one phone call. Is it possible that they were being honest and I have no reason to lose my trust in them> Yes, of course. Maybe I’ve jumped the gun – or maybe not. But it doesn’t really matter. Because whether they deserve my distrust or not, I will never trust them again. No, not a chance. (Just because I’m paranoid doesn’t mean they …

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Obamacare Seeks Navigators – Is There a Role for You?

It seems that word is getting out about one of the aspects of the Affordable Care Act that hasn’t been highlighted much before now. That is, the role of “navigators” and “in-person assisters” as they are called by the government. Many of the folks who read this blog are interested in whether there is a role for them (especially whether they can make any money from such a role!) The answer is – maybe – but probably not. Because these “navigators” may not be what you think (or hope!) they are. Here’s why:

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