Health Advocate

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

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

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

• Ranked in Inc. (magazine) Top 5,000 Companies by Industry – Health: six years in a row (2006-2012)^[18]
• 2007 Ranked 3 in Inc. (magazine) Top 5,000 Companies by Metro Region—Philadelphia-Camden-Wilmington, PA-NJ-DE^[19]
• 2008 Inc. (magazine) 500: America’s Fastest Growing Private Companies^[20]
• 2009 Inc. (magazine) 500: America’s Fastest Growing Private Companies^[21]
• Ranked in the Philadelphia 100 Fastest Growing Private Companies 6 years in a row (2006-2012), Philadelphia Business Journal/ Wharton Small Business Center,^[22]
• 2007 Top 20 Best Places to Work, Philadelphia Magazine^[23]
• 2008 CFO of the Year, Philadelphia Business Journal, Finalist^[24]
• 2009 CFO of the Year, Philadelphia Business Journal ^[25]
• Philadelphia Business Journal - 2009 Best Places to Work^[26]
• 2009 Eastern Technology Council - Life Sciences CEO of the Year - Mike Cardillo Winner^[27]
• 2010 IBPA Benjamin Franklin Award, Bill Fisher Award for best First Book (non-fiction) – Martin Rosen and Abbie Leibowitz, M.D.^[28]

Published Works

• 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

• Health Advocate

References