How to Be Your Own Medical Advocate

In 1996, I had an illness that nearly killed me. I was exhausted, felt awful, could barely stand up, and had trouble remembering things. Yet I somehow had to find the energy not only to take care of my newborn and 5-year-old, coordinate our upcoming move, consult with doctors and other medical providers on my condition and treatment, and receive treatments that might or might not help me regain my health, but also track our quite substantial medical bills in order to forestall what would have been economic ruin for us.

At the time, most of our medical providers did not file insurance claims, so that task fell to me. One of my clearest memories is sitting on the floor of our home office, surrounded by piles of medical claims that needed to be reconciled. I remember the babysitter coming into the room to ask me a question; when she saw the piles of paper surrounding me, she turned around and walked out of the room without saying a word. She later told me that she’d been shocked that a person in my condition would have to deal with paperwork.

Reconciling those claims was a daunting task for anyone, but especially for a person with a critical illness and little energy. And yet, as with most things in my life, it turned out to be a great learning experience. Below are the guidelines I took away from this process. These apply not just to filing insurance claims, but to any area of life that requires an investment of time, energy or resources in order to facilitate a specific outcome.

  1. Decide if the return on investment is worth it. Is the outcome worth your time and energy? If not, consider delaying or deleting completely. If so, be strategic in how you go about following up.
  2. Document everything. When communicating with insurers, providers, attorneys, and other professionals, note the date, time, name and outcome of each conversation.
  3. Track the resolution of each communication. What did the person you spoke to say they would do? Did they do it, or are they in the process of doing it?
  4. Use a calendar to notate a follow up date and action, and continue to do this as needed so you remember to track things as they are completed.
  5. Follow up as needed until you gain the result you want, or until it becomes clear that you will not attain the result you were hoping for.
  6. Be organized. It is still surprising to me after all these years that when we call our insurance company they remember us. I believe this is less because there are good people on the other end of the phone and more because they know, from our past interactions, that we are super organized and track (and pursue) things as needed.
  7. If you aren’t getting the results you want, consider hiring an attorney. Sometimes all it takes is a call from a legal professional to show you are serious. Hiring an attorney gives credibility to your claim.
  8. Learn from each experience. What will you do differently next time? What worked and what didn’t? How can things be streamlined in the future?

Have you ever had to advocate for yourself with regard to an illness? We would love to hear your story.

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2 thoughts on “How to Be Your Own Medical Advocate

  1. juliebestry says:

    Excellent advice. The sad truth is that the more complex one’s health problems, the more adept one is likely to become at figuring out the nuances of the health system. Thankfully most doctors’ offices do file (at least primary) insurance, but I hate that you went through that. I hope people read your guidance before they actually need it.

    Liked by 1 person

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