A couple of things happened in the last two days that made me think it is time for me to again mention patient advocacy; including self-advocacy. First, the monthly meeting of Chronic Disease Coalition Ambassadors occurred and the importance of patient advocacy and even self advocacy came up. The second thing to occur, beginning yesterday, was the potential delay in another treatment due to an "insurance authorization" issue. I had already been digging down to identify the actual issue when the CDCA call occurred.
Across my career I've ensured that people had a shared mental model and understanding. When it came to patients, I welcomed and encouraged them to identify advocates, or advocate for themselves. But, what is advocacy? It really is about speaking up, questioning, addressing concerns, asking for clarification, and ensuring that one's needs and desires are heard and understood. Healthcare professionals are human and make mistakes and sometimes these cause harm to patients. Advocacy is a way to keep patients safe and minimize the risk of harm; or at least lessen its impact.
One place that I've turned for educational content that uses engaging video to help consumers and patients better advocate for themselves is the Joint Commission's Speak Up Initiative. Below is just one of the videos, on the topic of identifying a family/friend advocate. Videos also address scenarios and issues, such as, doctor visits, at home, preventing medication errors, reducing your risk of falling and more.
Back to my advocacy issue... I was told by the speciality pharmacy my treatments scheduled for next week would have to be delayed because insurance authorization for payment was still pending. The disappointment and frustration I felt "activated" me and my first call was to the insurance company to check on the status of the authorization. I was told that one had not been submitted by the pharmacy. After a few more questions and some digging by the customer service rep, I was told that there was an authorization from January that covered my treatments through mid July.
So, I called the speciality pharmacy back to explain this and ask why they needed a new authorization. They did some digging and found out that yes, next week's treatment is actually already covered. In the process, I identified some opportunities for my insurance plan to improve their communication process and for the speciality pharmacy to improve their tracking processes. In addition, I learned a bit more about how the authorization process works for these recurring treatments, so if this happens again, I'll be prepared to ask even better questions.
The result is that my treatment remains as scheduled and it won't disrupt my plans for the next few weeks. Had I just accepted that initial phone call and the needed delay as fact, I would have been frustrated, stressed and a bit angry that I would have to cancel my plans for a little road trip to get away and rejuvenate.
So, ask questions until something makes sense. If the healthcare providers don't have answers, encourage or ask them to look into the matter and get back to you. Follow up on leads that take you back to the person who has the information you need. Also, don't be afraid to make a little noise and reach out to a supervisor, manager or even the chief executive officer, if something is especially important.