February 27, 2024

Many people find health care to be daunting and difficult to navigate — because it is.

One of the things I’m most passionate about as a Nurse is patient advocacy. This was such a large part of my job during a stint in bedside nursing– advocating for what I saw in a patient throughout a 12-hour shift versus what the doctor observed in their morning rounds.

This dynamic elevated my awareness of how critical advocacy is —patients may be too exhausted to ask questions or not have loved ones nearby to have a full conversation with the care team. Unfortunately, many people find health care to be daunting and difficult to navigate — because it is. However, there are multiple ways to advocate for yourself or your loved one when in the patient chair.

1. Have an honest conversation with your provider

Misunderstanding your provider or test results can lead to unnecessary fear or anxiety around your health. Often, this can be taken care of with simple clarifications.

For instance, medical professionals often use a lot of medical jargon. For those of us who did not go to medical school, this can create confusion. There is absolutely no shame in asking your provider to re-explain a diagnosis or treatment in plain wording that anyone could understand.

Tip: Ask them to write terms or credible websites down for you to do further research after your appointment!

2. Know when it may be appropriate to ask for a second opinion

Patients often accept their doctor’s treatment advice without understanding what alternative treatments are available. Alternatives can have different levels of cost AND effectiveness. Remember, asking questions is a good thing and can help you to decide what treatment plan is best for both your health and your wallet!

I always like to know- what treatment are you recommending and why are you recommending it? You can always be honest with your doctor. Let them know that you may want a second opinion before making any decisions.

Often, patients are worried that this will offend their doctors. But doctors that are truly for you and your health want to get the best treatment plan in place for you. They should welcome a fellow medical professional’s thoughts. They may even have specialists in mind they would recommend you talk to!

3. Know your way around a medical bill

Something that was most shocking to me when I transitioned to a clinical role in benefits was learning the ins and outs of medical billing. Unfortunately, medical bills are becoming increasingly complex and difficult to read.

If bills were accurate, that would be one thing. But did you know that nearly 80% of medical bills have errors? As a result, it is critical you take the time to review your bills and ensure you aren’t overpaying.

Medical Billing 101

There are three main documents that you need to look at BEFORE you pay any medical bill.

  1. When you go to your doctor for your visit, ask for a LIST OF SERVICES PERFORMED. This is a note that shows every service performed during your visit so you can see a real-time log of what you will be billed for.
  2. Ask for an ITEMIZED BILL. When the dreaded medical bill arrives, there is often just one large total, with no explanation of how it was calculated. It is your right as the patient to ask your doctor for an itemized bill that shows you a list of the services performed as well as the cost associated with those services. As you review, also make sure to check your bill for any typos, duplicate charges, and incorrect services.
  3. Lastly, reach out to your insurance company to see your EXPLANATION OF BENEFITS. This is a document that shows what the medical facility charged insurance, what insurance paid, and what you owe. You can compare this with your medical plan to make sure you are not paying more than your out-of-pocket max should be (if your procedure was in network). If the price is higher, there is a chance insurance may not have processed it correctly.

If you want some additional tips on reading your medical bill, along with a printable version you can keep handy, check out this post.

Remember, you do not have to be a health professional to successfully navigate the health care world. Simply remember to be honest, ask questions and advocate for yourself or your loved ones. Your care team is there to take care of you and provide the information to make the decisions that are right for you!

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Jordyn Schwerin, RN

Authored By

Jordyn Schwerin, RN

Kinetiq Health Program Manager

As a Kinetiq Health Program Manager, Jordyn works to create customized and unique wellness solutions, aiming to improve her clients’ overall health and quality of life. Her responsibilities include collaborating with client wellness teams and hosting one-on-one client meetings to communicate and implement wellness plans based on specific needs.

Meet Jordyn