6 questions to ask a health advocate

"A social worker could help you find home-based care," Weil says. "If you need billing assistance, a medical-billing coder who knows what those insurance codes mean can better reconcile your medical records and your bill."

2. How long have you been in business? Find an advocate who has been working at least two years, says HealthCare Advocates' President Kevin Flynn. "Ask them how many cases they've done. An established advocate should have done at least 25 medical cases a year."

3. Do you have references? Ask the advocate to give you contact information for former clients. Ask the client about the services they provided, how they handled the situation and what the outcome was.

4. How much do you charge? Some advocates charge an hourly rate, others a flat fee. HealthCare Advocate charges an annual membership fee of $20, then between $50 and $400 an hour depending on the situation and research involved. Health Advocates charges a $30 annual fee, then $125 per hour. Its Medical Bill Saver service negotiates down out-of-pocket bills of more than $400. If it succeeds, Health Advocates' fee is 25 percent of the savings.

5. Are there extra expenses? Be clear about the advocate's billing structure because not everything is included. "Some charge you extra for travel expenses, like driving from their office to the hospital," says Weil.

6. How long will this take? Ask for a cost estimate and resolution time. A good advocate can explain how your goal can be measured and achieved. Ask how he'll keep you posted on the progress. If your advocate is local, a face-to-face conversation may be good enough, but if you're communicating by phone or e-mail, written reports are a good idea. Ask if there's an extra fee for them.

One way to keep costs down and get your problem solved is to keep all paperwork to hand to the advocate. "The more organized you are and the more facts you have, the easier it is for us to get to the crux of the matter," Rosen says.

Jot down names of doctors and hospitals you visited and dates of appointments and services. Save copies of all bills and insurance statements. Keep a diary of who you talked to and their response. If you need help such as finding the best treatment, ask your doctor or hospital for your medical records or give your advocate authorization to access them.

"That helps him know important issues like how serious the condition is, your medical background and family history," says Flynn. "That cuts down on paperwork and research time," and ultimately, your total bill.

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