Tips for being
an effective health care advocate
AARP,
September 18, 2018
En español
| As our parents and loved ones get older, it takes a lot more time — and
attention from a lot more people — to maintain their good health.
Managing doctor appointments, refilling prescriptions and tracking
insurance bills can be overwhelming for patients and caregivers. A trusted family
member or friend can be an effective health care
advocate. If you’re taking on such a role, or need to in the future,
here are some things to keep in mind:
Doctor Visits
First, gently ask your parent whether he or
she needs or wants your help communicating with the doctor. If your parent
agrees, talk to each other about what questions to ask
the doctor before the appointment — and write them down. During
the visit, let your parent take the lead in talking to the doctor. If a
question is overlooked or not answered, then follow up. Ask for an explanation
of unclear terms or direction. Take notes or, if the doctor allows, record the
conversation.
Prescription
Safety Check
Some
1.5 million people are injured by medication errors each year in the U.S.
Caregivers can stop a disaster before it happens by double-checking every new
and refilled prescription.
- Have the pharmacist compare past records with the
refill order. (If medications arrive by mail, compare the new bottle with
the old one.) If there’s a discrepancy in dose, amount, strength or
directions, call the doctor.
If
the prescription is new or you are uncertain about the medication, do the
following:
- Ask about side effects, adverse reactions, precautions
and warnings.
- Check the brand name against the generic name.
- Ask if the pill can be crushed or split.
- Read all included information.
- When prepping pills at home, review instructions. It’s
easy to misremember directions.
- Consider putting daily pills in a compartmentalized box
so you, or anyone filling in for you, will know if the daily dose has been
taken.
- Store medicine as directed.
- For additional information about a particular drug,
check out the AARP Drug Directory, Interaction
Checker, and Pill
Identifier
Hospitalization
When your loved one is hospitalized, even for
a routine procedure, have a written game plan to help ensure that nothing is
overlooked. Here’s what you need to know.
Step 1. Make sure the procedure is covered.
- Find out what Medicare covers. Enter the
procedure, surgery or treatment to find out.
- If the patient is a Medicaid recipient, see what Medicaid covers.
- If covered by private insurance, call customer service
to confirm the hospital accepts your loved one’s insurance and the doctor
performing the procedure is in network. If the hospital is in network and
the doctor is not, ask if the company will cover the doctor’s fees.
Step 2. Find the right
doctor and hospital, then:
- Contact your loved one’s insurer for preapproval.
- Ask for a confirmation number.
Step 3. Contact the doctor’s office a week before the scheduled
admission.
- Go over instructions. These may include fasting
requirements; temporarily discontinuing aspirin, blood thinners or other
medications; and what to bring to admissions.
- Confirm length of expected
hospital stay.
Step 4. Check in. Bring a to-go bag, containing your loved
one’s:
- Legal, current photo ID
- Insurance, Medicare, Medicaid cards
- List of all medicines currently being taken, including
vitamins and over-the-counter drugs, with doses noted
- List of questions and observational notes
- Names and contact information of doctors
- A short health history
- HIPAA agreement (This form allows hospital
staff to share the patient’s medical status with you or another trusted
person.)
Step 5. During hospitalization:
- Keep a journal to record your loved one’s condition,
changes, appetite and mood. Note dates and times.
- Remember that every patient has a right to review his
medical records and have terms explained clearly.
- If concerns go unanswered, contact the hospital’s
patient representative.
Step 6. Check out. Before leaving, ask:
- What is the expected recovery time?
- What are the possible side effects?
- Are you prescribing new medications?
- Should the patient continue taking medication
prescribed before hospitalization? Prescriptions? Vitamins?
- Will this be followed by patient rehab, physical or
other therapy?
- When is the next office appointment?
Track and Pay
the Medical Bills
Keeping tabs on the hospital tab is essential.
Mistakes happen, and when they do, the claim will likely be rejected. These
tips will help you track down and correct the error.
- Keep all medical receipts.
- If insurance, Medicare or Medicaid rejects a claim, call
the business office for the provider, service, clinic or hospital. Ask for
copies of medical records.
- Compare records with bills. Make sure your name,
insurance number and the services provided are correct.
- Report unexplained or mistaken charges to the business
office and ask for an explanation. Take notes. Include the date, time and
name of the person with whom you spoke.
- If the issue is resolved, ask for a new statement.
- If the provider checks the medical coding, dates and
services rendered but is unable to resolve the issue, contact the office
that rejected the claim.
- If there is a discrepancy between the provider and the
insurer, request that customer service set up a three-way phone call that
includes you and the provider.
- If the issue remains unresolved and they believe their
decision was correct, file an
appeal.
- If paying the bill will create a hardship, ask if it
can be adjusted and request a payment plan.
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