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Health advocacy
Bret Brummitt9/17/23 1:59 PM4 min read

What Does Advocacy Do?

How Can an Advocacy Service Help Your Employees?

Did you know health advocacy is a thing?  There are many different ways we can all use a little help when it comes to using our insurance benefits or just simply navigating the overly complex healthcare system in general.

And, this is where an advocate by your side could help.  Here are some simple ways that you can improve any benefits experience through adding an advocacy service.

Have you ever had trouble understanding complex bills and identifying errors?

We recently heard this story from a colleague.  “I had the honor of becoming a father this year.  Along with the bundle of joy came six bills in addition to the hospital charge.  Even being in the industry, this is no easy task to figure out which claims were processed correctly.  I had to ask myself, did this service get applied to my deductible? Is the provider covered correctly?  Was the claim denied?  Should I actually owe that much? Haven’t I already reached my out-of-pocket maximum?  And, finally, should I even pay this?”

Now, you can only imagine the time and energy to track down six companies.  Then, make six phone calls plus at least six more due to being transferred to different people and different divisions.

This is one of the big areas that an advocate can help.

Advocates can navigate the claims and bills you receive, make phone calls on your behalf and gather the data for you.  All you have to do is provide the bills and sign an authorization for the advocate to go to work.  Clearly, spending 10 minutes and waiting for the research from an unbiased, independent professional is such a better use of time than doing it all alone.

Have you ever researched where the service costs less?

Lab tests, MRIs and outpatient procedures  are just a few common items that can have huge variability in cost.   Oddly, there is no real rhyme or reason here.  Just know that the same service may be substantially cheaper from one provider to another, so shopping it is crucial.

For a real-life example, one of our team members shared their experience of saving $800 by pricing a local provider (think Dallas Cowboys) versus a close by Dallas hospital for a MRI.

Well, you don’t have to be the one calling around and speaking industry jargon like CPT or ICD-10 just to get a price.  An advocate will navigate that pricing chore for you.  They will consider your insurance network benefits first to maximize your plan.  Then, they’ll look at keeping your personal costs as low as possible.

Have you ever wanted to negotiate a lower fee or file an appeal?

You shouldn’t have to just give up in defeat.  We see members pay money they don’t owe and sometimes forego the care they deserve.  Accordingly, an advocate will attempt to negotiate any fees and help to keep your member’s out of pocket costs lower.  And, this can even be done prior to receiving services.

Now, those bills that come in from non-network, non-covered providers?  Your advocate will become your personal fixer.  They’ll reduce or even eliminate these costs from your employees.

Oh, and that dreaded appeal?  That process takes a specialist to handle. This isn’t for the faint of heart and is way more burdensome than necessary.  An advocate will help formulate the argument, gather supporting documents and write the letter of appeal for you.  They will even represent you in the event of a hearing.  You don’t want to go that alone. They are by your side.

Get a health advocate and have a better employee benefits experience.

Adding an advocacy plan to your benefits is really necessary.  No one person can handle the time and complexity of our healthcare system and at the same time best utilize their insurance plan.

Save yourself and your employees a great deal of time and frustration with:

  • Scheduling earliest appointments for hard-to-reach specialists
  • Facilitating the transfer of medical records, x-rays and lab results prior to a scheduled appointment with a new physician.
  • Finding options for non-covered services & negotiating discounts
  • Answering questions about test results and recommended medications/treatments
  • Helping your employees understand multi-tiered prescription plans
  • Locating lower-cost sources for prescription drugs
  • Resolving questions between your employees and pharmacies regarding their dispensed medications.
  • Securing second opinions
  • Coach employees for physician visits and procedure
  • Help your employees better understand medical terms, tests, medication and treatments.

Your employees shouldn’t have to fight to get information or get a reasonable bill.  But, it happens in reality.  So, bring on an advocate so your employees can focus on what’s important to them and put haggling over medical matters behind them.  Our team would love the chance to introduce you to some of the amazing advocates we trust!


Bret Brummitt

In 2019, Bret launched Generous Benefits, leveraging 20 years of experience in Employee Benefits. His mission is to transform communities through innovative benefits solutions. Bret envisions benefits beyond traditional offerings, aiming for a lasting impact by stretching, tailoring, and curating packages. He coaches insurance agencies with Q4intelligence, actively participating in communities like Health Rosetta and the Free Market Medical Association. Based in Austin, he balances his professional pursuits with running alongside Gilbert's Gazelles and playing baseball with the Austin Blue Jays.

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