Health Advocate

Core Health Advocacy1 About Health Advocate

Question How does Health Advocate work?
Answer Health Advocate assists employers and their employees (and eligible family members) through our staff of Personal Health Advocates (PHA). Members needing assistance call a special toll-free Health Advocate telephone number (1-866-695-8622). The member speaks with a PHA, who then becomes "their" Personal Health Advocate, personally helping them with their issue, problem or other need for assistance. After obtaining the necessary background information, the PHA, assisted by a staff of medical directors and administrative coordinators, researches and resolves the inquiry and establishes a time frame and method for responding back to the member.
Question What is the background of the Personal Health Advocate?
Answer Our Personal Health Advocates are trained healthcare professionals, typically registered nurses, who have a number of years experience working in healthcare-related jobs. Health Advocate’s staff is carefully screened to make certain that they have both the necessary professional credentials and excellent personal communications skills to deal with the problems members present to them.
Question What issues does Health Advocate typically address?
Answer The Health Advocate staff serves as a liaison for members with healthcare providers, insurance plans and other health-related community resources. This means they can address nearly any medical question and issue from finding primary care, specialist physicians and medical institutions to resolving claims and billing errors. Health Advocate also help members access community resources, including senior care services, that fall outside traditional healthcare coverage.
Question How do I know that my issues will be kept private and confidential?
Answer Health Advocate’s staff is specially trained to follow strict protocols that comply with all governmental privacy standards to ensure that members’ medical and personal information is fully protected. As with all health and assistance programs sponsors, employers or other plan sponsors do not receive or have access to any of your confidential information.
Question What are the benefits of Health Advocate for members?
Answer Health Advocate provides help and assistance in four major areas that cover virtually all healthcare and insurance-related issues.  The following is a brief summary of the types of support our members and their families can recieve: 
    • Clinical Services:  We help find physicians, hospitals and other healthcare providers; locate Centers of Excellence; schedule appointments; and help coordinate medical needs.
    • Administrative Services:  We assist with claims and billing issues, fee negotiations, coverage and benefit issues.
    • Health Coaching:  We help prepare members for their physician visits and help them better understand their chronic conditions so they become active participants in the management of their health.
    • Information and Service Support:  We provide assistance finding information and resources; for example, available senior care and treatment options.
Question What are the benefits of Health Advocate for Plan Sponsors?
Answer
  • Eases burden on HR staff
  • Facilitates interaction with a registered nurse and medical team advocating on your behalf
  • Demonstration of commitment to employees’ mental and physical well-being
  • Provides a way to ease the challenges of work-life balance
  • Improves employee satisfaction and morale
  • Opportunity to improve health outcomes
  • Increases employee productivity
Question What's the difference between health insurance coverage and Health Advocate's services?
Answer Health Advocate’s program is NOT health insurance and is not a replacement for healthcare coverage. Rather, the service is designed to help employees more easily navigate the healthcare and insurance systems through working one-on-one with the member's own Personal Health Advocate. Health Advocate’s goal is to maximize each person’s healthcare experience.
Question Can Health Advocate save me money?
Answer Yes and in several ways. First, the Health Advocate staff knows the “ins and outs” of the healthcare and insurance worlds and can get to the bottom of the problem quickly and find solutions. Saving time saves money.

Second, Health Advocate can identify billing and claims processing errors and help negotiate provider charges, which can be another source of savings.

Finally, Health Advocate can help get members in need of medical care to the right provider quickly, avoiding unnecessary shuffling between multiple providers and duplication of tests and services. This is not only an area of considerable cost savings, but also helps to enhance the quality of our members’ healthcare experience.
Question How do I access my Health Advocate benefits?
Answer You can reach Health Advocate using the convenient toll-free number: 1-866-695-8622 listed on the wallet cards attached to your member brochure. You can also email Health Advocate at answers@HealthAdvocate.com or fax information to 1-610-941-4200.
Question Can I still use Health Advocate when I travel?
Answer Yes. Although Health Advocate is headquartered in Plymouth Meeting, Pennsylvania, a suburb of Philadelphia, the team is always available to assist you wherever you are by calling the toll-free number 1-866-695-8622.
Question What are the hours of operation?
Answer Health Advocate can be accessed 24/7.  Our normal business hours are Monday - Friday between 8am and 9pm Eastern Time.  After hours and during weekends, on-call staff is always available for assistance with issues that need to be addressed during non business work hours.
Question Will I be able to talk to the same Personal Health Advocate each time I call with an issue?
Answer Yes. When you call Health Advocate for the first time, you will speak with your own “assigned” Personal Health Advocate (PHA) who will remain with you until your issue is resolved. If you call after-hours or on weekends, you may receive a return call from another Personal Health Advocate who is on duty to handle after-hours calls.
Question Can any member of a family call Health Advocate for assistance?
Answer Yes. You, your dependent children, spouse, your parents and parents-in-law are all covered by Health Advocate and can call directly for service.
Question Who should sign the Health Advocate Authorization on behalf of a minor child?
Answer Depending on the child’s age and state laws, a minor child may be permitted to sign the Health Advocate release. In other circumstances, the child’s parents or legal guardian is permitted to sign the authorization. This authorization gives Health Advocate permission to work on behalf of the child and gain access to medical information.
Question Can Health Advocate still help me and my family if I do not carry my insurance through my employer?
Answer Yes. You can still use all of the available services Health Advocate offers, no matter what insurance coverage you or an eligible family member has.
Question Can I call my PHA to locate senior services for one of my parents?
Answer Yes. Health Advocate will work with you to assist your parent in locating necessary services. If necessary, the staff can help you find information and even arrange no or low-cost community or government-based services.
Question My child has a chronic medical problem, and we have shuffled from doctor to doctor without getting a satisfactory solution. How can Health Advocate help me?
Answer One of the Personal Health Advocates, assisted by our team of medical directors, will review the details of your child’s medical condition and work with you to find the best doctors and other medical providers.
Question Can Health Advocate help get me a second opinion about a medication that my doctor recently recommended?
Answer Yes. Health Advocate’s staff can help you find another qualified physician who specializes in this condition for a second opinion.
Question What criteria does Health Advocate use when making suggestions to a member?
Answer Health Advocate’s staff carefully reviews available options. Depending on the circumstances of your case, they may contact leading medical authorities in local communities and acknowledged medical Centers of Excellence throughout the nation. They also review the medical literature and have access to other databases for assisting employees.
Question Can I get help for a doctor's bill that I think should be paid by my insurance?
Answer First, it is best to contact your health plan and try to resolve the issue. If that doesn’t work, simply call Health Advocate if you receive a bill that you believe has not been processed correctly. They will review the bill for you and, if necessary, contact the healthcare provider and/or your insurance company to attempt to correct any errors.
Question Does Health Advocate provide assistance with dental issues?
Answer Yes. Health Advocate provides assistance with dental issues.
Question I recently tried to obtain an appointment with a specialist physician and was told that I would have to wait more than a month to see the doctor.  Can Health Advocate help me get an expedited appointment?
Answer Often the answer is yes. If it is clear that your condition requires an earlier appointment, Health Advocate will call the specialist physician and attempt to arrange a more timely appointment.
Question Can Health Advocate help me sort through my doctor's confusing medical explanations?
Answer Yes. The Health Advocate staff can call your doctor's office to get a complete update about what you were told, but did not fully understand. They may arrange another time for you to talk to your doctor, or call you back and explain the status of your medical situation in simple terms.
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