The Professional Patient Advocate Workshop

Sharpen case and care management skills when working with consumers.

Tuesday, December 7, 2010
8:30-4:30
New York, NY
Continuing education: 7.0 hours of CE

The Professional Patient Advocate Workshop is a one-day course designed to improve your skills and effectiveness as a patient advocate and offers a step towards earning a Certificate in Patient Advocacy. This course is an introduction to advocacy with a focus on both private advocates as well as those employed by a hospital, an employer group or another setting. This course can be taken as part of the series of requirements to earn a Certificate or as a stand-alone educational opportunity. The Certificate Program is a comprehensive training process aimed to enhance the working knowledge of those in this specialized field, and it serves as a point of entry to professionals who want to transition to this new role, providing a course of study that builds on an existing body of knowledge.

Target Audience: Those who work directly with the consumer in any setting would benefit from this material.

The course addresses these basic health consumer needs:
1. When it comes to healthcare, what really matters to consumers? Answer: Feel good, pay only appropriate costs, get help with available resources, understand options, trust a health care advisor
2. Grant every patient access to a professional dedicated to his/her best health interests
3. Eliminate the need for the patient or family to navigate the complex healthcare system alone
4. Promote health care based on a competent and trusted advisor relationship
5. Understand basic state, federal and private healthcare programs
6. Help patients access basic behavioral and medical health services through insurance benefits and state programs
7. Advise about programs to extend benefits
By the end of this course, you will be able to:
Understand the trends in healthcare that lead to increased fragmentation, as well as unprecedented innovation and increased consumer responsibility.
Define patient advocacy and who can serve as a Professional Patient Advocate.
Define what services a Professional Patient Advocate can provide.
Define the scope of the Professional Patient Advocate Certificate Program.


Patient Needs Assessment/Coordination of Care
Analyze the patient’s needs, desires and options based on a patient/family interview, physician interview, medical records review, and employer review when appropriate.
Prioritize health management issues jointly with the patient and physician.
Explore options and related costs for addressing identified needs.
Explore both medical and behavioral health needs.
Advise about programs available to extend benefits.


Patient & Family Support Communication and Cultural Competence Skills
Provide support to the patient and family so that they are safe, comfortable and informed.
Interpret medical jargon, including diagnosis and treatment information, to the patient and family when appropriate.
Assist the patient in accessing reliable web-based information and assist them in understanding when it is appropriate.
Explain various diagnostic tests, treatments and medications.
Provide education and support for the patient's religion, values, dietary habits and end-of-life beliefs and desires.
Provide education related to various complementary and alternative medicine modalities.


Direct Patient Contracting
Provide an agreement with the patient for health advocacy services to be provided, outlining the specific service to be provided and the related fees.
Offer cost estimates.
Make payment arrangements.
Utilize legal consent and disclosure forms.
Understand transitions of care appointments and scheduling.
Schedule and coordinate doctor and treatment appointments.
Help transfer medical records, X-rays, and lab results.


Payer Provisions
Obtain an understanding of insurance contracts, patient co-pays, provider network features, pharmacy benefits, vision, dental and specialty policies.
Understand Medicare options, including Parts A, B and D, with the ability to help patients understand out-of-pocket costs and care implications for various choices.
Understand Veterans care, Tricare, CHAMPUS and various military service-related care plans, costs and implications to families.
Determine benefits available to families from long-term care policies.
Advise about programs available to extend benefits.


Healthcare Billing
Understand the basic medical codes utilized by providers and assist patients In resolving payment concerns and denials.
Analyze and negotiate provider bills to decrease inappropriate billing, thus saving money for the patient.
Obtain approvals for covered services.
Coordinate among multiple providers.
Identify the reporting needed and documentation required to accomplish the above.
Business Considerations.Create a business skills self-assessment to understand your strengths and potential weaknesses.
Create a full-fledged business and financial plan.
Learn how to create marketing and public relations materials, as well as fee structures and referral sources.
Explore the implications of and tips for success in operating a home-based business.

Agenda:
8-8:45Intro to Patient Advocacy
8:45-10:00Assessment & Coordination of Care
10:00-10:15Break
10:15-11:15Patient & Family Support/Communication & Cultural Competence Skills
11:15-12:15Direct Patient Contracting: Agreements, Payments, Transitions of Care & More
12:15-1:00Lunch Break
1:00-1:45Payer Provisions: Insurance Contracts, Medicare, Veterans & More
1:45-2:45Healthcare Billing: Medical Codes, Approvals, Negotiations, Approvals
2:45-3:00Break
3:00-4:15Business Considerations: Business Plans, Skills, Marketing, & More
4:15-4:30Q&A

Location: Offices of Access Intelligence,110 William Street, 11th Floor, New York, NY
Continuing education: 7.0 hours of CE
Instructors: Catherine M. Mullahy, RN, BS, CRRN, CCM and Jeanne H. Boling, RN, MSN, CCM of Mullahy & Associates, LLC Huntington, NY
Questions or for registration assistance, contact: Carol Brault, 301-354-1763
For more information on this event and to register online, click on the title above.