Health Advocate

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Health Advocate
TypePrivate
IndustryHealth care
Founded2001 (2001)
FounderMichael Cardillo
Arthur "Abbie" Leibowitz, M.D.
Thomas Masci, Jr.
David Rocchino
Martin Rosen
Headquarters
Plymouth Meeting, Pennsylvania
,
United States
ServicesHealth advocacy
Number of employees
640
Websitewww.healthadvocate.com

Health Advocate, Inc. is a US national health advocacy, patient advocacy and assistance company.[1] The privately held company was founded in 2001 by former Aetna executives[2] and is headquartered in Plymouth Meeting, Pennsylvania, currently run by Teleperformance. The company employs registered nurses, medical directors and benefits specialists[3][4] who address a range of health care and health insurance issues.[5] Personal Health Advocates can help members locate providers, address errors on medical bills, answer questions about coverage denials and assist with insurance appeals.[6]

The company's products include brands called Wellness Advocate, Benefits Gateway+Health Information Dashboards, EAP and Worklife, Pricing Decision Support, Personalized Health Communications, Chronic Care Management, and HR. The company offers a direct-to-consumer advocacy service, called Health Proponent to individuals who are not part of groups.

Products and services[]

Core advocacy

  • Clinical Assistance – medical and pharmaceutical advice and research.[7]

Clinical Assistance helps members understand tests, treatments, and medications recommended or prescribed by physicians, facilitating the transfer of medical records, X-rays, and lab results before a scheduled appointment with a new physician, arranging for home-care equipment after discharge from a hospital, facilitating review of test results with another physician for confirmation of diagnosis, consolidating a multiple-day testing schedule for members with special needs, arranging hospice and other services for the terminally ill, facilitating transfer from a community hospital to a tertiary care facility.[8]

  • Administrative Assistance helps resolve claims and benefits issues, and helps find assistance outside the health plan.[9]

For example: Researching a member's outstanding out-of-pocket responsibilities and resolving errors with providers and/or the member's health plan, correcting balance-billing problems, correcting charges incorrectly applied to the member's deductible, resolving eligibility problems and benefit and claim denials, coordinating benefits between dental, medical, worker's compensation, and disability carriers, assuring correct application of provider network status, correcting errors in processing of “blind” network provider discounts, resolving coordination-of-benefits disputes between carriers, satisfying plan requests for copies of referrals, providing correct member insurance information to providers.[8]

Healthcare Advocates, Inc. vs Health Advocate, Inc.[]

In October 2004, Kevin Flynn, the sole employee of Healthcare Advocates Inc. and the latter company, which Flynn had formed in 1996, sued Health Advocate Inc. claiming trademark infringement and unfair competition. On 8 February 2005, the suit was dismissed on summary judgement by the United States District Court for the Eastern District of Pennsylvania, upheld on appeal on 22 February 2006 by the United States Court of Appeal for the Third Circuit.[10]

Coverage[]

Employers generally offer the service to their employees as a benefit and extension to their healthcare insurance plans. The employee's immediate family is also covered. This includes spouses, dependent children, parents and parents-in-law.[11]

Those whose employers do not offer the service can purchase it from Health Advocate's direct-to-consumer arm Health Proponent.

Awards[]

  • Ranked in Inc. (magazine) Top 5,000 Companies by Industry – Health: six years in a row (2006-2012)[12]
  • 2007 Ranked 3 in Inc. (magazine) Top 5,000 Companies by Metro Region—Philadelphia-Camden-Wilmington, PA-NJ-DE[13]
  • 2008 Inc. (magazine) 500: America's Fastest Growing Private Companies[14]
  • 2009 Inc. (magazine) 500: America's Fastest Growing Private Companies[15]
  • Ranked in the Philadelphia 100 Fastest Growing Private Companies 6 years in a row (2006-2012), Philadelphia Business Journal/ Wharton Small Business Center,[16]
  • 2007 Top 20 Best Places to Work, Philadelphia Magazine[17]
  • 2008 CFO of the Year, Philadelphia Business Journal, Finalist[18]
  • 2009 CFO of the Year, Philadelphia Business Journal[19]
  • Philadelphia Business Journal - 2009 Best Places to Work[20]
  • 2009 Eastern Technology Council - Life Sciences CEO of the Year - Mike Cardillo Winner[21]
  • 2010 IBPA Benjamin Franklin Award, Bill Fisher Award for best First Book (non-fiction) – Martin Rosen and Abbie Leibowitz, M.D.[22]

Published works[]

  • Rosen, Martin B. & Leibowitz, Abbie. “Health Advocacy Programs Help Employers and Employees Navigate Health Care and Insurance Systems.” Employee Benefit Plan Review Volume 57, Number 4, October 2002
  • Rosen, Martin B. & Leibowitz, Abbie. “Health Advocacy Helps Employers and Employees Cope with Health Care and Insurance Systems.” HIU Health Insurance Underwriter November 2002
  • Leibowitz, M.D., Abbie. “What Do Patient Advocates Do?” National Underwriter Vol. 3, No. 2, December 2003
  • Cardillo, Michael & Rosen, Martin. “Benefits, Challenges of Consumer-Driven Healthcare.” Human Capital January/ February 2004
  • Rosen, Martin B. & Leibowitz, M.D., Abbie. “Health Advocacy Helps Employers and Employees Cope with Healthcare and Insurance Systems.” Philadelphia SHRM Chapter News February 2004
  • Rosen, Martin B. & Leibowitz, M.D., Abbie. “Health Advocacy: Saving Time and Money for Employers and Employees.” Employee Benefits August 2004
  • Leibowitz, M.D., Abbie. “Health advocacy: Strategic complement to consumer-directed Healthcare.” Inside HR/NY September 2004
  • Leibowitz, M.D., F.A.A.P., Abbie. “The Role of Health Advocacy in Disease Management.” Disease Management Volume 8, Number 3 2005
  • Rosen, Martin. “Health Advocacy: A New resource for Employers.” Pension & Benefits Update Vol. 16, No. 3, March/ April 2005
  • Rosen, Martin B. “Health Advocacy: Saving Time and Money for Employers and Employees.” The Healthcare Savings Chronicle Volume 3 August 2005
  • Martin B. Rosen and Arthur “Abbie” Leibowitz, M.D. coauthored The Healthcare Survival Guide: Cost-Saving Options for the Suddenly Unemployed
  • Rosen, Martin B. “Simple Ways to Organize Your Older Relatives.” Buttoned Up 6 January 2010
  • Rosen, Martin B. “Top 10 Ways to manage Eldercare.” S.I. Parent March 2010
  • Chiaro MSW, LSW, Michelle. "The Role of Social Work in Health Advocacy." Social Work Today Newsletter August 2010

References[]

  1. ^ Dorschner, John. “Healthcare advocacy experts aid workers.” Miami Herald 31 August 2010
  2. ^ Young, Lauren. “Advocates WhoHelp You Negotiate Healthcare.” BusinessWeek 22 October 2007
  3. ^ George, John (2–8 October 2009). "Health Advocate has the answers to health questions". Philadelphia Business Journal. Retrieved February 15, 2010.
  4. ^ Heubeck, Elizabeth (30 November 2007). "Personal health care advocates sell benefits expertise to firms". Baltimore Business Journal. Retrieved February 15, 2010.
  5. ^ Wells, Susan J. (1 August 2006). "Independent experts can help employees conquer mountains of medical paperwork, freeing HR to focus on other core concerns". SHRM HR Magazine. Archived from the original on 22 August 2011. Retrieved February 15, 2010.
  6. ^ Guterl, Gail O. “Advocating for clients.” Advance for Nurses 9 June 2003
  7. ^ Silverman, Ed. “Healthy Backing,” Human Resource Executive May 2003
  8. ^ a b Diamond, Frank. “Plan Lets Ombudsman Go To Bat for Members,” Managed Care October 2004
  9. ^ “Former Aetna Execs See Growth in New Patient Advocacy Company.” Managed Care Week 29 July 2002
  10. ^ "Flynn v. Health Advocate Inc". 2006 Decisions. 2006-02-22.
  11. ^ Rotenberg, Carl. “Health move,” The Times Herald 14 May 2003
  12. ^ "Archived copy". Archived from the original on 2011-06-06. Retrieved 2010-03-04.{{cite web}}: CS1 maint: archived copy as title (link)
  13. ^ "Archived copy". Archived from the original on 2011-06-06. Retrieved 2010-03-04.{{cite web}}: CS1 maint: archived copy as title (link)
  14. ^ "Archived copy". Archived from the original on 2010-06-23. Retrieved 2010-01-27.{{cite web}}: CS1 maint: archived copy as title (link)
  15. ^ "Archived copy". Archived from the original on 2009-08-17. Retrieved 2010-01-27.{{cite web}}: CS1 maint: archived copy as title (link)
  16. ^ "Archived copy" (PDF). Archived from the original (PDF) on 2010-02-02. Retrieved 2010-03-04.{{cite web}}: CS1 maint: archived copy as title (link)
  17. ^ "Archived copy". Archived from the original on 2009-10-08. Retrieved 2010-03-04.{{cite web}}: CS1 maint: archived copy as title (link)
  18. ^ "CFO of the Year Awards".
  19. ^ "Medium Company". 13 July 2009.
  20. ^ "Philadelphia Business Journal names 2009 Best Places to Work winners". 16 October 2009.
  21. ^ "Archived copy". Archived from the original on 2010-03-30. Retrieved 2010-03-04.{{cite web}}: CS1 maint: archived copy as title (link)
  22. ^ "Archived copy". Archived from the original on 2013-01-13. Retrieved 2013-01-08.{{cite web}}: CS1 maint: archived copy as title (link)
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