The Patient Advocate Group Inc.

Speaking for you, when you can't!

What is a Patient Advocate?

The Patient Advocate Group Inc.

A Patient Advocate is a person who helps guide a patient through the healthcare system. A patient advocate helps patients communicate with their healthcare providers, insurers, pharmacists, and family so they get the information they need to make appropriate decisions about their healthcare and allocate the financial resources necessary to receive the best possible care. 

Patient advocates can be as involved as needed in your medical decisions -- from setting up and accompanying you on to doctor visits and medical tests, to reviewing the care you received, to speaking with your insurance company, to providing referrals for financial, legal, and social support. We are here to help.

 

Ask yourself:

Do you feel like you are on unequal ground dealing with the healthcare system?

Do you feel like you can’t have a meaningful conversation with you doctors, where you are heard and your concerns are addressed?

Are your healthcare providers ignoring your symptoms?

Is your condition worsening regardless even though you have been seeing a doctor?

Did you have abnormal lab work and your doctor didn’t follow up with additional tests?

Did you get an infection after surgery?

Do you feel like your insurance company is constantly trying to take advantage of you?

Do you feel like you are forced to pay for things that your insurance company should be paying for?

Do you feel as though you are shuffled around like cattle when you are in the hospital or in a nursing home?

Has your Parent or Grand Parent sustained an unexplained injury in a nursing home?

Has your loved one been sent to the hospital multiple times from a nursing home?

Were you or your loved one in the hospital or nursing home that was understaffed?

You are not alone! Maybe it’s time to hire a Patient Advocate?

Scope of Services

It is important to understand that The Patient Advocate Group does not provide direct patient care, investigative services nor provide legal advice, however we will refer you to or hire on your behalf the appropriate licensed partitioners and communicate with governmental regulators, when necessary, to protect your interests. 

Similarly, a patient advocate is not going to make decisions for you. Our job is to help explain your options, help you communicate with care providers and family and help you manage your expectations.

The healthcare system’s many layers have created a need for several types of healthcare advocacy. In fact, a Harvard Business Reviewanalysis found that 52 percent of patients in the U.S. cannot navigate the healthcare system’s complexity without help.   

Types of Patient Advocate services we Supply (CLICK ON LINKS):

 

Whether assisting patients concerned about an unclear diagnosis or clarifying confusing medical charges, health advocates offer a range of services:

Medical Care Navigation

Medical care navigation services include:

  • Communicating with healthcare providers.
  • Setting, coordinating, and attending appointments.
  • Speaking up about patient rights.
  • Identifying health resources and making referrals.
  • Explaining confusing medical information.
  • Clarifying diagnoses and conditions.
  • Coordinating care between specialists.
  • Review of services received, providers rendering services and the facilities providing services.


Medical Billing Navigation

Services that help patients navigate medical billing can include:

  • Reviewing medical bills for accuracy.
  • Negotiating bills with providers.
  • Getting billing errors adjusted.

Health Insurance Navigation

Assistance in navigating health insurance may include:

  • Figuring out the coverage guaranteed by insurance plans, Medicare benefits, and veteran benefits.
  • Explaining copays and coinsurance to patients.
  • Investigating in-network and out-of-network provider options.
  • Advising patients on selecting health plans and insurance policies.
  • Researching additional potential benefits such as long-term care insurance.
  • Informing patients about wellness benefits such as preventive care and the use of telehealth.


Placement Navigation

Services that help patients find placements include:

  • Assisting patients getting admitted into or discharged from hospitals.
  • Coordinating patient transfers to nursing homes, assisted living, or rehabilitation centers.
  • Assist patients in evaluating specialists, surgeons, alternative providers etc.

Legal Navigation

Services that help patients find legal resources include:

  • Assist patients getting gathering medical and billing records.
  • Assist patients in communicating concerns to legal professionals.
  • Assist patients in finding alternative medical providers for assessment of conditions and effectiveness of previous interventions.
  • Assist patients' review prospective attorney's personality, empathy, responsiveness to concerns, legal credentialing and case history.



Unlike the Patient Advocate that works in a hospital type setting, The Patient Advocate Group is an Independent Patient Advocate not associated with your healthcare facility. The Patient Advocate Group owes our loyalty only to you and has a fiduciary responsibility to protect you and your loved one’s interests.

Medical Errors

An estimated 161,250 preventable deaths occur each year in U.S. hospitals. Of course this estimate is likely significantly underestimated as providers are likely to underreport their own culpability. According to the Medical Malpractice Report by the National Practitioner Data Bank, $348,065 was the average payout for medical malpractice claims in 2018, and plaintiffs received more than $4 billion in malpractice lawsuits collectively.

Corporate Liability

Additionally, across the United States each year, fines and legal settlements against Big Pharma, insurance companies, hospitals, doctors, and nursing homes amount to many more billions of dollars. An overwhelming majority, 85%, of the pharmaceutical companies sampled had received financial penalties between 2003 and 2016. In all, the 26 pharmaceutical companies paid some $33 billion in fines during the 13-year period. The top 11 most trusted pharmaceutical companies, alone accounted for $28.8 billion, or 88%, of the total.

This observational study, which analyzed publicly available data on campaign contributions and lobbying in the US from 1999 to 2018, found that the pharmaceutical and health product industry spent $4.7 billion, an average of $233 million per year, on lobbying the US federal government; $414 million on contributions to presidential and congressional electoral candidates, national party committees, and outside spending groups; and $877 million on contributions to state candidates and committees. Contributions were targeted at senior legislators in Congress involved in drafting health care laws and state committees that opposed or supported key referenda on drug pricing and regulation.

Less than 1% of those who are entitled to financial compensation file suit or even know that they have been harmed. The sooner you hire a Patient Advocate the more likely you or your loved one will not become a statistic. 

Medical Records

Essential to determine what care you received or are currently receiving, and the projected course of treatment, it is necessary to examine your records. 

Almost everyone is surprised by the inaccuracies and inconsistencies in their medical records. Most providers look at your medical records and provide care based on the information contained therein and do little to confirm that information or correct inaccuracies. We take efforts to review what is in your files and notify the providers of inaccuracies that may negatively affect medical care or hinder your future attempts to acquire health and life  insurance.

Regulatory Review

When evaluating your providers, we can access previous State and Federal Complaints and Violations and monitor facility compliance of regulatory oversight and enforcement history, to see where the facility has fallen short in previous regulatory investigations, such as the Joint Commission and State Department of Health Surveys, to make sure your loved one is getting the care they need.

By assessing previous complaint and violation history we can track patterns of care deficiencies and help your loved ones by utilizing this knowledge on your behalf. With a phone call we can trigger an immediate visit to the facility from State and Federal Regulators (including the Ombudsman's Office, State Department of Health and Attorney General's Office, and Center for Program Integrity at CMS for Medicaid and Medicare). 

Insurance Concerns

Insurance companies frequently ignore legitimate services and medications requested as the requests from medical providers are missing lab results or symptoms that were inadvertently left off your medical chart. Common insurance company violations include not paying claims in a timely fashion, not paying properly filed claims, or making bad faith claims.

Thankfully, there are many laws designed to protect consumers like you, and it’s not uncommon for a policyholder to sue his or her insurer. If you are the victim of insurance bad faith in the form of denying a valid claim, you may be able to sue the insurance company. Dealing with illness, injuries, the death of a loved one, or some other misfortune is hard enough. So, if you’re forced to fight your insurance company on top of all that, it’s easy to feel overwhelmed. The Patient Advocate Group can help you evaluate your coverage and put you in touch with legal experts that will fight for you. 

Staffing Issues

Nursing shortages force nurses to work extra shifts, with a higher patient load than legally permissible with little time to recuperate. Sometimes they are forced to neglect providing essential services that can set in motion disease processes that can shave decades off your loved one's life.

Although medical staff are required to go through stringent background checks, some facilities, desperate for staff, ignore violent past offenses that may place you or your loved one in a position to be harmed.

All too often nursing homes and hospitals, distracted by COVID-19, have been negligent. Additionally, more than half the staff don’t have up to date CPR training, have not been fit tested for respirators to prevent the spread of infectious diseases, are not current in their Antibiotic Stewardship programs, and have not received appropriate training prior to starting work on the floor. If you or your loved one contracted an illness or infection while receiving medical care, you might consider further evaluation of the circumstances and the staff involved and policies and procedures in place.

We look into staffing issues that may endanger your loved one. When appropriate, we can quickly negotiate a change to a better staffed unit in the same facility or a sister facility to avoid the potential for an incident that might harm your loved one.

In some instances, further medical interventions and diagnostic studies will be required. With your direction, we would look to address these issues and find appropriate physicians, physical therapists, diagnostic testing centers, etc. who will work with your insurance coverage. 

In some instances, you might feel as though it is in your family member's best interests to transfer out of the facility where they are staying, and we will help guide you through the process. 


Legal Issues

Although we do NOT provide legal advice or function in the capacity of an “attorney at law” nor provide legal advice, we will help you interview and evaluate and retain experienced legal representation. Of course, legal action is a last resort and should be avoided when possible. Our single most important goal is to get you the best care possible. We use every attempt to make sure we preserve the relationship you have with your healthcare providers and avoid any awkwardness in future encounters. We try to remain objective and will not bully a provider who has done nothing wrong. 

Sometime you just need a clear explanation of what occurred. In most instances things work out quickly and everyone is happy.

In those instances where the family is looking for financial compensation from the healthcare provider(s) or facility, it is important that an accurate record of wrongdoing is documented in a timely fashion and to investigate similar complaints by other patients to show a pattern of neglect, abuse, or malpractice. Again, we will not function in the capacity of an attorney or doctor, nor provide legal or medical advice, but we will advocate on your behalf by securing the medical records and our other findings to help your attorney present as strong a case as possible. Pricing for our services

After an initial phone consultation, we will discuss the particulars of your case with our team members and come up with an initial budget cap, hourly rate, and retainer.   We will try our best to work within your budget. Of course we have typical packages of services that fit most client's requirements.


Whether it simply attending doctor’s appointments, calling your insurance company, encouraging your attorney to take action or summoning state and Federal regulators to intervene on your behalf, we will do what is necessary to protect you and your loved ones.

About Us

President & CEO  - Jim Bock, Registered Nurse, Ordained Minister & Paralegal

Jim has been a registered nurse for 16 years and has had many years experience in the Emergency Department, Substance Abuse Treatment, Nursing Home Management and Private Practice. Jim also graduated in 1982 from Institute Paralegal Studies in Linden New Jersey with the highest grades they ever had and youngest to ever graduate and has also been an ordained minister for 8 years.

Jim has dedicated more than 30 years of his life helping others​. 

 Jim started the Survivors Foundation in 1996 and helped fund therapy and provided training to counsellors and therapists that help adult survivors of abuse. Survivors Foundation partnered with The Pennsylvania Ad Council, Betty Ford Center & Caron Foundation to provide training to therapists.

Not a day goes by where Jim doesn't lay down his life to help right the betrayals that some institutions inflict upon their vulnerable residents. 

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