Health Advocate


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

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.

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

Awards