How can you help patients overcome financial barriers to healthcare?

1 Assess their situation

The first step is to assess the patient's financial situation and their healthcare needs. You can use tools such as a financial screening form, a benefits eligibility checklist, or a risk stratification model to identify their income, expenses, assets, liabilities, insurance status, and health risks. This will help you determine their level of financial hardship and their potential sources of assistance.

2 Educate them on their options

The next step is to educate the patient on their options for obtaining or improving their healthcare coverage. You can explain the different types of insurance plans, such as Medicare, Medicaid, CHIP, or marketplace plans, and how they work. You can also inform them about the eligibility criteria, enrollment periods, and application processes for each program. You can also help them compare the costs and benefits of different plans and guide them to choose the best one for their situation.

3 Connect them with resources

The third step is to connect the patient with resources that can help them pay for their healthcare expenses. You can refer them to programs that offer financial assistance, such as charity care, sliding scale fees, payment plans, or discounts. You can also help them apply for grants, scholarships, or loans that are available for specific conditions, treatments, or populations. You can also link them with community organizations, such as food banks, housing agencies, or transportation services, that can reduce their financial stress and improve their health outcomes.

4 Advocate for them

The final step is to advocate for the patient's rights and interests when they face financial barriers to healthcare. You can help them negotiate with their providers, insurers, or creditors to lower their bills, waive their fees, or extend their deadlines. You can also help them appeal any denials, errors, or disputes in their claims or coverage. You can also support them in accessing quality care, following their treatment plan, and achieving their health goals.

By following these steps, you can help patients overcome financial barriers to healthcare and enhance their well-being. As a case manager, you play a vital role in ensuring that patients receive the care they need and deserve.

5 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?