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Health care navigators: Advocates for employee health

The health of your employees is crucial to your business. Health care navigators can help your employees stay healthy so your company can thrive to its fullest potential!

What is a health care navigator?

Health care navigator may be an unfamiliar term because it is a relatively new concept and industry. In practice, you choose a company to serve as a liaison between your business, your covered employees, and the insurance provider. Employees can then communicate with the health care navigation firm's care coordination staff and use its website to address health care and insurance needs.

Health care navigation helps employees:
  • Understand their medical coverage, benefits and billing
  • Resolve a health challenge
  • Improve wellbeing and workplace engagement

Studies have shown that this type of service can greatly improve medical outcomes, and help employees better understand their insurance coverage, benefits, billing and more. In turn, your business benefits through the improved health and wellbeing of your staff, improved employee engagement and satisfaction, and retention of top talent.

Advocates for employee health

When a covered employee is faced with a medical challenge, a personal health care navigator can be a valuable advocate. Here's how they can help:

  1. Expedite initial and second opinion appointments
  2. Help find the right doctor for care within or outside of the network
  3. Assist with medial record gathering
  4. Serve as liaison between medical providers and other facilities or medical entities, including pharmacies and medical equipment providers
  5. Help make sense of insurance coverage, benefits and billing
  6. Provide counseling services
  7. Offer tele-doc support and more

The importance of the liaison role cannot be overstated. Many doctors' offices, clinics and medical groups are brimming with patients. Getting a response to an appointment request, medical records inquiry or other questions may take some time. Primary care doctors and other health care services can also be slow to fill prescriptions for medication, medical services and equipment.

Health care navigators can often speed up the processes, based on their years of experience and connections within the health care system. Their knowledge of our complex health care system can be invaluable when issues arise.

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Health care navigation in action

Are you curious about health care navigation in action? Let's look at an example.

Robert is an employee with full medical coverage. After learning about his company's health care navigation benefit, he registered with the program's website. Robert was impressed with the access given to him to view his coverage, benefits and more. He was even more impressed when he decided to change dentists and easily found an office close to home that was within his network. Robert enjoyed the ease of use and fast service, all on one company-wide, internal platform.

A few months later, Robert began to struggle with debilitating fatigue. He was having trouble sleeping through the night and developed brain fog and anxiety about trying to get proper rest. Robert remembered that he had access to a health care navigator and called the hotline. He described his symptoms and side effects. Robert's health care navigator suggested that he may be suffering from sleep apnea and advised him to see his primary care doctor for help.

Robert visited his doctor who prescribed a sleep apnea test. The test arrived a week later, and Robert completed the two-night exam. The test results were sent to his doctor and a follow-up visit was scheduled. Robert and his doctor reviewed the results, which confirmed that he had moderate to severe sleep apnea. His doctor prescribed a Continuous Positive Airway Pressure (CPAP) machine. Robert was told that the medical supply company would contact him soon.

Health care navigators can help employees with:
  • Suggesting a diagnosis and treatment support
  • Finding a physician
  • Expediting the fulfillment of prescription medications and medical equipment
  • Serving as a liaison between separate physicians, medical facilities, and medical equipment providers

Two weeks passed and Robert had not heard from the medical supplier. He was over two months into his health challenge, and the effects became more pronounced. He struggled daily to remain focused, and his work began to suffer.

He contacted a health care navigator again who advised him that she would take care of the problem and contact him when progress was made. The next day, his health care navigator called Robert and explained that the prescription was never sent. She requested the prescription to be faxed to the supplier. Additionally, she scheduled an appointment for Robert to pick up his CPAP the following week. Robert felt immediate relief that a possible resolution to his health care challenge was near.

The effects of long-term sleep apnea without relief can be detrimental to one's health and wellbeing.1 Even though Robert had to endure months of sleep deprivation, he was thankful that his care coordinator took control and expedited his care.

Health care navigator options

You can help foster optimal health and wellbeing for your employees and their families with health care navigation. There are dozens of companies to choose from. If you currently provide health care benefits to your team, contact your insurance provider to discuss which health care navigator is right for your business's size and the needs of your employees.

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