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The Life Transition Blog

Help for Caregivers: Patient Advocates


I am very excited to introduce a new feature of the Life Transition Blog, interviews with leaders in fields serving those in transition. My hope is to help you get a better understanding of the many professions that are at your service and will help you feel less overwhelmed. If you know of a profession and/or professional you’d like to see interviewed for this feature, please be sure to be in touch.


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Maria Freed is a Managing Partner at ORNOA, a firm that provides patient navigation services that connect patients seeking a wide range of medical services to various specialists and medical centers. ORNOA does not offer medical advice. They are health advocates who coordinate care for patients. ORNOA is located in South Florida.

Briefly describe the profession of Patient Advocate or Patient Navigator

We initially started our Patient Navigation service as a way to meet the needs of many international patients who are overwhelmed with the process of reaching the appropriate providers in South Florida. Eventually we were asked by local folks to help them out too, so we now focus on all patients regardless of their country of origin.

What do you and your colleagues do?

ORNOA has four Patient Navigators and we offer a wide range of personalized services, such as: help identify appropriate specialist(s), make appointments, interface with insurance carrier for quick authorizations & appeals, gather medical records, get second opinions, accompany patient to the medical visit, make hospital visits, attend clinical team meetings, work w social workers, work w case managers, arrange for transportation, offer discounted lodging, arrange for home health, pharmacy delivery, at home phlebotomist, audit medical bills, look for financial assistance for clients in need.

Who usually hires you?

Our clients are patients or their family members, insurance companies and self-insured employers

Why are you usually hired?

There are many reasons, such as a family member who is not living locally wants us to direct the care of a loved one, or a patient is having a difficult time with a physician or medical center and wants our help resolving the matter. Insurances look to us for our expertise working with value providers so that their clients do not have to shop around. Benefit managers from a company will ask their employee to contact us directly so we can tap a specialist and coordinate the entire care process.

How are you different from other, similar professions?

We are privately owned and independent and are not employed by a hospital, physician or insurance carrier.  This autonomy allows us to do what is best for our client-patients.

How did you get into this field? What is your “story”?

I have been working with patients for the last 25 years, and developed and ran several clinical and international services departments in hospitals including the University of Miami Medical School. It was a constant frustration to get medical centers to focus on patient needs, and not just on promotion of service lines. The phrase patient-centered was overused and the concept poorly understood. I like working directly with patients and was never totally comfortable with corporate medicine.

What training, education, and/or experience are required or helpful to do what you do?

I have a Masters in Health Services Administration and am a hospital administrator by training. My career was focused on trouble shooting and turning around troublesome hospital units, such as diabetes, arthritis, neuroscience, and oncology programs. Being a contingency manager is great preparation for being a Patient Navigator. I am a pretty good problem solver. I never got the easy assignments. My objective was to improve programs, trained others to manage effectively and then move on to the next weak program. My assignments have taken me to Texas, South Carolina, Missouri, New Jersey and other regions within the United States, not just Miami facilities.

Are there special certifications? If so, what does obtaining them entail, and how important is it for a consumer to look for someone who has it?

To date there is no official certification for health advocates. Patient Navigation as a profession has not been around for very long and so no national credentials exist.  I think the experience of the Patient Navigator should be an important factor for a consumer. We are members of APHA, The Alliance of Professional Health Advocates and abide by their code of ethics and try to stay connected with the patient empowerment “movers and shakers”. There are a lot of incredible folks out there enriching patients, and ORNOA is proud to be part of this tribe.

How can someone like you be found by a consumer?

Typically, local clients in Miami and Fort Lauderdale find us by word of mouth, and international clients are referred to us by their physician or insurance carrier. Consumers can search for help at www.advoconnection.com, the website provided by The Alliance of Professional Health Advocates.

What are the three most important questions to ask before hiring a Patient Advocate?

After sharing your objectives or why you think you need a Patient Navigator I would ask:
  • Is there a need: Is this something you think I could handle myself or is there a need to hire a professional? A professional should be hired only for tasks where they can really help. Most Patient Navigators are honest, and have so much work that they will want to add value to a client, not duplicate efforts.
  • Cost: What is your fee? And how many hours do you think you would be engaged with my case?
  • Communication Flow: How often would we communicate? What is the best method (phone, email, in person)


What are your top tips for working with a Patient Advocate?

Think carefully about what you hope to achieve by hiring a Patient Navigator. Be specific, and have a realistic timeframe. For example, for clients that have chronic illnesses and need longer oversight we recommend a yearly membership fee for our services. Otherwise, the hourly fee would be cost prohibitive given the time commitment we would give this person. When you look at a case as having a beginning, middle and a conclusion it is much easier to predict the level of service needed from a Patient Navigator.  We have clients that need us through pre op, and surgery phase but not during recuperation. Knowing this helps establish the parameters of our work. We try to discourage clients from hiring us to do “everything” or “money is no object” or “however you can help”. We try to be specific in our dialogue as this leads to better outcomes and happier clients.

Anything to add?

I find that some clients, especially family members who are caregivers just want someone to talk to. This is understandable given the pressure of doing the right thing for a loved one. We counsel, listen, probe and try to be supportive in these cases.  Patient Navigators are good researchers, and can be the backup team for the family.

Please visit Maria’s website at www.ornoa.com. You can subscribe to ORNOA’s newsletter there.
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