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What is a dedicated clinical guide and how can they help?

Healthcare can be hard to navigate. A dedicated clinical guide can help those unfamiliar with the ins and outs of the healthcare system get the best care.

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The healthcare system can be complex, especially for lay people with no background in the medical field. Too often, people do not know where to go, how to proceed, or what kind of treatment to get when experiencing a healthcare issue.

Despite efforts to increase public knowledge, many people still have a hard time accessing the healthcare system, which can be due to several factors, like:

But with the help of a healthcare guide and care navigation, patients, companies, and employers can easily navigate the health system without barriers. Health navigators, often called health guides or clinical guides, can help address patient hindrances and accompany patients every step of the way.

However, not many people are familiar with what a navigator does. Below, we outline what a healthcare navigator is, their importance, and how healthcare navigation can be a benefits to an organization.

Healthcare Navigators: What is their Role?

Have you ever felt at a loss with what to do after you get diagnosed with a disease? The obvious course of action would be to trust and follow what your doctor told you, right? But what if you didn't fully understand?

When you are experiencing a health-related crossroad, the best thing to do is seek a healthcare navigator's help.

A healthcare navigator refers to a skilled individual or organization who aims to help patients, small businesses, employers, and employees navigate the healthcare system.

Healthcare navigators can render their services in either of these two niches: the health payer space or clinical space.

1. The Health Payer Space
Health payers refer to companies that pay a set amount to healthcare providers for their medical services. This includes insurance companies, third-party health insurance administrators, or government medical programs.

Healthcare navigators can usually be found in the health payer space. Their role in it includes:

2. The Clinical Space or Setting
Although a bit uncommon, healthcare navigators can also be found in the clinical or hospital setting. They aim to help patients navigate the maze that is the healthcare system. Some of their specific roles in the clinical space include:

Clinical guides can be nurses, doctors, or other healthcare professionals. They can also be highly trained individuals who understand the ins and outs of the healthcare system, like billing codes, on-site and off-site facilities, and how to find top-quality doctors.

Personalized support creates healthier members.

Learn more about our care navigation and PBM solutions.

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