Clara Lambert Discusses the Role of Financial Navigators and Explaining Insurance Coverage

Often when financial navigators have discussions related to cost with patients, they have to start out defining the patient’s insurance benefits, said oncology financial navigator Clara Lambert, BBA, OPN-CG, chair of the ACCC Financial Advocacy Network Advisory Committee.

Often when financial navigators have discussions related to cost with patients, they have to start out defining the patient’s insurance benefits, said oncology financial navigator Clara Lambert, BBA, OPN-CG, chair of the ACCC Financial Advocacy Network Advisory Committee.

Transcript

At what point after a cancer diagnosis do patients and families start thinking about the financial costs?

I really think that they start thinking about the cost almost immediately. I mean there’s the initial, the diagnosis—"I have cancer”—but then the next thing that they think about is “How much is this going to cost me? Can I afford it? Will my insurance cover my treatments?” Those questions just start spinning through their mind almost immediately.

What is an oncology financial advocate, and how do they fit into the care team?

A financial advocate or financial navigator is somebody who has been hired specifically to help the patient navigate the financial part of the journey. Generally, they are part of the multidisciplinary teams. They work directly one-on-one with the nurses, the social workers, the physicians. So they’re part of the multidisciplinary team.

A lot of our work, we’re constantly going back and forth, talking to nurses, talking with the doctors, talking with the social workers in order to complete the work that we’re doing to help the patients.

When you start working with a patient, where do you find their understanding level is of their own health insurance?

Most of the time, and especially since insurance has been changing and evolving so much lately, but just in the last quarter century insurance has made some big changes, and around 25 years ago people used to be covered—if they had insurance it took care of everything for them. And now there’s a lot more financial patient responsibility, and people don’t understand that. They don’t understand that if they have to pay something—I’ve heard people say that they’re not covered for it just because they have financial responsibility.

So, I think just defining health insurance, and that’s part of our first discussion, really, sitting down with the patient, looking at their benefits, looking at how things are covered and helping define so they understand their insurance and how their insurance is going to work with this journey.