Keeping up with doctor’s appointments is essential to managing health and staying informed, but it can often feel overwhelming. From scheduling and transportation to understanding medical advice and ensuring proper follow-up, there are many details to manage. This is where Understood Care can help. Our advocates serve as trusted guides, working alongside you or your loved one to make the process easier, more organized, and more comfortable.
Personalized Support Before and After Every Appointment
Understood Care advocates provide hands-on help with all aspects of medical visits. We help you schedule appointments, confirm provider information, and prepare for the visit itself. This might include reviewing your questions ahead of time, making sure prescriptions are current, or gathering any medical records needed. After the appointment, we help you understand the doctor’s recommendations and take the right steps to follow through on care instructions, referrals, or additional tests.
A Partner to Help You Understand Your Care
Medical visits can involve unfamiliar language, new diagnoses, or complex treatment plans. Your advocate is there to help translate this information into clear, understandable terms. We make sure you feel confident about what was discussed during the visit and that you know what actions to take next. If something is unclear or left unanswered, your advocate can follow up with your provider to get the information you need.
Coordination Across Your Care Team
Many people receive care from more than one doctor. Your advocate helps ensure that your care is well coordinated across primary care providers, specialists, and other professionals. We help share information between offices, keep records consistent, and make sure appointments align with your overall care goals. This reduces confusion and helps prevent important details from being overlooked.
Support for Getting to and From the Appointment
Transportation should never be the reason you miss a doctor’s visit. Your advocate helps you arrange reliable ways to get to and from appointments. Whether that means booking a ride service, coordinating with a caregiver, or finding community transportation resources, we make sure you have safe and timely access to care. We also consider mobility needs, language assistance, and other accessibility factors to support your comfort and safety.
Emotional and Practical Support Throughout
Doctor’s visits can bring up feelings of stress, uncertainty, or fatigue, especially when managing long-term conditions or complex health needs. Understood Care advocates are here to offer steady support throughout the experience. We are here to listen, provide encouragement, and help you make informed decisions without feeling overwhelmed.
Confidence in Every Step of the Journey
With Understood Care, you are never alone in managing your medical appointments. From the moment you schedule your visit to the follow-up that comes afterward, your advocate is there to help you stay organized, prepared, and empowered. We make it easier to stay connected to the care you need and to move forward with confidence.
Introduction
A patient navigator is a trained professional who helps you move through the healthcare system with clarity and confidence. Navigators work alongside your clinicians to remove barriers to care, coordinate appointments, arrange transportation, and connect you with community support. If you feel overwhelmed by medical details or insurance rules, a navigator can simplify what comes next and walk with you through it.
This article includes a short video. The message in the video is simple and encouraging. Patient navigators are healthcare professionals who guide people through a complex system so that they can get the right care at the right time. Navigators help schedule appointments, look for transportation, connect you with social groups, and explain treatment options so you can use the benefits available to you. Many people can receive navigation through Medicare and many Medicare Advantage plans when program criteria are met and the services are billed by your clinician using appropriate codes
What a patient navigator does for you
Appointments and scheduling
If keeping track of visits and follow up feels stressful, a navigator helps you organize the schedule, confirm what to bring, and set reminders. Navigators can also prepare you for telehealth visits if you prefer a video call
Preparing for conversations with your clinicians
Navigators help you write down questions, gather past records, and understand how your symptoms and goals should guide each visit. You will feel more prepared and more confident during appointments
Understanding treatment options and benefits
Your navigator explains the purpose of tests, medicines, therapies, and referrals in plain language. They can review common side effects, help you consider risks and benefits, and make sure you know what is typically covered by your plan
Transportation and logistics
If getting to the clinic is hard, a navigator helps find reliable rides, building access details, and safe mobility routes. For ongoing transportation help, visit
Community services and social support
A navigator can connect you with meal resources, home safety programs, caregiver support, and local social groups. For caregiver tips, see
Insurance and paperwork
Navigators help you gather forms, understand prior authorizations, and share required documents with your care team. They can explain the differences between Medicare, Medicare Advantage, and other plan types so you know how services are approved
Emotional support and communication
Healthcare brings big emotions. Navigators listen, validate what you are feeling, and help you express your preferences to the care team. They can identify when extra support would help, such as counseling or community groups
How patient navigation works with your care team
Who provides navigation
Patient navigators can be nurses, social workers, community health workers, or other trained professionals. They are part of a team that includes your primary care clinician, specialists, pharmacists, therapists, and community partners
Training and standards
Navigation programs focus on barrier assessment, care coordination, communication skills, and safe handoffs between settings. Many programs use structured tools to track needs and progress so that your plan is organized and consistent
Privacy and respect
Navigators follow privacy laws and share information only with your permission or as allowed by law. You remain in control of your choices. Navigators provide unbiased information to support your decisions
Coverage and costs
Medicare and many Medicare Advantage plans cover navigation services when specific requirements are met. For example, Principal Illness Navigation can support people who live with a serious or high risk condition. Community Health Integration can support people with health related social needs such as food insecurity, housing challenges, or transportation barriers. These services are delivered by trained personnel under the supervision of a Medicare billing clinician. An initiating visit is usually required, and the services must be documented and billed correctly. If you have Medicare Advantage, your plan can cover these services when they meet program rules. If you are unsure about eligibility, a navigator can review your situation and coordinate with your clinician to confirm what is covered
Evidence that navigation helps
Research programs across many health systems show that navigation can shorten the time from an abnormal test to diagnosis, improve the start and completion of treatments, increase patient satisfaction, and reduce missed appointments. Navigation also helps address barriers that lead to inequities in care by linking people to trusted information and community support. These benefits are reported for cancer care and increasingly for other complex and chronic conditions. The consistent theme is practical, person centered help that reduces delays and makes care easier to use
Getting started
Step one set goals
Write one or two goals such as fewer missed appointments, better understanding of a new diagnosis, or safer transportation to care. Share these with your navigator
Step two collect key information
Gather a recent medication list, allergy list, and the names of your clinicians. Bring your insurance card. If you track blood pressure, glucose, weight, or symptoms, bring your notes
Step three prepare questions
Examples include What will this test change, What are common side effects, What is the plan if my symptoms worsen, and When should I call for help
Step four schedule your first navigation session
Ask your primary care clinician or specialist to place a referral for navigation support. If you receive Medicare, ask whether Principal Illness Navigation or Community Health Integration is appropriate for you
How Understood Care can help
Understood Care provides navigation and advocacy services that coordinate appointments, arrange transportation, connect you with mobility equipment suppliers, and help you understand treatment choices and benefits. If you need help with mobility equipment or a home safety review, see https://understoodcare.com/care-types/mobility-equipment. For transportation to and from appointments, visit https://understoodcare.com/care-types/transportation-help.
Frequently asked questions
Are patient navigators covered by Medicare
Yes, when program requirements are met and the service is billed by your clinician using approved codes. This may include Principal Illness Navigation for serious or high risk conditions and Community Health Integration for health related social needs. Coverage in Medicare Advantage plans is common when the same criteria are met. Your navigator and clinician can confirm eligibility for your situation
Do I need a referral
In most cases your clinician initiates navigation after a visit. If you think navigation would help, ask your primary care clinician or specialist to refer you and document the condition being addressed
How is a patient navigator different from a case manager
Both coordinate care. Navigators focus on removing barriers and guiding you through the system day to day. Case managers are often payer based and focus on authorization and plan rules. Many teams use both so that you receive complete support
Can a navigator attend my appointments
Your navigator can join by phone or in person with your permission and the clinic’s approval. They can help you take notes, ask questions, and understand next steps
Is my information private
Yes. Navigators follow privacy rules and only share information as permitted. You control who is included in conversations
What conditions qualify for Principal Illness Navigation
Principal Illness Navigation supports a serious or high risk condition that is expected to last at least three months and places you at significant risk of hospitalization or complications. Examples include cancer, advanced heart disease, severe lung disease, serious mental health conditions, and other complex illnesses. Your clinician will confirm whether the definition applies to you
How does navigation help with social needs
When food access, housing, utilities, or transportation make it hard to follow a care plan, your navigator can connect you with community resources and coordinate with your clinicians. This is part of Community Health Integration in Medicare
Do navigators replace my doctors
No. Navigators support you and your clinicians. They do not diagnose, prescribe, or replace medical advice. They make care easier to use and help you follow the plan that you and your clinicians choose
References
- Centers for Medicare and Medicaid Services Care Management overview with Principal Illness Navigation and Community Health Integration
https://www.cms.gov/medicare/payment/fee-schedules/physician/care-management - Centers for Medicare and Medicaid Services Medicare Physician Fee Schedule final rule summary for calendar year 2024 including new navigation codes
https://www.cms.gov/files/document/mm13452-medicare-physician-fee-schedule-final-rule-summary-cy-2024.pdf - Centers for Medicare and Medicaid Services Health Related Social Needs frequently asked questions covering Community Health Integration and Principal Illness Navigation billing and requirements
https://www.cms.gov/files/document/health-related-social-needs-faq.pdf - National Cancer Institute dictionary definition of patient navigator
https://www.cancer.gov/publications/dictionaries/cancer-terms/def/patient-navigator - Agency for Healthcare Research and Quality definition and overview of care coordination
https://www.ahrq.gov/ncepcr/care/coordination.html - Cleveland Clinic overview of patient navigators and their role on care teams
https://consultqd.clevelandclinic.org/patient-navigators-at-the-center-of-cancer-care-teams - Patient navigation in cancer treatment a systematic review of outcomes
https://pmc.ncbi.nlm.nih.gov/articles/PMC11063100/ - National Cancer Institute Patient Navigation Research Program methods and outcomes
https://pmc.ncbi.nlm.nih.gov/articles/PMC2698219/ - Timeliness of care improvement with navigation in esophageal cancer
https://pmc.ncbi.nlm.nih.gov/articles/PMC10243024/ - Effectiveness of system navigation programs linking primary care with community and social services
https://pmc.ncbi.nlm.nih.gov/articles/PMC10165767/
This content is educational and is not a substitute for medical advice. Always consult your healthcare provider for personalized care.
Deborah Hall
- About: Deborah Hall’s primary specialty is other healthcare benefits access. She helps people apply for coverage, clears questions, and connects them to programs fast.
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