Advocacy Department Overview
American Ally operates an in-house advocacy team that sets us apart from most carriers in this space. Most clients who buy health insurance are handed an 800 number and left to figure things out on their own — we do not operate that way. This document covers what you handle yourself, what goes to advocacy, and the exact process for submitting a request.
1. What You Handle - Doctor Lookups and Prescription Pricing
Two things should always come back to you directly: finding a doctor and pricing out prescriptions. These are quick tasks that create high-value relationship moments. Every time you handle one of these personally and promptly, you deepen the trust with that client and increase the likelihood of a referral.
For doctor lookups, pull up the First Health provider lookup, find a doctor in their area, and walk them through it on the call — do not send them to find it on their own. For prescription pricing, use GoodRx or the plan's prescription lookup to check the cash price or network rate and give them the number directly. One thing to know: on simple generic medications, the GoodRx cash price is often lower than the plan co-pay. Be upfront about that when it applies — the plan is most valuable on expensive brand-name or specialty medications.
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Why You Do This Personally Sending a client to a website to find their own doctor is a missed opportunity. The two minutes it takes to do it with them on the phone builds more trust than anything else. That is how referrals happen. |
2. What Advocacy Handles - and How To Submit A Ticket
For anything more complex than a doctor lookup or prescription check, do not message advocacy directly — submit a ticket through HubSpot. This keeps a record of every request, ensures the right person picks it up, and makes sure nothing falls through the cracks.
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Pre-pricing a scheduled procedure (surgery, CT scan, MRI, etc.)
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Bill or debt negotiation — high out-of-network bills or unexpected charges
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Claims filing or claims review
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Children-only applications — advocacy will handle getting the application filled out and sent out for signature. Once ready, it will be sent back to you for submission.
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HIPAA authorization forms — advocacy will send these to the client on your behalf
How to Submit a Ticket
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Open the client's Contact record in HubSpot
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On the left-hand side panel, click "Submit a Ticket"
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Fill out the ticket with the details of what the client needs
- Advocacy picks it up from there — follow up with the client to confirm it's in motion
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Yu Stay In The Loop Submitting a ticket does not mean handing the client off. Let them know you submitted on their behalf and that you are making sure it gets handled. That follow-through is what separates agents who get referrals from agents who do not. |
3. You Are the Client's Source of Truth
Make it a habit to be the first call for your clients — before they call the insurance company, before they call the hospital, before they Google anything. Insurance companies and hospital billing departments can give incorrect or incomplete information. If your client gets bad information before reaching you, it creates confusion that is hard to undo. If you are the first call, you control the narrative and protect the relationship.
At the end of every application, tell the client to save your number. Any questions, any issues, any time they need to find a doctor or check on a medication — call you first. Stay aware of open advocacy tickets so you know what your clients are going through. If a health event reveals a gap in their coverage, that is an opportunity to adjust the plan and make sure they are getting the best value.
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The Bottom Line Handle doctor lookups and prescription checks yourself — these build the relationship. Submit everything else through a HubSpot ticket. A client who feels like they have a real person in their corner is a client who stays enrolled, stays happy, and sends you referrals. |