Frequently Asked Questions

Healthcare Advocacy & Insurance

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What is healthcare advocacy?

Healthcare advocacy provides support to individuals and families who are having difficulty navigating healthcare-related concerns. Espoir can help you organize information, better understand the issue you're facing, prepare questions, communicate concerns, and explore possible next steps.

What types of healthcare concerns can Espoir assist with?

Depending on the circumstances, Espoir may assist with concerns involving:

• Health insurance claims and denials

• Medical billing concerns

• Prior authorization issues

• Insurance coverage and benefit questions

• Communication with healthcare providers or insurance companies

• Organizing healthcare and insurance information

• Preparing questions for providers or insurers

• Healthcare-related disagreements or disputes

Because every situation is different, we recommend starting with a consultation so we can better understand your concerns.

Can Espoir help with a denied health insurance claim?

Yes. Espoir may assist you with reviewing and organizing information related to a denied claim, understanding the reason provided for the denial, identifying questions to ask your insurance company or healthcare provider, and exploring available next steps.

Assistance does not guarantee that a denial will be reversed or that an insurance company will approve or pay a claim.

Can Espoir help with medical billing concerns?

Yes. Espoir may help you review and organize information related to a medical bill, identify questions or discrepancies that may require clarification, and help you prepare for communication with the healthcare provider or insurance company.

Espoir does not determine whether a medical charge is legally valid or provide legal advice regarding collection matters.

Can Espoir help with prior authorization problems?

Yes. Depending on the circumstances, Espoir may help you understand information related to a prior authorization concern, organize relevant documents, identify questions, and communicate with the organizations involved.

We cannot guarantee that a prior authorization request will be approved.

Can Espoir communicate with my insurance company or healthcare provider?

Depending on the service you select and appropriate authorization, Espoir may assist with communication involving an insurance company, healthcare provider, or other organization related to your matter.

The specific assistance available will be discussed during your consultation or service review.

Does Espoir guarantee that my insurance claim or healthcare issue will be resolved?

No. Espoir cannot guarantee claim approvals, payment, coverage, reimbursement, authorization, settlement, or any other particular outcome.

Our role is to provide professional support, advocacy, organization, communication assistance, and dispute-resolution services within the scope of the service you select.

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Mediation & Dispute Resolution

What is mediation?

Mediation is a structured process in which a neutral mediator helps participants communicate about a disagreement, identify concerns, explore possible solutions, and work toward a mutually acceptable resolution.

The mediator does not decide who is right or wrong and does not make decisions for the participants.

What is healthcare dispute resolution?

Healthcare dispute resolution focuses on disagreements or communication problems involving healthcare-related concerns.

Depending on the circumstances, Espoir may help identify the issues involved, organize concerns, facilitate communication, and explore possible paths toward resolution.

What is the difference between advocacy and mediation?

In an advocacy role, Espoir supports the client's interests by helping the client understand concerns, organize information, communicate effectively, and navigate available options.

In mediation, Espoir serves as a neutral third party and does not advocate for either participant.

Because these roles are different, we will explain which service is appropriate before beginning an engagement.

Does Espoir provide legal advice or legal representation?

No. Espoir is not a law firm and does not provide legal advice, legal representation, or courtroom representation.

If your situation requires legal assistance, we may provide information about appropriate legal resources or referral options when available.

Does Espoir provide medical advice?

No. Espoir does not diagnose medical conditions, recommend medical treatment, prescribe medication, or replace your physician or other licensed healthcare provider.

Questions about diagnosis, treatment, medication, or other clinical decisions should be discussed with an appropriate healthcare professional.

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Appointments & Virtual Services

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Where is Espoir located?

Espoir's office is located in Munster, Indiana. In-person services are available by appointment.

Does Espoir offer virtual appointments?

Yes. Espoir provides virtual appointments by phone or video, allowing clients to access select services without visiting our office.

Do you work with clients outside Indiana or the United States?

Yes. Espoir offers virtual services, allowing us to assist clients across the United States and internationally when appropriate. Service availability may vary depending on your location, the type of service requested, and the circumstances involved.

What should I have available for my appointment?

Depending on your concern, it may be helpful to have relevant documents available, such as insurance correspondence, explanation of benefits (EOB) documents, medical bills, denial notices, prior authorization information, letters, or other communications related to your concern.

Please do not send sensitive documents through unsecured communication methods. Espoir will provide instructions when secure document submission is needed.

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Fees & Getting Started

How do I get started?

Start by requesting a consultation. We'll learn more about your concerns, determine whether Espoir's services may be appropriate, and explain possible next steps.

You do not need to know exactly which service you need before contacting us.

How much do Espoir's services cost?

Fees vary depending on the service selected, complexity of the matter, time involved, and level of support required.

Applicable fees will be explained before paid services begin.

Please visit our Fees & Financial Accessibility page for additional information.

Does Espoir offer sliding-scale or reduced fees?

Limited reduced-fee or sliding-scale options may be available to qualifying clients depending on financial circumstances, the service requested, and availability.

Reduced-fee services are not guaranteed and eligibility is determined during the intake and case-review process.

What happens after my consultation?

If Espoir determines that your matter may be appropriate for our services, we'll explain the recommended service, applicable fees, and next steps.

You can then decide whether you would like to move forward.

If your needs fall outside Espoir's scope, we may provide information about other appropriate resources when available.

Am I required to become a client after a consultation?

No. Participating in a consultation does not automatically enroll you in ongoing services.

Before paid services begin, you'll have an opportunity to understand the recommended service, applicable fees, and what the service includes.

Still Have Questions?

We're here to help you determine the right next step.

If you aren't sure whether your situation fits Espoir's services, contact us to discuss your concerns.

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