Meet Morgan Kelley, a patient advocate based in Chicago who uses social media to educate people about healthcare and health insurance issues. Morgan discusses how she leverages platforms like TikTok to reach a wide audience and provide education on health insurance terminology and how health insurance works in practice. She shares personal stories about her experiences navigating the healthcare system and adds humor to her content, particularly highlighting the frustrations of dealing with insurance companies and making difficult phone calls.
But, Morgan is much more than a TikTok advocate. In her professional Independent Patient Advocacy practice, she helps individuals understand their health insurance benefits, reviews explanation of benefits statements, and negotiates medical bills from nonprofit hospitals. She also assists people in choosing suitable health insurance plans. Morgan emphasizes the importance of financial education in healthcare and aims to bridge the knowledge gap between patients and providers.
Meet Morgan Kelley, a patient advocate based in Chicago who uses social media to educate people about healthcare and health insurance issues. Morgan discusses how she leverages platforms like TikTok to reach a wide audience and provide education on health insurance terminology and how health insurance works in practice. She shares personal stories about her experiences navigating the healthcare system and adds humor to her content, particularly highlighting the frustrations of dealing with insurance companies and making difficult phone calls.
But, Morgan is much more than a TikTok advocate. In her professional Independent Patient Advocacy practice, she helps individuals understand their health insurance benefits, reviews explanation of benefits statements, and negotiates medical bills from nonprofit hospitals. She also assists people in choosing suitable health insurance plans. Morgan emphasizes the importance of financial education in healthcare and aims to bridge the knowledge gap between patients and providers.
Host
Morgan Kelly, welcome to the patient advocacy now podcast. Thank you so much for being here. How you doing today?
Morgan Kelley
I'm doing well, thank you so much for having me.
Host
Yeah, it's an honor. It's a pleasure. You are, uh, you are one of the younger advocates in the field. And so one thing that we could start with right away is I've noticed, uh, and, and other people at greater national advocates have noticed you've kind of been using social media and interesting ways to talk about issues in the healthcare system or, you know, things that you'd like to see changed. Um,
Can you tell me a little bit about you, you know, what you found experimenting with social media? Is it a good platform? Kind of what your thoughts are on, on it for this cause.
Morgan Kelley
Yeah, so there's definitely pros and cons to social media in general. One of my good friends encouraged that I get on TikTok and start making videos just to reach a wide audience. So since I've been doing that, one of my main focuses is education surrounding health insurance. Most of us have health insurance, most of us have encountered the
Morgan Kelley
And a lot of us don't really understand terminology or how health insurance works in action. So for example, a lot of my videos are giving definitions and examples, like what is a deductible and how does that impact the cost of services?
Sometimes I even share personal stories about my experience with health insurance and sort of navigating the system as a patient and then occasionally I will attempt to be funny in my videos of what it's like to professionally work in patient advocacy and health insurance and medical billing and coding and just how frustrating the system can be especially when like, you know making those difficult phone calls to health insurance companies
Host
I'm gonna kill you.
Host
Yeah, where you get stuck in a phone tree for 35 minutes and then the call drops and you have to figure out how to get back there and that kind of stuff.
Morgan Kelley
There was actually my record time as being on hold for about four and a half hours. And what I ended up doing is tagging the insurance company on Instagram and they gave me a call back right away. So I'm learning some techniques with social media for sure. I wouldn't call myself an expert by any means, but a lot of times people do watch those videos of kind of giving a rundown of the definitions
Host
Wow.
Host
Wow.
Morgan Kelley
The differences between Medicare and a Medicare Advantage plan for example, you know there is a lot of information out there and unfortunately I don't find it accessible for the average person so what I like to do is break it down so that hopefully anyone can understand it.
Host
Yeah, I think that's a good goal. I mean, I have four kids and we get a package every year saying, these are the changes. And it's like, you know, I would say maybe 12 pages of small font with language that I don't know. And my wife and I both have a lot of clinical experience. And yet we're still kind of like, let's, let's get to the hard numbers. What's max out of pocket? What's, you know, what's the deductible? What, what do what's covered on prescriptions? And then we're just kind of like cross our fingers and pray.
You know, like that's kind of it.
Morgan Kelley
Exactly, exactly. Or the benefits booklet that we all get, that's 40 pages and it's essentially a magazine. And as if we're actually going to read that, understand everything. And you know, usually for me, it just goes in the trash, to be honest. So and I think that's what happens with a lot of people. Yeah.
Host
Yeah.
Host
Yeah, I think everybody. Yeah, everybody throws that away. They're just like they're intentionally being confusing, so let's just let them be confusing and fight it when something comes up. You mentioned your own experience. Is there are you dealing with serious health issues or did you kind of get into it because you had an and if it's too personal, I don't want to pry but I mean, usually when someone says their own or is it just like?
Morgan Kelley
Right.
Host
when you had to see your general practitioner or something like that.
Morgan Kelley
You know, it's really just run-of-the-mill stuff that I think most of us deal with and just maybe don't talk about. So the most recent, I'd say, sort of shocking insurance had to do with my partner. He switched insurance companies, and so I'm actually now on his insurance through his work. And his new insurance did not cover a...
medication of his. So he had to get permission or like not really permission but his psychiatrist had to write a letter to the insurance company saying this medication works so I'm requesting that it's covered. This happens more often than we think right like certain medications are covered under insurance plans while others are not and so then you need a doctor's note to appeal and go through this whole process. Then
Host
Uh huh.
Right.
Host
If it's not on there, if it's not on there, what do they call it? The formulary or something like that? Yeah.
Morgan Kelley
Yeah, if it's not on their list of like, these are the approved medications. Then this medication at that time did not have a generic version. It was only brand name. So even with insurance, it costs over $1,000 for a 30 day supply. Um, which was very confusing to me.
Host
Wow.
Morgan Kelley
You know, even though I've worked in this field for a while, it's like, he needs this medication, it's non-negotiable, and we also don't have $1400 to spend every single month on this. So what I ended up doing is I called the insurance company to get a better idea of different costs. You know, costs can be different when you pick it up from a pharmacy versus if you get it in the mail.
Host
Mm-hmm.
Morgan Kelley
So the final solution was calling the pharmaceutical company, like the people who manufacture it, and we got a coupon for $900 off. And you can use that with insurance.
Host
Oh wow.
Host
Okay.
Morgan Kelley
So we did that and it was still a hefty price, but you know, thankfully now there's generic medication that's cost him $10 a month now. So, but it's this, this happens to so many people and then they go without medication or they have to switch medications. And oftentimes those options just are not great.
Host
Manageable.
Host
Right.
Host
Yeah, I mean, I've had friends and family members who sometimes leave the country from just for medication where they have to like, they're like, well, I need an infusion and I can't get it here. So we're going to Mexico or we're going to Europe or, and it's like, cause I can get it over there or Canada and it's, it's crazy. So it sounds like your specialty, uh,
Morgan Kelley
Yeah, definitely.
Host
As an advocate. Well, what, let me ask you, what do you provide as an advocate? Cause people are so splintered and different in terms of the services they provide. So if you were to work with a client, what's something typical you would do on their behalf or with them?
Morgan Kelley
My main focus is the financial aspect mostly as it relates to health insurance. So what that could look like is reviewing an explanation of benefits to see what insurance paid, what the patient owes, making sure that aligns with that person's benefits.
Mistakes do happen, right? We're all human. There's humans processing all of these insurance claims, making sure that the statements from the provider lines up with the explanation of benefits. You know, I've helped people with negotiating medical bills from nonprofit hospitals.
I'm currently helping someone who's going to be getting a knee replacement surgery And so just ensuring that he has coverage for that as well as inpatient rehab afterwards So really all things health insurance I've even helped people choose health insurance plans because I feel like a lot of times we get down to that crunch time and we Don't really know what plan to choose and that's one of my favorite things is figuring out what plan Works best for that individual
Host
Mm-hmm.
Morgan Kelley
module.
Host
Yeah, that makes a lot of sense. How did you find that this is something you wanted to gravitate towards?
Morgan Kelley
It happened very naturally. When I was in high school, my parents taught me a lot about health insurance, specifically my mom.
And we had a primary and secondary insurance. So I was trained to give the information we needed upfront at doctor's appointments. And then I had experience submitting my own out of network claims. So essentially, when I got into small business health care, I naturally gravitated towards that financial aspect.
Host
Thanks.
Morgan Kelley
medical billing and coding, talking with patients about estimations for the cost of treatment, setting up those payment plans, because I really find that when we think about patient care, maybe not enough attention is given to that financial aspect. And for me that has everything to do with patient care, that has everything to do with informed consent, and that decision making when
accessing and receiving Services, right and it's something I think we often look over but it's one of the biggest Barriers for people receiving health care and medical debt is one of the leading causes of bankruptcy in the US
Host
When you say that it's something that isn't paid enough attention to, what do you think the solution is? Is, I mean, I know you're working on educating patients. Do you feel like that is the end all be all solution? We just have to have a better way to educate people or are you looking for more of a, you know, hopeful or, you know, optimistic or, or even not, but by what you would like to see as a more of a systemic change in the
insurance world in general on the other side, instead of putting the onus on the patients, more so in the doctors, the hospitals, and the insurance companies.
Morgan Kelley
Both. Healthcare reform takes a really, really long time. And so my philosophy is while we work on changing the system.
We're forced to participate in the system that we have right now for better or for worse. So that education piece is important. At the same time, we are looking to create change. The one thing I would say with that education piece is I would love to see provider offices take more initiative with transparency around finances and
I often feel there's this assumption that we all know how health insurance works. And in my experience, that is the complete opposite of reality. So just having more conversations around how health insurance works, estimated costs, you know, I would love to see patients and providers come together and work as a team versus opposing each other.
Host
Yeah.
Morgan Kelley
right, a lot of the conflict that I see it has to do with health insurance companies. And so I'm hoping that there can be more transparency of it's not necessarily on the patient for not understanding or it's not necessarily on the provider because they accept these health insurance plans. It's the system that we have to participate in and we're kind of all in it together.
Host
Yeah. You know, it's interesting talking about education. I remember being in high school and being forced to take certain classes that I've never used, right? I've never used certain, like, you know, I understand the necessity of certain math classes and stuff, but it's like, you know, in terms of your day to day life, is it more, unless you're going to get an engineering degree of some sort, is it more important to be able to do geometric proofs?
or to understand how your health care works. And so it's like, I remember taking an economics class, I believe I was a sophomore or junior, and it was really eye-opening on how the market worked, and they had financial planners come and talk to the whole class. And yeah, I mean, there's always gonna be a few kids who just fall asleep, but I felt a little more literate. And it's like, I feel like this should be mandatory in high school, like freshman, sophomore year during health class. Like this is how.
health insurance works in this country. And then if we make a system, you know, that is taught across public schools, then we can also require insurance companies to kind of conform to it. Or, you know, and we kind of do, there are the EOBs are somewhat regulated, right? And so it's like, you have to, maybe there's a way to educate people at a younger and younger age, as opposed to, well, when they go buy it, they can go figure it out. Do you have any thoughts on something like that?
Morgan Kelley
So it's so interesting when we think about what's taught in our education systems versus what we actually use. I would be all for just making the health insurance system different and more simplified. But you do bring up a good point that we don't learn anything about it. And then at a certain age, we're actually signing a legal contract with health insurance companies. And
That's how serious it is, right? It's not like we're signing up for a gym membership. Like we're signing a contract and we're paying every month for insurance. And it's like we treat health insurance differently than other types of insurance or other sorts of legal contracts. But it really is that serious and the majority of us are going into it completely blind and no concept of how it actually works. And I think we often have a lot of faith in health insurance.
that.
Morgan Kelley
I don't want to say it's unwarranted faith, but it often doesn't meet our expectations. And that's where I feel like becoming more educated on that system at a younger age could be beneficial. So we have reasonable expectations once we have our own health insurance and are actually using it.
Host
Yeah, I would agree with you there. I mean, there's reasonable expectations with health insurance. It almost seemed like oxymorons for certain carriers, but the reasonable expectation is that everything's denied and nothing's covered. You talked a little bit about having more transparency with the health insurance. What do you think that might look like?
Morgan Kelley
Yeah.
Morgan Kelley
I love that you asked this. So in, I believe it was 2021, the Transparency Act was passed, which essentially made fee schedules available to the public. Now this is out on a rolling basis. So, and this is my long time dream come true. So for example, if I go to the doctor,
And let's say I have Blue Cross Blue Shield of Illinois. That's the insurance that I have. It costs a certain amount, right? Like because I'm seeing that doctor who's in network, the price is already set for what that doctor will get paid.
Host
for whatever services are rendered.
Morgan Kelley
Exactly. The doctors up until that act was passed legally could not tell me the fee schedule. They couldn't actually tell me the price because what you do as a provider, you sign an NDA, like a clause that says you're not going to share the cost of services that Blue Cross Blue Shield of Illinois has set with anyone else. So it's a secret. So it was essential.
Host
because it's a negotiated rate, that's why, right?
Morgan Kelley
Right, and it could be different at different hospitals, it could be different with different, you know, there's like minor differences, and so you, the provider signed an NDA, so if I said exactly how much is this visit, they couldn't tell me, oh, it's $51.73 for that service, right, they can't tell me until after the fact. So it's like you're grocery shopping, and you don't know how much the apple costs, but you need the apple, so you buy it, and then afterwards they're like, yeah, this apple is $60.
Host
Right.
Morgan Kelley
but then that's it, like you already bought it. There's no take backs, right? So what this Transparency Act is doing is saying that all of that has to be public because how are we as consumers, healthcare consumers supposed to shop and do price comparison if we legally don't have access to the rates because...
before this act was passed, that's how it was. It might be cheaper for me to go to and get a knee replacement at one hospital versus another. However, I didn't have access to that information as a patient.
Host
Right. It also allows someone who wants to open even a private pay clinic and be able to be competitive, even with insurance rates to be able to actually enter the market. Because now it's like, well, maybe I'm willing to do new replacements for 50 bucks, you know, but like you don't like I'm going to publish my price. And if you don't know what you're paying, you're just like, Oh, insurance is going to cover it. And it turns out at 6,000 I'm using obviously extreme examples, but that's the thing.
Morgan Kelley
Right.
Host
Now I love that it's been passed. I will say on a personal level, I haven't seen that in the hospitals. It's something where like you still have to request it. Like the education that act has passed is completely fallen on deaf ears for the public.
Morgan Kelley
Yeah, and that's why I love to talk about it because now, of course it is on a rollout basis. Hospitals are required to have cost lookup tools. So I.
believe I did this recently with, I wanna say Rush University, where you go on, you enter your insurance. So like your insurance information, right? Cause that's attached to a specific fee schedule or pricing. And then you can look up common procedures to see a cost estimate. Now, because it's on a rollout basis and there's so much data, I don't...
foresee it being comprehensive for a few more years. So it's only common procedures right now. And it was kind of sad because last fall it checked in only 16% of hospitals were compliant at that time with this law. I haven't checked recently, so I don't know the compliancy rate right now, but.
regardless of whether they're compliant or not, this is now a patient right. We are able to shop based on pricing and we are able to ask the hospitals and doctors for that information so we can make more informed decisions about our care based on cost.
Host
You mentioned compliance. Have you ever looked into what the penalty is for hospitals to not be compliant?
Morgan Kelley
Yeah, it's money, it's fines. And so I think.
Host
But are they high enough to be prohibitive is my question.
Morgan Kelley
Some hospital systems make a lot of money. And I also don't know who, I don't know what body is in charge of regulating this. And so I don't know, like I haven't looked into it enough to know like our hospitals actually being fined.
Host
regulating that, yeah.
Host
Yeah, yeah. I'll give you an example. So like I remember when paper straws came out, I don't do, is that something that happened in your neck of the woods too? So paper straws came out mostly because of the turtles, right? Everybody was environmentally conscious about the turtles. And so now everybody's drinking out of these straws that become mush, right? And everybody got upset. And so some restaurants are like, Oh, we're going to use plastic straws. And it turned out, at least in my area in Los Angeles,
Morgan Kelley
Yeah.
Host
that it was like a one-time fine and most restaurants were like, screw it, we're going to pay it. Like we're just done. Like here's the fine. And that's it. And it wasn't repeatable. Like once they were fine, they couldn't be fined again. And so, you know, that's not the same as healthcare, right? Obviously, but paper straws versus plastic straws is a pretty innocuous debate, except if you're a turtle in the ocean. And, uh, but when it comes to healthcare, like if the hospitals are being fined a flat fee one time,
and it's not even that high. And like you said, the hospitals are making a lot of money. Maybe there will be some hospitals that have just intentionally not be compliant is like one fear that I would have. But I like the idea that it is a law. So like, if you aren't happy with your hospital, maybe you can find another hospital or a different insurance carrier that is more compliant and wants to be more transparent with things. And then hopefully,
the way economics work, you know, there's enough buyer demand for that transparency that everybody kind of has to bend. I guess that would be my hope.
Morgan Kelley
But for that to happen, we need more media coverage of this. And I don't know, maybe it's in my media bubble, I'm not seeing it. I'm sure that there are some.
environments where there's a lot of news about this, but it's, it's to me, it's very similar to the fact that nonprofit hospitals have to offer financial aid to people who qualify based on income. Even if you have health insurance and used it, people can still qualify for some of their bill to be written off. However, the hospitals don't tell you that. You just have to know it.
and then you have to apply. And so it's like if people don't know about it, they're not going to utilize it. So what I try to do is tell everyone always, and then especially with this transparency act, what I've casually been doing is looking at hospitals in my area in Chicago, and I'm using their lookup tools to see how comprehensive they are. Are they user friendly? Because that's another thing is if they're not user friendly, if they're not easy to find,
accessible. Even if they are technically compliant, if it's not accessible it doesn't count in my book.
Host
Have you found a kind of an all star player that's really kind of gone above and beyond and has something that's both compliant and accessible and is user friendly or not yet in Chicago.
Morgan Kelley
I don't think I have gone through enough hospitals to name a winner.
Host
Yeah, but nobody stands out quite like right away.
Morgan Kelley
No, I don't think so.
Host
Yeah. And they're slow moving bodies. Like you said, they're, it's, you know, just like health insurance is a slow moving process. I think for them to develop the technology and then man, someone to update it regularly, it probably is going to take a little bit of time, but the demand has to be there. So you using social media to kind of get the word out and kind of inspire people to really require it. I mean, ideally, what would be nice is when you check in,
for your appointment is they hand you, they hand you your intake form and they also hand you a price sheet of sorts, for the most common practices, which will at least give you a hint of like, hey, if your thing's not on here, ask, right? And so that would be nice to see, and it might even take some kind of PSA, national public service announcement of sorts that says like, ask for the price sheet.
Morgan Kelley
Great.
Host
You know, or something like that where people could go, yeah, I'm going to ask, I'm going to, I'm going to be more proactive about that process.
Morgan Kelley
Well, and what I try to make sure I do with clients that I see is I will send them the links and I tell them, look this up, play around with it, and then in hopes of they get comfortable using these tools and then they can tell their friends and family about these tools so that it's sort of like.
We're all just talking about it, right? And unfortunately that does take time and that's where I do think social media can be a really great tool of spreading information very, very quickly about these tools.
Host
Fantastic. Tell me about the Healing Histories Project.
Morgan Kelley
So I recently came across this on Instagram, and there's a lot of things about our current health care system that, as I think many of us agree, are not really working.
and they are of a systemic nature, right? I mean, things sort of just build upon each other through time. And so I came across this Healing Histories project and it's very abolitionist based, which is something I'm learning more about with abolitionist social work and, you know, different types of systems. So I've been following it and I feel like it could be a really, really great educational tool for those of us looking to.
engage in health care reform. So I'm still learning about the project myself. So I'm not just going to say things that I come up with off the top of my head. But for anyone really interested in patient advocacy and looking to get in some sort of policy and reform, I encourage them to follow on Instagram because there's going to be a lot of stories coming out, a lot of different artistic installations and things like that to help with educating us
Host
Sure.
Morgan Kelley
the healthcare system and sort of how to move forward in a different way. Yeah.
Host
super interesting. I'm going to check it out myself. It's new for me. So I'm kind of excited to sink my teeth into it. Um, what's next for you personally? Where do you see your career or your future in this space going?
Morgan Kelley
I'm very open to where I'm going next. Currently, I'm still finishing grad school. I'm getting my master's in social work, and specifically, I'm focusing on macro practice, so things like policy and research, maybe some nonprofit work. I'm really interested in legislative advocacy and kind of getting involved in governmental processes.
So I'm open, but I know health care and health insurance systems is definitely one of my biggest focuses. From a patient advocacy standpoint, one of my favorite things that always just makes my day is just helping individuals and their families navigate the system. You know, whether it's just helping...
understand what an EOB is telling them, informing them of their rights and helping to helping individuals feel empowered to advocate for themselves I think is a really big part of what I value. So I'm just going to keep continuing doing my patient advocacy work while I finish up school and then after that I'm kind of open for anything.
Host
Very cool. Well, I'm going to definitely keep tabs on you and I think other people will want to also. What's the best way for them to follow you? Is it through TikTok?
Morgan Kelley
TikTok or Instagram, I also have a website and I'm always uploading new resources for people to check out. So my name is Morgan Kelly, K-E-L-L-E-Y. My official business is MK Consultations. So my TikTok and Instagram are at MK Consultations. I'm always posting videos. Same thing for my website, MK Consultations. And if anyone wants to get in touch with me, they can text, call.
email or you know hit me up on Instagram or TikTok.
Host
it's mkconsultations.info, right?
Morgan Kelley
Correct, yes, dot info.
Host
Okay, great. Morgan Kelly, you've been amazing. Thank you so much for sharing all your wisdom and experience in the field and for being with us today.
Morgan Kelley
Thank you so much for having me.