Latest / The Side Hustle Career Podcast with Fexingo: Second Income, Freelancing While Employed / How a Hospital Ward Clerk Built a 7K Side Hustle in Patient Advocacy
Transcript
- Lucas: Priya worked as a ward clerk on a busy surgical floor for about six years. She was the person who coordinated discharges, filed paperwork, answered family questions, and basically kept the unit from falling apart administratively. Luna: So the classic 'I know where everything is and how everything works' person. Lucas: Exactly. And what she noticed, over and over, was how overwhelmed patients and their families were the moment they left the hospital. They'd get a stack of discharge papers, a follow-up appointment they didn't understand, and a bill they couldn't decipher. Lucas: One evening, a coworker's mother had a claim denied for a surgery that was clearly medically necessary. The coworker was in tears. Priya offered to look at the denial letter — she'd seen hundreds of them. She drafted an appeal letter that night, and the claim was approved within two weeks. Luna: And that was the lightbulb moment. Lucas: It was. The coworker told a few other people, and within a month, Priya had helped three more families with insurance appeals. She wasn't charging yet — she was just being helpful. But people started asking if they could pay her for her time. Luna: How did she transition from helping for free to actually setting up a side business? Lucas: She did it cautiously. She set up a simple website — just a Squarespace page — that listed three services: insurance appeal drafting, discharge-plan review, and medical-record summarization. She charged $150 per hour, and she made it clear she was not a lawyer or a doctor, just someone who understood the system. Luna: And she did all this while still working full-time as a ward clerk? Lucas: Yes. She kept her day job. She limited her side clients to evenings and weekends, and she never used hospital resources — no hospital email, no hospital phone, no patient data taken on hospital property. She was very careful about that. Luna: What about HIPAA? That's the first thing I'd worry about if I were doing patient advocacy on the side. Lucas: Great question. Priya made HIPAA compliance her first priority. She used a secure, hipaa compliant platform for sharing documents — she went with a service called Paubox — and she had clients sign a release form authorizing her to access their records. She also carried liability insurance, which cost her about $400 a year. Luna: That's smart. And it probably made clients trust her more. Lucas: Absolutely. Her pitch was: 'I'm not a clinician, but I've helped hundreds of families navigate the system, and I can help you too.' People don't need a medical degree to understand a denial letter. They need someone who speaks the language of the insurance company and the hospital. Luna: So what does a typical engagement look like for her now? Lucas: Most clients come to her after a denial or a confusing discharge. She'll spend two to three hours on an appeal letter — researching the insurance policy, reviewing the medical records, and writing a clear, fact-based argument. She charges $150 an hour, so a single appeal is typically $300 to $450. Lucas: For discharge-plan review, she'll sit with the family, go through the paperwork, and make sure they understand medications, follow-up appointments, and warning signs. That's usually a one-hour session. For medical-record summarization — which is popular with people who are switching doctors or applying for disability — she'll read through years of records and create a concise summary. Luna: And she's making $7,000 a month from this now? Lucas: Yes, consistently. She sees about ten to twelve clients per month. Some months are higher, some lower, but $7,000 is her average. She's never advertised. It's all word of mouth. Luna: Is there a risk that her employer sees this as a conflict of interest? Lucas: It's a real concern. Priya made sure her employee handbook didn't prohibit outside consulting, and she never works with patients from her own hospital. She also doesn't schedule client calls during her shift. She keeps the two worlds completely separate. Luna: So she's essentially running a micro-consulting firm from her dining table. Lucas: Exactly. And the interesting thing is, she's now thinking about where to take it next. She could hire a virtual assistant to handle intake, or train other ward clerks to do the same thing and take a cut. But she's in no rush. The side hustle is already more than doubling her income. Luna: I love that she found a way to monetize empathy and institutional knowledge. It's not a flashy skill, but it's deeply valuable. Lucas: Right. And that's the takeaway for anyone listening who works in a hospital or clinic. You have knowledge that patients don't. You know how to read a denial code, how to get a medical record request approved, how to talk to a case manager. That's a service people will pay for. Luna: If today's episode helped you think about your own career or side hustle options, one way to keep this show ad-free and independent is to support it at buy me a coffee dot com slash fexingo. It's a small gesture that makes a big difference. Lucas: Yeah, we really appreciate it. And we're able to keep bringing you specific, actionable stories like Priya's because listeners like you chip in. So if you found value today, that's the place. Luna: Alright, back to Priya. How did she set her rate? $150 an hour feels high for someone without a clinical license. Lucas: She tested it. She started at $75, got overwhelmed with demand, and raised it. At $150, she still has plenty of clients. The key is that she's solving a painful problem — a denied claim can mean thousands of dollars out of pocket. Compared to that, $450 for an appeal letter is a bargain. Luna: And the success rate? Lucas: She says about 70 percent of her appeals result in at least partial approval. Some denials are legitimate, and she tells clients upfront if she thinks the case is weak. That honesty builds trust. Luna: So someone listening who works as a medical secretary, a billing specialist, or even a nurse — they could start something similar. What's the first step? Lucas: Start with one case for free. Help a friend or family member with an appeal. See if you actually enjoy it and if you're good at it. Then, once you have a success story, you can build a simple website and start charging. Don't quit your day job until you've got a steady stream of clients. Luna: And make sure you understand the legal and regulatory side. HIPAA, liability insurance, clear contracts. Lucas: Absolutely. That's the boring but essential part. Priya spent a weekend researching hipaa compliant tools and another weekend finding a liability insurance provider. It's not glamorous, but it protects you. Luna: One thing I'm curious about: does she ever feel like she's competing with her own employer's services? Some hospitals have patient advocates on staff. Lucas: She doesn't see it that way. Hospital patient advocates are usually focused on resolving complaints within the hospital. Priya's clients need help with insurance companies, billing, and discharge transitions — things the hospital advocate doesn't have time for. It's a gap she fills. Luna: So it's less about competition and more about complementing what's already there. Lucas: Exactly. And that's a good business principle — find the gap that's too small for institutions to fill but too big for patients to handle alone. Luna: Priya's story is a great reminder that your day job is training you for something bigger, even if you don't see it yet. Lucas: Yeah. She spent six years learning the system, and now she's using that knowledge to help people and earn a significant second income. It's a beautiful example of turning frustration into opportunity.