The tangled, inscrutable bureaucracy of the American healthcare system has given rise to a brand new profession: the patient advocate.

Often second careerists from the insurance industry or the healthcare profession, they're independent contractors hired by individuals to help navigate the system to save time, money, and to connect them to resources or specialized care.

Karen Vogel, an insurance and administrative advocate, spent 29 years working in the insurance industry and became frustrated at the missed opportunities to really make a difference in patients’ lives.

“It was hard to come to terms with what was I doing and was I creating any good in the world, and who was I really serving?" Vogel told VICE News. “Because our healthcare system is so fragmented it's so broken and there are so many opportunities to get into it to make it work for people. And I just wasn't satisfied with the path that I was on.”

Over the past two and a half years of working as a patient advocate, Vogel has helped her 45 clients wade into the specifics of the insurance claim and reimbursement process.

About a quarter of what she finds are simple errors; the rest of her work is advocating on behalf of patients for out-of-network coverage or special considerations. Her biggest save was $109,000 by appealing out of state care to count toward in-state benefits.

Advocates charge between $75-$400 dollars an hour and, according to the Association of Professional Healthcare Advocates, there are over 650 Patient Advocates nationwide.

Some advocates that have specialized backgrounds in parts of the healthcare process, accompany patients to appointments. AnnMarie McIlwain was hired by Robert Doyle and Mary Murphy last year to help Robert take control of his high prescription count and connect him to specialists that have few openings for new patients.

“I was almost dead because the doctors didn’t know how to treat me.” Doyle says. “It felt like if this person was in our life at the beginning we we definitely wouldn't have gone down some of the dark alleys dark places that I've been through.”

This segment originally aired June 27, 2018 on VICE News Tonight on HBO.