We've been so busy with Dan's diagnostic and treatment schedule, that I have been letting the mail pile up for a long time. Yesterday, I got a friendly reminder call that I need to start getting on top of our medical bills.

I've never dealt with medical bills in large quantities...just an occassional doctor visit here or there.

I am wondering if anyone has created a good system for tracking the bills and the insurance reimbursements. Our institution does not bother us with the co-pays, so even though I know we have good insurance...I know there will be lots of bills to pay.

And, our insurance company (which we are very thankful for) isn't always spot on with payments and sometimes they make mistakes...by not covering something that should be covered.

I know I'll be able to sort through this mess...but, I thought if someone had a good system for organizing and tracking the overwhelming amount of paper, bills and forms...that maybe I wouldn't have to reinvent the wheel.

Plus, I'd like to track this in a way where I can get an idea on what this whole mess costs...insurance and out of pocket...just for curiosity's sake.

Any advice or guidance would be greatly appreciated.

Thanks,

Hi Margaret,

We have a large 3 ring binder with several tabs. Every tab represents a different doctor. Because all of Dad's doctors are affiliated with the same medical center, sometimes the bills are all coming in broken down on one bill. Same with the EOB's from the insurance company. When the bill comes in it is matched up with the EOB (sometimes we have to make copies to keep it all straight and so that everything has something matched up to it) and then we punch holes in them and put them in the respective spot in the binder. You could also do the same thing by using file folders. I'm a very visual person so I would suggest colored folders. When the bill first comes in before insurance pays, I would have a pending folder. That way when the EOB comes in you just look in the pending file for the correct bill that it corresponds to.

If you wanted to track how much the bill was, what insurance paid, what you paid, etc., and be able to see everything at a glance, I would suggest using an Excel spreadsheet.

I hope this helps.

Joy

When I was taking care of the mail and bills for my son, there were several doctors and even several different departments at the same hospital with separate bills. I had different colored folders for the different doctors, plus a separate folder which contained separate bills (clipped toether) for the same hospital. I finally had to talk to the accountant at the hospital so she could tell me which department was taking care of which bills to straighten it out. I also had a spreadsheet which was Appleworks (very similar to Excel) on which I had different columns for the doctor or hospital department plus date bill was received and date paid, balance due, and name of contact person with phone number. I also had a column for notes so I could remember what the contact person said. Whenever I made changes to the apreadsheet, I dated the spread sheet and sent copies to my son's computer so he could check it out and have all the phone numbers and info for when he took over the task.

A spreadsheet is also good for tracking medications taken, food & liquid intake and outgo, as well as prescriptions, drugstore phone numbers, appointment schedules, etc. I kept a list of appointments on my notes section of my cell phone or iPod so I could check it quickly when making new appointments. Another good thing to do is to learn the names of the secretaries/nurses/interns at the doctors' offices so that when you call you can ask for a particular person as well as office hours, after hours phone numbers.

Also, look for mistakes in the bill as some Insurance Companies reimburse you for money you save them. In my case, I was taken to recovery at 2:15 PM. They did not get me to my room until 8:00 PM because they couldn't find anybody to clean my room. So, for about 5 hours I was in recovery which charges $10.00 a minute! That was an extra $3,000 they applied to my bill and in addition to the $95.00 a day normal room rate. I contested it and didn't even get an argument form the hospital. I was reimbursed 50% towards my $2,000 deductible. Yes, I am self employed thus, the large deductible to keep rates down.

Margaret, I also used an Excel spreadsheet -3 actually- one for drugs only, the other for Docs and hospitals and the 3rd for misc. equipment and supplies. Mine were detailed enough that I could prove 8 months after the fact that we did not get reimbursed for about $220 worth of 2Cal HN, and I got a check from the Ins Co to cover it. The biggest problem we had was getting the EOBs several months after the service date, so you have to stay organized about entering them. The other thing that really helped us was having an Ins Co 'Nurse Case Manager' assigned to us and she was Super and our best advocate with any claim issues. It will truly help if you can keep your payments and documentation on a spreadsheet. Remember, there will be lots of medical "stuff" you can claim on your taxes if you can document it. I use Quick Books and I dumped all of the over the counter drugs, gauzes, sterile water, wound care products [anything the Ins Co. didn't cover that was related to caring for John- into a medical exp. account- along will all gas expenses, hotel exp. associated with his trips to Doctors. It gave us a sizable deduction last year. I will admit that at one point I thought of hiring someone to take care of all of this because it took a large amount of time to track it all. Good luck. Amy in the Ozarks

Thank you, all, for the wonderful suggestions. I do know our insurance company has a history of making mistakes and I am a little overwhelmed with starting this project, as I have been ignoring the growing pile of bills.

I like the idea of the color coded folders and the spread sheets. JAM, I haven't even taken into consideration items that can be deducted for tax purposes. Thanks for the heads up.

Dan is resting comfortably, my kids are gone for a few hours and I'm ready to tackle this next. :-

Margaret, I just reread your 1st post and have some thoughts- You will probably never be able to track what all of this costs because the EOB's [if they are like the ones we got] are tough. Here's what you need on a spread sheet or on paper- however you are doing this. I'm assuming you have a deductible to meet, a coinsurance amount to meet and an out of pocket $ amount not to exceed. If this is true, put each of those figures at the top of a column. Then start entry lines under each column as you read the EOB's. [this is tough sometimes- in our case, some of the bills on one EOB were split between several areas, and John's drugs also went toward the deductible and co-ins.] But because I kept good records of the checks or credit card charges in the beginning, I knew before the Ins. Co. did, when we had met our obligation. I also watched closly for "non allowed" charges on EoB's and called the billing dept of the Dr. or hospital to challange them. The most IMPORTANT thing I learned was that as long if I could get a Doctor to write a perscription for something, it would be covered. [suction machine, air pressure mattress, wheelchairs, all canned peg tube food, salves, mouth rinses, etc.] This got more complex as the 2nd year rolled around, but if was worth doing. If you have an understanding of the bills, you can fight to get them paid by Ins. As for trying to keep up with the overall cost [not your cost] you can do that for "fun", but it will be alot of work- there are too many games being played between the Ins. Cos, medical people, etc. That "Billed Amount" on the first line is a made up figure. By the way, I also found out early that I could negotiate a very favorable payment plan with all providers, at no interest, for paying large chunks. [John's long time Ins Co. dropped him in the middle of treatment and we had 2 deducts and 2 copays to meet in one year, plus expenses during the few months he was "between" Ins. Companies. Good Luck. Amy in the Ozarks

My goodness Amy, I do not know how you managed. I read your caregivers journal and I am amazed at how you coped day to day with the caring and ultimate loss of your loved one.

Then, I read your post above on how you managed all of the bills/records and then being "dropped" by insurance...isn't catastrophic illnesses one of the reasons we pay premiums? Wow, I am just so in awe of your strength, courage and abilities.

Thank you for your help and advice.

Margaret

Hi Margaret,

I wished I had asked that same question when we started all this. I have also done spreadsheets with all his bills mainly because it was hard to keep everything straight. I have also kept a sheet with his Medicines that he takes. This has on it the Drug name, Amount of Medication (Mg), Dosage to take along with how often, Dr who ordered it, What he takes it for, Pharmacy and When I logged it. I keep it in my binder and take to all appt. I also have one that I have listed the Drug, Time that was given, Date, Feeding, Time, Date, Calories and Can #. This is all done in the landscape set-up so it all fits on one page. I have one blank one on a clipboard in the bathroom where all his med and feeding is done. This has all been worth the extra time it takes. If there is a reaction I note that on the Drug report.
You will also want to get all his lab reports each week this can also be kept in the notebook. I have also received copies of the scans and biopsy reports this was good to have when we went into see his ENT Dr and he had not received the reports and this way you can ask questions about the results too. I also kept a paper with his pressure and wt. on it.
My husband laughed at first but I think now he is glad this was all done. Even tho we are thru with treatment he stills keeps track of everything.
I hope this helps. It does get better. He finished with his radiation May 31 and tomorrow he is going to go back to work don't know how many hours he will work but even if its 2 hours come home and rest and then go back for another 2 hours that will be ok. He does have to work 25 hours a week to maintain his insurance which they just changed the first of July and now we have to call because they won't cover his feeding and if that wasn't bad enough the drugstore we were using won't accept that insurance co. Sure glad we will beable to go back to our reg. drugstore.
Good luck. You have found a great forum I check it at least 2x's a day.

Janet

CG: Larry 61
Dx first Biopsy 7-06, 2nd biopsy 1-07, T1,N1,Mo Squamous Cell Carcinoma of the Tongue on right side. All teeth removed in Feb 07, had 2 wks on chemo. 31 treatments of Radiation.