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EASY SYSTEM FOR HANDLING HEALTH CARE CLAIM PAPERWORK

Here is a simple, yet effective system for handling and tracking a multitude of health care claims. This works whether you have Medicare, Medicaid, insurance, PPO's, HMO's, etc. (For ease, the word "insurance" is used to mean all of these). While it sounds quite complicated, it is really easy to set up and maintain.

The advantage of this system is that it makes it easy to track what is happening and when, keeps all the paper work together, and helps tremendously when income tax time comes.

Caution: Like so many other things, this system is easier if you tackle medical records as they come in. If you wait until the end of the year, it's a nightmare.

If you have an easy system of your own, please feel free to share it with us. When dealing with insurance, we all need all the help we can get!

1. Label a set of file folders or large brown envelopes, one for each month. If you are expecting a large number of bills for one month, create a sub-set of folders for that month--one for doctors, another for hospitals, another for lab tests, another for x-rays, etc. Place folders in an easy to reach box, drawer, or file box.

2. Label "monthly pages" of lined tablet paper, one for each month. Draw columns up and down across the page. Then label each column as follows:

3. As a bill arrives or is brought home, the information is entered onto the "monthly page." It is important to place the information on the month page according to the date the care or service was provided. (For instance, if the x-ray was done on June 30th but the bill arrived July 3rd, use the June page.) If the bill involves an extended period of time (hospitalization from June 30th to July 3rd),determine which date the insurance is using as a reference date. OR you can decide to use the beginning or ending date, but be consistent about it with ALL of your bills.

4. Drop the bill into the file folder labeled with the month that matches the month (date of service) in step #3.

5. When the insurance "explanation of benefits" (EOB) page arrives, add that information to the "monthly page." Be especially careful to note the insurer's EOB reference number, as all subsequent forms usually only give that number and nothing else. Place this EOB reference number in the first column of the "monthly page." Then drop the EOB into the file folder where the original bill is already resting.

6. For the next 60-90 days, use the "monthly page" to match EOB reference numbers with the bills. If any payments are made by the insurance company, note the amount and date on the "monthly page." (For instance, insurance paid $240 of a $350 bill, did it deny coverage, etc.) Then drop those papers in the same file folder, matching date of service, as the very first bill.

7. For the same 60-90 days, some make no payments to any health care provider until after they feel the insurance has paid all that it is going to pay. Use only the "monthly page" to determine this. Waiting to make payments avoids the hassle caused by duplicate payments , over-payments, or credits. Question any final bills you don't understand, especially bills for more than what was paid by a HMO or PPO.

8. At the end of 90 days, insurance has usually paid whatever it is going to pay. By looking only at the "monthly page," you will know what you still need to pay if you have been matching EOB's reference numbers to the original bills. Fill in the final columns on the "monthly page": when the bill is paid in full, your check number, and amount paid.

9. When final payment is made, open up the monthly file folder. Gather up all of the bills, EOB's, and other papers associated with that one specific bill/claim and staple them together. Place them back into that same folder.

10. If you are tracking things for income tax purposes, make one more page for each month, listing the EOB reference number, date of service, provider, service (x-ray, etc.), amount insurance paid, and amount you paid. Then, at income tax time, add the column which contains the amounts you paid. This gives you the monthly and yearly total of extra medical expenses.

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