Health Care Paperwork – Sigh…
When I managed the library of an international law firm with fourteen offices, one of my primary jobs was to create systems to manage information. I developed methods of tracking resources, budget, etc. to systematically deliver materials to different classes of users based on their specific needs, all on a timely basis.
Which, one would think, would make tracking health care payments a breeze.
Let me make one thing clear: I have a pretty simple health care situation. I have insurance, and it provides coverage for (most) pharmaceuticals. I don’t have any major chronic health problem, and I have avoided substantial acute issues in the past year. I don’t have any “para-medical” needs, such as physical therapy, chiropractic care, acupuncture, etc.
And it took me almost an entire work day to develop a system to track my health care expenses.
Mind you, I wasn’t trying to enter data from an entire year of health care. I wasn’t trying to deal with the flurry of papers resulting from acute crises. I wasn’t trying to cope with having changed physicians.
I just wanted a system that would let me see what my doctors required me to pay and whether I had paid it. Along the way, I decided it would be a good idea to fold in tracking of my Health Care Spending Account (that pre-tax money that I set aside for certain health expenses), to see how and when it is being used.
The problem, of course, is that there is zero standardization in the bills received from doctors. Some require me to pay up front. Some put everything through to insurance, to see what my insurer will pay. Some split, requiring up front payment on some things, submission to insurers on others. Primary care is treated differently from well-woman care, and both are treated differently from specialist care. Pharmaceuticals are treated completely separately from all that, as are dentists and optometrists. In some instances, I receive the insurance company’s laughingly-named Explanation of Benefits (“EOB”) as the first paperwork associated with a health care event; other times, the precipitating paperwork is payment from my health care spending account, or a bill from the doctor.
And that doesn’t even get to the problems of mistakes (intentional or otherwise) — a doctor who records a five-minute “office visit” checkup preparatory to refilling a prescription as a “surgery”.
I wanted to get this done now, when I don’t have any crisis in process, so that I can use the system if/when I have major, complicated medical care to track. I built the system using three months of data from the end of last year, and I tested it with one month of data from this year. (That test proved to be … amusing, because it included an EOB received in January 2012 for services rendered in May 2011, the first time I officially received paperwork on that particular expense…) I am certain that my system will be tweaked throughout this year.
But I’m left wondering how other people handle this stuff. What happens if you don’t have a working knowledge of Excel (or familiarity with paper-based bookkeeping)? What happens if you don’t have the reading skills to parse the EOBs? What happens if you’re sick or old or exhausted?
What happens if you’re not a stubborn, over-educated professional manager of information with the time to devote to doing this?
(I know. You pay what they tell you to pay, and you hope it’s right. That’s entirely separate from whether it’s fair and whether you have the money – those are other rants.)
(And I also know that there are services out there that do this. Simplee is free and has great buzz, but it doesn’t cover my insurance plan. Other services are expensive — several hundreds of dollars to clear backlogs of paperwork and maintenance fees of several hundreds of dollars a year.)
There’s got to be a better way.
Mindy, bemused that the best advice she found was on a support site for ovarian cancer patients…