Paying Medical Bills as Simply as Possible
By Margaret Hancock
For those navigating FPIES – or any rare disease – hospital, specialist, nutritional, and additional medical bills can be quite confusing and time-consuming. I am grateful for a brief stint that I had with an insurance firm as I learned through this customer service experience the necessary skills for organizing, communicating, understanding, and generally dealing with medical claims. I had no idea how much this would come in handy in the subsequent years of my life.
The complexity of FPIES means that my toddler son and I have stepped foot in too many hospitals and doctors’ offices to count and the subsequent bills are, simply put, not the simplest. Some specialists are in-network, others are not. Some labs and procedures count towards our deductible, others do not. Some hypoallergenic formulas are covered, others are only processed if they are a certain weight or poundage (that is actually true). Some food introductions need an additional authorization, some need the official seal of the Governor (that is not actually true, though it doesn’t feel too far off).
To navigate as simply as possible (drawing on my healthcare customer service days), I stick to a strict system for paying bills.
As a first step, I collect:
-Oodles of patience
-A writing utensil
-Folders marked Explanations of Benefits, Bills, and Paid Medical Bills
The second step is to marry Explanation of Benefits documents (EOB) and bills. After I receive both an EOB (sent by the health insurance company) and a corresponding bill (sent by the healthcare provider), I make sure they align. For example, if the EOB says the immunologist appointment is covered by insurance except for $34, I ensure the bill from the immunologist is $34.
The third step becomes sort of like “choose your own adventure.” If the EOB and bill amounts are the same, I pick up the phone and pay the bill. I pay via phone and speak to someone in the billing office instead of sending a check so that I have a confirmation number or authorization code immediately. This limits the room for error such as checks lost in the mail, an administrator claiming it wasn’t paid, etc. I then write the confirmation number down on the bill, staple the bill to the EOB, and file it in a folder labeled “paid medical bills” and the year.
If the amounts on the EOB and bill are not the same, I call insurance customer service. A friendly yet generally annoyed agent then tells me – while I stay cool, calm, and collected as that is always best – that they will reprocess / put it in a queue / whatever they need to do to determine the reasoning for the discrepancy. I always ask for an anticipated time frame for an answer and write that date, as well as the date of our phone call and the name of the representative with whom I spoke, directly onto the EOB. (Some unfortunate lost Post It notes led to writing all related notes directly on the paper.)
Afterwards, I immediately call the billing office of the healthcare provider to speak to a different friendly yet generally annoyed individual and request that their office put a hold on the bill until the date insurance provided. This way, they will not send a second bill. I then patiently wait for insurance to provide their answer, or follow up if I have yet to hear back by the given date. (Here is where it helps to have the name of the representative.) Once the insurance folks and I connect, I take notes on the claim status per the representative and then get to work chasing down the Gov’s signature or whatever I must do to make sure all discrepancies are corrected. And once they are, I pick up the phone and finally pay the bill and add it to the “paid” file.
Then I can check it off the list and head to prepare a yummy meal of safe foods for my sweet son!
This post was written and contributed by Margaret Hancock. Margaret is a writer, a mother to three including a toddler with FPIES, and an allergy navigator herself since the age of twelve. Margaret recently launched Hots&Olives, a blog dedicated to living joyfully with allergies that can be enjoyed at hotsandolives.blog