A new calendar year is nearly upon us — always a good time to "get your house in order" in various ways. Today, D-author and fellow mother of three Amy Stockwell Mercer joins us to report on her recent adventures in getting her family's medical bill situation cleaned up, with a little help from some new tools.
Special to the 'Mine by Amy Mercer
My son Reid is 2 ½ and we are still paying off the medical bills from my "high risk" pregnancy and delivery. In a family of five, it seems our stack of medical bills is unending. Between the pediatrician, the optometrist, the allergist, the endocrinologist, Caremark (for my test strips and insulin) and the dentist, some months our medical bills are higher than the mortgage, and we have insurance. My approach to getting organized has been avoidance, but this year, I'm determined to get proactive. With tax season on the horizon, my first priority is our medical bills. But where do I begin?
When I have a question I always start with Google, so my first step in getting organized was to type in "how to manage medical expenses?" Cake Health and Quicken Medical Expense Manager came up on the first page. After some digging around I also discovered Simplee, a similar resource that pledges on its home page to help you "solve the most common health care frustrations, from understanding your health care plans to paying your medical bills." All three of these free health care management systems act like Mint.com, a personal money management system, to help users manage medical expenses, detect errors, and make decisions about which health care plans best fit your family's needs. Okay, I thought, let's get started.
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As a visual learner, I was immediately drawn to Cake Health's cute heart shaped logo and the contemporary design of the website. I didn't get very far however, because my insurance company, Blue Cross Blue Shield of South Carolina is not linked to their system. So I moved onto Simplee and even Quicken, and was frustrated to discover that BCBS of SC wasn't connected to any of these services!
Stopped in my tracks but undeterred, I contacted Simplee's VP of Marketing who gave me a demo login that allowed me to play around on the site. What I could see from the demo gave me hope, because there is an enormous amount of information available, way more than on the EOB (explanation of benefits) printouts I get in the mail that usually get tossed in the recycling bin because they give me that hyperventilating feeling.
Here is what I discovered on Simplee: to create an account, you type in your insurance member ID and your account is uploaded. Then you have access to a customized dashboard with information of every bill that has been submitted to your medical, dental and vision insurance carriers. At the top of the dashboard are five boxes titled: Total Health Care Costs, Your Responsibility, Your 2011 HSA Balance, Doctor's Visits and Transactions. Below that is a graph that changes depending on which square you choose. For example, if you click on the doctor's visits square, the graph below will show annual doctor's visits by each family member in different colors. Below the graph is a listing of claims that you can click for specific details. What was paid and what you owe is spelled out in big, bold letters at the top of each listing.
There is also a tool that allows you to pay directly from this site. Small extras that make a nice difference are a pencil in the bottom corner that enables you to make notes about the claim, and a tool to flag the claim for whatever reason. If it sounds overwhelming, it is, but it's also presented in a user-friendly way and is easier to use than it is to explain. Demo videos like this one from Simplee are helpful.
Cake Health — named for the catch phrase "a piece of cake" and also the notion that "more birthdays mean more cake" — offers similar tools for tracking, insights and managing costs, but is more geared toward "decision support." Founder Rebecca Woodcock defines this as services to help users make smart choices about the type of health insurance they need during re-enrollment periods, because "people don't want to do their taxes, they want their taxes to be done."
These words were exactly what I wanted to hear. I wanted to type in my insurance ID and have Cake Health magically make sense of all the mess — but alas, I'll have to wait. For those who have Aetna, Cigna, United Healthcare ,Anthem Blue Cross, Blue Shield or Blue Shield of California, you are in luck and can start using Cake Health right away. New users are welcomed with a "Howdy Guest," offer of a free iPhone app, and a cute animated video explaining the service.
"We wanted it to be approachable because health care is not approachable. We wanted to take something immensely difficult and make it a piece of cake," Woodcock says.
For those who prefer a more personal approach (and can afford it), private medical advocates are another option. For about $125 per hour, a medical advocate will help users navigate the maze of the healthcare system. Robin Giangrande, owner of one of these firms, RG Advocates in South Carolina, says, "According to a 2011 study by the American Medical Association, nearly 20 percent of insurance claims are incorrectly processed, resulting in underpayments and denials for many with insurance. In the case of people with chronic, pre-existing conditions such as diabetes, many are considered 'uninsurable' even when their disease is well controlled by diet, exercise and medication. It's our job to make certain that medical bills are 'fair and reasonable' and that insurance coverage is processed correctly."
A third and final option, for those who are more confident at the whole budgeting thing, is to act as your own medical advocate. Here are some tips I've learned:
- Be Proactive - don't wait for collectors to start calling. Once medical bills are turned over to a collection agency, this debt goes on your credit report.
- Analyze your bills - mistakes are made. Look over your bills and if something doesn't seem right, call the doctor's office and ask for an explanation. If a claim is denied, send it in again.
- Put it in writing - if possible, keep a medical journal and write down all the services you and your family receive, this will help when and if there is a dispute.
- Shop around - my husband and I are done having children and he is considering a vasectomy. I was surprised to discover the price ranges from $800-$1,100 for the procedure, so it pays to shop around!
What I like the most about these services is that they can help me feel empowered about my medical bills. Instead of that feeling I get when I listen to the car mechanic (with my eyes glazed over) as he explains what's wrong with my car, using the Simplee and Cake Health sites make me feel as if I'm learning something. As a busy working mom, I can see the long-term benefits of using Simplee, Cake Health, or Quicken every few months to review my medical expenses. I'm not sure they are something I would use consistently, but they would definitely be helpful during re-enrollment periods and at tax time. People with diabetes have enough to worry about, wouldn't it be nice if this aspect of our lives were simplified?
It sure as heck would, Amy M, thank you!