Let’s Talk About Bills, Baby

Do you remember when I said I would rather talk about s-e-x than medical bills? That’s still true. But today is not that day. Really, no day will be that day. Because this ain’t that kind of blog. Anyway, we’re talking about bills and the special needs family.

Specifically, how to handle the paper trail. Because bills are always there and will take over your sanity if you don’t have a system.

I’m not the most organized person. I was before I actually needed to be. My college work and assignments were in pristine order. My classroom systems were pretty top notch. But then I had children. It’s like they siphoned out my ability to put paper in the right place. Or to even remember to switch the laundry. Or to shave my armpits. I know I can’t blame all my inadequacies on children, but my armpits were always smooth before these kiddos entered the world.

One of the questions I most often get: “What do you do with all the paperwork and bills?” After I confuse them with, “Paperwork and bills? What are you talking about? We don’t have bills.” we get down to the nitty gritty. And I use the word gritty literally, because most of our paper gets food on it somehow. The downfall of keeping our office baskets in the kitchen. Explanation of Benefits with a side of dried peanut butter. All natural from Aldi, of course.

Long before a bill is born, it is an appointment in my planner. For our example, Adelaide is being evaluated and fitted for an IronMan suit. Why? Because it’s more fun than 1,000 words about boring old stuff. Someone from somewhere referred us to the suitbuilder. We call and schedule it. I keep everything in my paper calendar. Dave teases me, but I’ve messed up only two appointments in almost 3 years. That’s a pretty decent record for a woman with unshaved armpits.

Next, we go to the appointment. Hopefully, they haven’t rescheduled without telling us. That happens. We  are on the schedule. Woot. Our copay is one of three amounts…they are never really sure about how much we owe…but I put both printouts in my planner after we pay and sign. I put a checkmark in my planner next to our appointment, so I know we attended. Today, we are called back after only 20 minutes. Hollllaaaa!

We answer two gazillion questions about Adelaide and determine that she does need an IronMan suit. We leave the exam room and go to the front desk. We schedule the follow-up appointment, which I put in my planner. We load up three kids and pray they fall asleep while I drive through to get a Diet Coke. I deserve it. I put the receipts in the basket in the kitchen.

We get a bill in the mail from the doctor. It hasn’t gone through insurance yet. So I don’t pay. I don’t even call. If I call, I will just hear that there was a lag time and I should call my insurance to ensure they received the original bill. I did all this a few years back, before I knew better. Young and naive special needs mom. I put the incorrect bill in the basket.

Next, we receive the Explanation of Benefits (EOB) from our insurance provider. I check it against my calendar to make sure they are paying for something we actually attended. I put it in the basket.

We receive another bill from the doctor. This time, we get the correct amount. I get out the copay receipts, EOB, and corrected bill. I do all the math to make sure our remaining balance accounts for the copay.

I log into the system and pay online anything that is correct and cannot be negotiated. I use the Flexible Spending Account (FSA) until it is all used up. That usually happens at the end of summer. After that, I call to see if they will take less with a debit card lump sum. I write all payment amounts, dates, and confirmation codes on the bill. I put the receipts, EOB, and latest correct bill with my notes into the correct month of my accordion file. No paperwork that is ‘finished’ goes back into the working basket.

We have gone to the follow-up appointment and started the cycle all over again. I keep each visit’s paperwork separate, even though it’s the same end goal: IronMan Suit.

Most of the time, if we paid for something with our FSA debit card, it will need to be substantiated. We get a letter. I go to the accordion file and retrieve that visit’s paperwork. We scan it and upload it. This resolves the issue about 20% of the time. If our paperwork isn’t accepted, we get another letter.

I send the letter, cover letter, and EOB with Dave. He faxes it. Fax machines woul be obsolete if it weren’t for special needs children. Dave brings back the papers plus the fax confirmation paper. It all goes back into the accordion file.

What about the bills that came in incorrectly a few steps back? I wait them out. There has usually been a lag. Again. And we usually get the correct bill by the 4th bill. Until I get the correct bill, that paperwork stays in the basket.

Nothing goes into the accordion file until it is paid or on a payment plan. Each time I make a monthly payment, I write the date, amount, and confirmation code on the bill. And it goes back into the accordion file.

What happens to paperwork that I never resolved? Fire. I set it on fire. No? Okay. I call and spend 2-3 hours getting it resolved. It goes back into the basket until we get the correct bill.

When we get a letter from a creditor, I dig out the paperwork with all my notes and call. I give them all my codes. It usually takes 6 weeks for everything to be resolved. In the meantime, we receive calls every single day from creditors for bills we paid a long, long time ago. Once everyone’s systems are on the same antiquated page, the creditors stop calling. This happens at least one dozen times a year.

After Adelaide’s IronMan suit is delivered, all the paperwork goes into the ‘I’ tab of the accordion file. We will receive several incorrect bills on it before we get the final and correct bill. Once it’s been paid and noted, we move the financial papers to the correct date section of the folder and leave the user’s guide in the ‘I’ section.

We will have a follow-up appointment and follow all the same filing steps from before. I keep everything separated by date.

Before we even went to the first meeting, I checked to see if IronMan suits were even an option. I was just as shocked as you are to hear that insurance would partially cover the suit. Festivus miracle. Most of her gear isn’t covered, so all that out-of-pocket paperwork is filed alphabetically.

If the core for her suit needs a prescription, that will be filed under the pharmacy. Along with her seizure meds.

The incorrect bills, EOBs, correct bills, substantiation letters, and creditor letters all arrive in waves, but aren’t consistent. If I didn’t have a system in place, I might pay things we didn’t owe. Or double pay what has already been paid. Or spend days getting ready for taxes.

Taxes. Almost forgot. I use my planner to do mileage. I have everything in my accordion file for expenses. I can usually enter all our medical expenses in an hour. I do our taxes. I get several Diet Cokes. And usually a movie or book. Mommy needs a treat after all that number-crunching.

After taxes, I move all the papers from the accordion file to the appropriate binder. We each have one. Adelaide’s is about 5 times thicker. But everyone’s medical paperwork is filed in chronological order and ready to be accessed when the hospitals, offices, insurance representative, or creditor have incorrect information.

There is a short period of time when a new year starts and we are still dealing with last year’s paperwork until tax time, yet receiving the new calendar year’s paperwork. I just keep everything new in the basket until the old can go from the accordion file to the binders.

It’s not perfect, but it works for us. We’ve also been able to prove a few thousand dollars’ worth of payments that were still showing in other systems as unpaid. I am ecstatic when my time sorting and organizing actually saves us money. And I save hours during tax season. Such an awesome feeling. But not as awesome as an IronMan suit. I wonder if insurance will make a partial payment on one for me…

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3 thoughts on “Let’s Talk About Bills, Baby

  1. Amber says:

    Hugely helpful! My mum took care of my bills for a long time, and I’ve finally moved out and am not in charge of my own, but have the worst organizational skills ever! I’m going to try something like this. Thanks for sharing even if you’d rather not. Bills are never a fun topic :(

  2. […] 5. We have doctors to check our special parts if they need to be checked. And Graham, obviously, never sees a doctor on his own. And we tried to make a blanket rule about not even playing doctor, but that blasted Doc McStuffins became so famous. So we made a rule about the things we can do when we play doctor. Height, weight, blood pressure, shots, check eyes/ears/mouth/nose, and knee reflexes. We do not remove clothes or check special parts when we play doctor. Graham’s favorite part of playing doctor: “Take dis medicine and get a sticker and don’t forget to use yours doctor debit card to pay me.” Little eyes always watching everything, even when we pay with a Flexible Spending Account. […]

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