How to Handle the Insurance Flood
by Evangeline Vela, (originally published in "Scleroderma
Voice," 2005 #1)
Insurance companies often seem to
thrive on paperwork, and the flood can seem overwhelming.
But there are ways to deal with it–starting with
a plan to organize yourself and ending with a sense
of humor about it all.
 Your
loved one is finally out of the hospital. You're getting
used to the new daily, weekly and monthly routines.
All of a sudden, you notice there is a lot more mail
than there used to be. Envelopes that look like bills
are arriving from Dr. So and So, Chemistry Lab or City
Medical Practice. Other strange envelopes are starting
to show up with what appear to be important-sounding
return addresses. Some may say, “Explanation of
Benefits” on the outside. What does all this mean
to you, the overworked caregiver?
The overflow of insurance paperwork can be very confusing,
especially if you hate it the way I do. But there are
ways to wade through some of this. I am not an expert
on insurance matters, but I have some suggestions to
keep it from feeling like the end of the world when
you get the flood of paperwork. Chances are that it's
not as bad as you think. How long have you been dealing
with the paperwork? If it is six months or less, you
will be all right, but even if it has been longer, you
can work through it.
Get yourself a box of file folders and make a folder
for each doctor and/or hospital. Now, start putting
the Explanations of Benefits and the bills in the right
folder for each doctor. Once you have things in place,
then you can start matching up the payments made with
the bills that have been sent. Go by dates. It usually
takes Medicare and other insurance companies a while
to get it together, so the payment may be at least a
month later than the bill date. (Big secret: they are
in worse organizational shape than you are!) Ask a good
friend or trusted relative whom you consider to be organized
to help you and to keep you from panicking when you
start filing. Wait until you have finished your organizing
before calling the doctors’ offices. If you have
solid info in hand, you will feel more in control.
Call and say you are verifying the amount still open
on the bill. You can also then say you have not yet
received the information they are giving you (if that
is true, of course) because you will have all of your
information in front of you. Don’t worry if you
don’t seem to have everything. Go with what you
have. Ask questions. Ask for copies of missing documents.
Look for them in the mail. Explain your circumstances.
Keep asking questions until you understand.
Next time you go to each doctor’s office, pick
up the business card of the office manager, billing
person or insurance person so you have his or her contact
information available. Staple it to the inside front
cover of the proper folder.
Whenever possible, talk to the person in charge of
insurance at your doctors’ offices. They should
be able to help explain at least their part of the paperwork.
If they are nice, they might be willing and able to
answer general questions about some of your other paperwork.
Remember, they have a vested interest in helping you.
They want to be paid. Try calling only one office a
day if your time during office hours is limited. If
you get a call from an office that you are not prepared
to deal with, tell them you will have to call them back
and make an appointment for a particular day. Make sure
you find out the name of the person to talk to and the
best time to reach them. Also, if any of the offices
or hospitals have social workers available, talk to
them. They are supposed to understand the paperwork.
The Georgetown University
Health Policy Institute has written "A Consumer
Guide for Getting and Keeping Health Insurance"
for each state and the District of Columbia—51
in all. These guides summarize your protections
and rights in each state, and are updated periodically
as changes in federal and state policy warrant.
To access these guides
and other information about your rights as an
insurance consumer, please visit the resource
section of our website. |
If your loved one is receiving disability or retirement
income, call the representative at your insurance company.
The ones I have talked to have always been very good
at explaining what I need to understand. Ask the representative
if they need a signed W-4, an Employee's Withholding Allowance
Certificate, to tell them that you are exempt from taxes
(if you are). Otherwise, they may take the highest percentage
allowed for taxes out of any disability income or retirement
income checks you receive. The W-4 usually needs to be
signed and sent to them once a year at the beginning of
the year.
Last, for your own sanity, take some time to laugh.
Read something funny, or watch a funny movie. It will
improve your outlook and help you smile. You need to
be at your best to help your loved one best. And remember,
you are not alone.
Evangelina Vela has been a caregiver for her husband
for over seven years. She is a Texas state coordinator
for the National Family Caregivers Association and is
the Content Manager for the website familycaregiverweb.com
from which this article is reprinted. |
