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How to Handle the Insurance Flood
by Evangelina Vela

You're finally out of the hospital! You're getting used to the new daily, weekly, and monthly routines. All of a sudden, you notice that 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 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.

1) How long have you been dealing with the paperwork? If it is six months or less, you will be all right. Even if it has been longer, you can work through it.

2) 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 awhile 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 that 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 you call the doctors' offices (Item 3). If you have solid info in hand, YOU will feel more in control. Then, you can call and say that you are "verifying" the amount still open on the bill. You can also then say that 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 out for them in the mail. Explain your circumstances. Keep asking questions until you understand.

Next time that you go to each doctor's office, pick up the business card of the office manager, billing person, or insurance person so that you have their contact information available. Staple it to the inside front cover of the proper folder.

3) 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 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.

4) 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.

5) 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.

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