Adventures with Social Security and Billing

I got a bill the other day from Samaritan Health Services for $1217. At the time, I was on a phone with a nurse from my insurance company who was checking in to make sure I was well after surgery. I told her about the bill, so she got someone from one of the departments who helps patients with bills like this. From what he could tell, it seemed that Samaritan hadn't given me the full adjustment amount (as stipulated in the contract between Samaritan and Providence) they were supposed to. So, he said he would call Samaritan's billing department and talk to them. He called me back about 10-15 minutes later and reported that I shouldn't have to pay the bill and to call Samaritan and make sure that I owed a zero balance.

When looking into what my social security benefit might be, I found a statement from two years ago. Then, on my blog, Caroline told me that they stopped sending paper statements and said that I could go to SSA's website to get an estimate of my benefit amount. So, I tried that, but after giving them the identifying information (social security number, name, place of birth, birthdate, mother's maiden name), the site couldn't complete my request. I tried a couple of times and then I called the SSA office's 1-800 number. A few minutes later, a real person called me back, she asked for my identifying information and then informed me that there was a discrepancy between what she had and what I answered. The fix? To go to the local office and bring my birth certificate and ask them to straighten it out.

Well, I had to turn in paperwork there anyway, so I brought my birth certificate. The woman who helped me said that there was no discrepancy - that when she pulled up my SSN, what she had in my computer matched what was on my birth certificate. She had no idea what the discrepancy might be.

This is why you start this process as soon as you can.

One can also make a choice about how to approach situations like this. I could get angry and all stressed. Or, just calmly figure out what hoop to jump through and jump through it. And, then laugh at the absurdity of it all!

I will say that other than this silly discrepany, things have happened fairly promptly with the local SSA office. I applied online on Wednesday, filled out the Medical History form online yesterday, which was the same day I received forms that I needed to fill out, which I brought in this morning. Zip zap. Let's hope the rest of this application process goes as smoothly as it has!

Dad's Home . . . and Fatigue . . . and Flexible Spending Accounts

Dad came home yesterday afternoon. She is finally eating more solid foods and we are all working to figure out our new roles in the household. I expect we'll continue to settle into these new roles for awhile.

I have also been experiencing fatigue in the late afternoons and evenings. I still manage to get out and about sometimes, but I'm really just gonna try to sit and relax as much as possible.

I also signed up for a healthcare flexible spending account and while I occasionally have issues with insurance reimbursements (taking sometimes over two months to get reimbursed for acupuncture) and with the billing department at the hospital or the clinic, I must say working with ASI Flex has been a real pleasure. They are prompt with the processing and reimbursement of my claims. I filed a claim on Sunday evening and was reimbursed by Thursday. A heck of a lot better than 2+ months for insurance reimbursements. The flexible spending account also allows me to claim up to the amount I contribute over the year, even if I haven't paid the full amount into the account yet. So, for instance, if I have $1000 taken out of my check over 12 months, I can claim the whole $1000 in January if I want to. What this means is that at the beginning of each calendar year, I have a $1,000 out of pocket maximum. That often means that I will get a bill from the hospital for about $1000 in March - so while I haven't paid that much in yet, I can still claim it and pay the bill. This week, I got the reimbursement before the bill was due, so now I have the cash to pay it. Whew! The money they take out of my check is also pre-tax dollars, so it lowers my total tax bill.

It's always nice to end on a positive note, eh? : )

Yes, another post!

I just had to vent a little bit:  I got a bill from Samaritan Health Services today.  It's the third time I've gotten a bill from them since April. 

The reason why this is bad is because I have already met my $1,000 out-of-pocket maximum for the year.  I met that in February.  This means that I do not have to pay any more medical expenses out of pocket for 2010.

I get my statements from insurance explaining what they've paid.  The rest is to be written off (or, in insurance-speak, "adjusted off") by the hospital. 

For some reason, the billing folks at Samaritan keep missing these adjustments. So, I've gotten three bills, running anywhere from $80 to $200, when I shouldn't have received any at all from them.

I've had to make three telephone calls in the last three months - after I have to dig out my insurance "explanation of benefits" statement - to Samaritan billing and explain that I should not have gotten the bill, that they messed up, and that I don't plan to pay the statement.  Each time, they apologize. 

I asked the person (Chrissy) today if there was anyway they could flag my account to make sure that I don't get any more bills this year.  She wasn't sure if she could.

Frustrating!

Can you imagine?  What if I hadn't been keeping track of what I've paid out of pocket?  I could have paid an extra $400-500 because of this.  I can imagine some patients who don't understand our convoluted health care system would go ahead and pay this bill.  This is exactly what a cancer patient does NOT need. 

Sheesh.