Paying the Medical Bills

NOTE: Information for this chapter is adapted from Paying the Bills: Tips for Families on Financing Health Care for Children with Special Needs, Eleanora Wells, et al., Boston, MA: New England SERVE; 1992. This and other publications are available at the New England SERVE website at http://www.neserve.org/neserve/publications.html.

Introduction

Even if you have good medical insurance, getting the bills paid for your child's services will test your knowledge, skills, and patience. You have probably used health insurance to pay for a specific medical expense, like a physical examination or x-ray. Unless someone in your family has had a major illness, you may have had few experiences with your insurer. Because your child may need lots of services, your insurer will review your medical bills and requests for services carefully. Your insurer may ask for detailed, written documentation. It is the insurer's way of ensuring unnecessary treatments are not done.

Besides health insurance, there are other programs that may help you pay for your child's services. For example, there are local and national programs as well as special foundations that may assist with the financial costs related to your child's care. One way to locate these resources is to contact the Brain Injury Association of New Hampshire. You know your child better than any one, and you are the best advocate to make sure your child gets what is needed.

This chapter discusses paying for medical care and basic needs. It will help you:

1. organize the paperwork for your child's care
2. identify your child's current needs for treatment and services
3. interact with your insurer or payer
4. identify other funding sources for medical care and basic needs

Note: The term provider is used frequently. It refers to any person or organization providing medical care or services.

Tackling the Paperwork

Even after your child has returned home, you may spend many weeks or months sorting through insurance forms and medical bills. Staying on top of the paperwork will require some organization on your part. To successfully get the bills paid, you need to keep lots of written documentation about your child and your family's finances. Keep copies of all correspondence with providers. Do not underestimate the need to keep a copy of paperwork.

In addition to the paperwork, you are responsible for coordinating communication between doctors, insurers, school, and your family. Keeping good written records helps the communication process and gives you supporting documentation that can help you resolve questions or disputes. Many parents of children with special health care needs have found it helpful to set up a three-ring binder or filing system to organize their records. It is important to save records on your child's health, finances, education, job skills, special interests, and needs. A filing system or notebook arranged by these topics helps keep everything organized.

Health Information

Save health information about your child before and after the brain injury.

Medical history from before your child's brain injury:

1. Dates of immunization shots
2. History of childhood illnesses
3. History of medications
4. Special conditions
5. Allergies
6. Name of pediatrician/primary care doctor
7. Specialists your child has seen

You can obtain this information from your child's pediatrician.

Record of medical care after your child's brain injury:

1. Date of injury
2. Length of coma
3. Physical injuries
4. Surgeries
5. Special tests
6. Dates of hospital stay
7. Other diagnoses
8. Hospital discharge plan
9. Dates of rehabilitation program
10. Out-patient services
11. Referrals for follow-up care
12. Current medications
13. Seizures
14. Special equipment
15. Effects of injury on memory and behavior

A journal or a logbook helps you to record your child's day to day medical care, progress, and important events. Your child's doctor can mail you a copy of any letters and reports between professionals or payers if you ask for them. Ask for copies of reports and minutes from meetings as they occur. You will also want to record the names, addresses, and phone numbers of all people involved in your child's care. To record hospital contact information, use the Worksheet for Hospital Contacts, or use the Rehabilitation Program Staff Contact Sheet to record rehabilitation program contacts.

Finances

Keep all information about your child's insurance coverage handy, including:

• Identification numbers and cards
• Billing addresses
• Phone numbers
• Policies

TIP: Ask the insurer to put approvals in writing for anything outside the standard coverage.

TIP: Make a paper trail.

• Get copies of all claims submitted by providers.
• Keep a copy of each bill, filed by date of service.
• When you receive a statement that a bill has been paid, attach it to the bill.
• Check itemized bills and payment statements carefully.

At the end of this chapter there is a Medical Bill Log to help you keep track of the bills.