Updated Financial Estimates

I just wanted to let you all know that I changed the cost estimates because I learned that the enrollment period for my insurance is actually January to December. That changed the estimated costs per year a little bit.

Lessons Learned in Medical Payments

Managing all of the claims, bills, and medical payments has been an interesting learning process. First, I was receiving claims that were not being approved, because the Insurance company thought that Ben had a pre-existing condition. We had to submit some paperwork to prove that he did not have a pre-existing condition and have those claims re-submitted. Then we would receive bills that did not match up to certain claim. Finally the hospital wanted to charge us up front for what they "thought" our deductable or co-pay might be. The problem with that last one, was that by the time the hospital actually submitted the claim, I would owe nothing because Ben's deductable and co-pay limits were eaten up by other medical costs. I would have had to go back to the hospital for a refund.

So this is what I have learned in all of this.
1. Watch every claim. One claim went through as out of Network, and I would have had to pay $1,560 for just one Dr. visit. Fortunately, I made some calls to the Dr. and insurance and everyone realized that it was not out of Network and I owed nothing, the insurance took care of it.

2. Make sure claims and bills match. I received one bill where there were charges not included in the claim. The Dr. office said that their records showed that we did not have insurance, so I promptly gave them my insurance info, and they re-submitted the claim.

3. Fill in insurance paperwork promptly.

4. Follow-up, follow-up, follow-up

5. Ask for what you want. If you don't ask, you don't receive. When the hospital wanted to bill me upfront, I asked, "Are you billing me at the contracted amount of my insurance," they said, "Probably not," I asked, "By the time the hospital submits the claim, are you sure that my deductable will not have been reached yet?" The answer is no. So I suggested that they have set up the system for me to have to come back for refunds each time they charge me, and that my desire would be for everything to go through the claim process first, and then the hospital can bill me. That way it will be a lot cleaner, and we reduce the administrative nightmare of refunds. I assured the hospital that Ben is in this process for 3 years, and I do not want to jeopardize his medical care by not paying, so I am motivated to pay, and second they know where I live. The hospital said, "That does seem fair."

6. I have learned that the hospital, the Dr.'s offices, and my insurance are really great. Managing medical costs for a condition that Ben has is never easy, but all of the parties have resolved issues quickly, and in a professional manner.

Thank you all who have supported Ben, and thank you for all of the great meals people have brought. You all are amazing to us.