Originally posted on “Get Organized Already”
Organizing medical paperwork is no fun, I know! I will walk you through my process.
There’s also a printable PDF with all of this info on it near the bottom of this post.
Tori was on vacation with her kids and her husband when she found out her mom had cancer. Her sister didn’t want to interrupt Tori’s trip. But, how could she wait?! So the phone call came. The family tried to enjoy the rest of their vacation, but of course Tori could enjoy nothing.
Once they got home she got on another flight to go see her mom.
Ironically people are bombarded with medical claims exactly when they DO NOT have the emotional (or mental) capacity to handle them.
If a family member or close friend has been diagnosed with a serious condition or disease, the paperwork generated by insurance can be nearly impossible to stay on top of.
Health insurance in America is so frustrating that if you have a mental disorder, or distress brought on by a recent trauma, the medical paperwork resulting from that trauma can increase your condition!
Get some help
In a minute I will show you my systems for keeping health insurance forms organized. Stick with me.
First I want to let you know that there is help out there.
If your situation is extreme, contact the state for a case worker which is usually covered.
If your situation doesn’t warrant state assistance, a good professional organizer (like one from get organized already in Pasadena) will help you organize and file claims as well.
If you have insurance through your job*, you may also have access to a liasson company (like Compass) to help navigate your employer’s health insurance system.
If you’d like to get your health insurance situation organized on your own, here is the system I have developed after many years of trial and error.
How to organize health insurance papers
Find and sort the information
Gather all of your medical papers and clear a working surface**. Separate the papers by who they are from– insurance companies in one pile, doctors/providers in another pile. If they are still in the envelopes, don’t open them yet. Sort the envelopes.
If you have bills from collection agencies keep them in a prominent pile. Hopefully we will find some answers to get help paying those bills. But if not, you still don’t want to lose them!
More fun than Christmas morning!
Now open the envelopes. WAHOO! Think how good you will feel when this is OVER! (<–sarcasm font)
First open everything that’s from your insurance company. These are probably going to be Explanation Of Benefits or EOBs. Find the doctor’s name and date of service or DOS and highlight those items for easy locating and matching.
Match each bill and/or receipt with an EOB
Next, open and look at the bills and receipts from doctors and labs. As you open these, match them with the corresponding EOB (from the first pile). Write directly on the top of each bill or receipt the amount you were reimbursed (even if it’s $0) and the date the EOB was sent.
Once you’ve written this payment information from the EOB onto your bill/receipt, recycle the EOB. Less paper to keep up with.
If you are lucky and your doctors are in-network, this will pretty much take care of your papers. Birds will tie ribbons in your hair and your skinny jeans will now fit perfectly! BUT…
Bills and receipts with no matching EOB
If you have any receipts for services that you had to pay out-of-pocket, you will need to submit them to the insurance company yourself.
First, you’ll need more than a receipt, so find the full bill–some offices call it a SUPER BILL which sounds scarier than it is.
It’s just a bill from the provider that includes these muy importante things:
procedure codes and
Dr’s tax ID #s
NPI which honestly I have no idea what that is.
Of course name of patient and date of service
Once you get used to looking for these things on a bill, it isn’t so confusing. The first time can be totally mind-blowing though. So take a deep breath. Save the glass of wine for when you have it figured out!
PRINT an online claim form
Next, you will need to find the right claim form to submit. Do an online search to find medical claim forms. Enter the name of your insurance company and the words “claim form”. You’ll get a list of results.
Look for the “PDF” letters in the description. Once you find the right form, print out one copy or download it and fill it in digitally with a PDF signature app or program.
mental/behavioral health forms may be different
Create a master form for re-use
If you have a printer which will scan and make copies I recommend this trick: Partially fill out a claim form with your personal information which doesn’t change. Leave the doctor info blank as well as the dates of service. This partially filled out form is now your master copy.
Make actual paper copies of this master sheet and paper clip all of those together for future use. Now you never have to fill out those items of the form again. Heeeyy!!
Fill out a form for each doctor’s visit or procedure
If you see a therapist or other provider regularly, you can usually fill in one form with multiple visits to one doctor.
Start with your oldest receipts because insurance company have deadlines for sending them this stuff and often –OFTEN– you will screw up and have to resubmit it.
Make 1 copy each of the bill/receipt and the completed claim form to go with it. Send the copies to insurance and keep the originals. You can use an app on your phone for scanning, or use your printer’s copy mode.
You can send these digital scans via email to the insurance company (or the liasson company if you’re using them). Sometimes I find it easier just to snail mail the damn papers, though. Whatever feels easier to you, do that!
File the originals
Now you gotta wait to hear back and get your money. While you are waiting, you don’t want to lose the papers. So, here’s my filing system for health insurance claims.
Set up a hanging folder for health insurance.
Use one hanging folder for each patient if you are dealing with multiple family members on separate plans. Most families can get away with one single hanging folder for all health insurance papers for the year.
Use interior folders (what I used to call manilla folders before I went to fancy schmancy filing class) to separate and track what’s been paid and what your insurance has reimbursed.
I name the interior folders-
- To be submitted
- Pending claims
- Completed claims
Place the piles you have created into these folders as appropriate.
PRO TIP: I write the address to which the claims should be mailed on the “To be submitted” folder in sharpie just to reassure myself I’m doing it right the next time. I don’t want to relearn this every few months, you know?
Can I deduct medical expenses?
Note: The IRS allows you to deduct qualified medical expenses that exceed 7.5% of your adjusted gross income.
REAL TALK– if you make $100k a year, you’d have to spend over $7,500 out of pocket to start to get a deduction. So, that would be a really bad year. Most people will not be able to deduct health expenses, so I don’t spend a lot of time organizing medical or prescription receipts.
You did it!
Hopefully you will have some reimbursement money coming your way after you finish submitting all of this crap-a-tola.
If you didn’t do it –if you aren’t able to figure out how to submit the paperwork to be reimbursed and are really struggling with health insurance claims, bills, your budget, or other things that aren’t traditionally called clutter– call a professional organizer for some relief.
Often we will save you more money than you pay for our service. ! That turned out to be true for Tori when Get Organized Already came in to help her get on top of her mom’s health papers. Remember Tori, from the beginning of my post? We organized her and her family’s health files while we were there, too.
Thank you as always for reading. This topic is particularly tedious, so extra thank you this week! We also have a condensed version of this process as a step-by-step guide available here.
Show me the guide
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Give yourself a break for not being perfect and give yourself a big smile for being perfectly you. You are terrific!
*Maybe you also have a pet unicorn! They are just as rare as company health insurance plans these days.
**If this is going to be a marathon project, I recommend setting up a folding table where you can spread out for a few hours or days. You’ll want to take breaks — to leave and come back again without having to lose your place in the process.
Are you swimming in medical paperwork like the rest of us? Here is a great