THE CLAIM DRAIN

“Paperwork would be so bad if it weren’t for all the paper. And the work” – Darynda Jones

Last month while I was waiting for my younger son to finish his neurotherapy session, one of the office staff noticed me sitting in the reception area writing out insurance claim forms; I rolled my eyes and told her I was processing all the previous month’s invoices and getting them ready to submit to the insurance company.

The number of invoices for doctor’s visits and neurotherapy never seems to diminish. Over the past several months, we average three visits a week for neurotherapy or Lyme treatment. At the end of each visit, I am provided with an invoice for service, which I typically glance at and then shove in my purse telling myself “I’ll deal with it later.”

When I get home, the invoice goes on top of the stack of invoices that I’ve collected over the previous weeks that will stay there until the end of the month when I review them and work on submissions for reimbursement from our insurance provider.

I hate sitting down to write up claims. Each one must be handwritten; the insurance company does not allow the use of an online form or submissions via fax or email. The process involves filling out the claim form by hand, typing up a cover letter that includes the date of service, patient information, explains that we have already paid for services, and instructs the insurance company to pay us rather than the physician. Once the cover letter is written, I attach the invoice and the claim form. It is a tedious process that is repeated for each invoice.

Once the claim is ready, I add it to a spreadsheet, organized by patient name, that includes the date of service, the description and amount of service. I then cross-reference my list back to the appointment history the doctor’s office has provided to make sure I haven’t misplaced any invoices. Then I scan all the claims into my laptop. Even though I’ve got the system down to a science, it takes a big chunk of time sending off 12 claims every few weeks.

As I explained my process to Erica, she was impressed with my system; apparently, some patients don’t want to deal with the hassle of filing claims. I completely understood, but to me, the 40% the insurance company covered is worth the hassle. I found a way to make it easier by streamlining the process: printing out a dozen blank claims and then filling out the basics: name, address, subscriber and group info – while I sit in the doctor’s office waiting for the kids to finish their neurotherapy session.

It’s a great feeling, dropping off the thick Priority Mail envelope off at the Post Office; this is the only part of Lyme disease where I feel complete, accomplished and in control. It is the only part of Lyme disease where I feel like I am winning when I can get some of our money back.

Erica and I laughed: I could make it a business, processing claims for patients. I probably could, but I won’t. Instead, I’ll use my waiting room time to work on writing out claims and updating the spreadsheet to stay ahead of the pile of invoices, waiting for the day, I won’t have any more to submit.