How To Help Your Aging Parents – Medical Billing

By on November 9, 2007

It wasn’t until Dad mailed me the collection notice that I realized he was losing his ability to track and pay his medical bills. He had complained during our phone chats on several occasions that the hospital had messed up his billing. They kept phoning him to get him to pay his bill.

He insisted that he had paid the bill– $124.34.  The hospital billing staff asked him to send a copy of the cancelled check. But, Dad adamantly refused to go through the work of getting the cancelled check. It was the hospital’s mistake for losing the payment.

I was dumbfounded by his vehement refusal to deal with a straightforward problem. Ironically, in his younger days, my father had been a stickler for financial details. As a young adult, I would have gotten a scalding rebuke for failing to take action on something like this.

His unusual behavior was a warning that his dementia was beginning to impair his judgement, while his anemia left him so fatigued that even a trip to the bank seemed like an overwhelming task. I didn’t recognize it for what it was. I thought he was just being obstinate.

Being 3000 miles away, I tried to get my father to read his checkbook to tell me the check number for that hospital bill. Then, I went online to see if that check had cleared.  The check number he gave me had been cashed but it wasn’t anywhere near the correct amount for the bill. I looked for another check with the amount $124.34. I didn’t see any in that month that matched.

I told my father that the only thing to do was pay the bill. He refused. No amount of reasoning worked. So I made a deal with him — I would pay the bill and he would reimburse me.

Grudgingly, he agreed.

My father had already signed a power of attorney giving me the authority to handle his finances and one for health care, too. So, I began learning first hand about Medicare,  supplemental heath coverage and prescription drug benefits.

Dad had to sign a form to allow me to access his online medical insurance claims and to speak for him to the insurance representatives. I left instructions for them to phone me first since Dad’s hearing was poor.

I paid the bill. Dad eventually reimbursed me. The collection notices and phone calls stopped.

It wasn’t until a couple of months after my father’s death that I found the entry in his checkbook. Dad was right all along. He had paid the hospital within days of receiving the bill.  But, he was so certain he remembered the correct check number that he never looked it up. I was too far away at that time to double check it myself.

The story doesn’t end there.

Another billing mistake almost happened today. I started to pay a doctor’s bill for my father’s estate and discovered that it was more than it should have been. 

The doctor is supposed to bill Medicare first. After Medicare determines what it will pay, the doctor sends the bill to the supplemental insurance.

Only after the supplemental insuror has completed the claim, should the doctor bill the patient for any balance due. But this latest bill didn’t show any payment from the supplemental insurance, so I checked the online claims information.

The supplemental insuror had rejected the claim because documentation was missing.  Well, sometimes paperwork does get lost.  You need to follow up to get another copy sent.

I called and spoke to the medical billing person in the doctor’s office.  She pulled up the records on her computer. She stated that my father owed this amount of money. I asked if she sent it to the supplemental carrier.

She said, “Yes.” And promptly read my father’s account number for the insurance.

I asked her, “Why do the online records say your claim was rejected for lack of documentation? The amount you are billing doesn’t appear to include any payment from the supplemental insurance.” 

People do make mistakes (including me). Where there is an honest mistake, you can hear the surprise in the person’s voice. “How did that happen?” Sometimes, they laugh self consciously.

There was no surprise in this woman’s voice. There was no admission of a mistake. “We understand your concern . . . we will make sure it gets handled.” She was billing my Dad for the entire amount rather than resubmit the bill to the insuror with the information that was needed. Efficient but totally lacking in ethics.

I wish I could say this was the only mistake I have found. Unfortunately, billing mistakes have happened so many times in the past 9 months of settling my father’s estate.

How many elderly patients pay too much because they don’t have the patience or focus to follow up?

If you have been wondering how you can help your aging parents, discuss helping them with tracking medical bills. Have your parents collect everything (bills, medicare statements, supplemental insurance statements) in a folder. Set up online access to insurance if its available.  Make a regular date to go over the bills each month before anyone writes checks.

You may need to make phone calls for your parents. Be aware that privacy rules prevent the insurors from talking with you about your parents’ account unless your parents have given permission in writing.

You’ll be providing peace of mind and possibly saving money for your parents, too.

About CK Wilde

CK Wilde has been writing about topics close to her heart--family caregiving and multigenerational families--since 2007. She grew up in a multigenerational household and understands the positive and negative aspects of close family living. CK believes that caring for her father during the last two years of his life and raising two terrific young men have been her most important accomplishments.

One Comment

  1. Craig Collins-Young

    June 3, 2009 at 10:11 am

    June 4 Congressional Call-In Day

    AAHSA, along with a coalition of organizations, is hosting its third Congressional Call-In Day. Our goal is to get 10,000 callers to tell Congress how important it is to include long-term services and supports in this year’s health care reform effort. We’ll once again be focusing on the Senate.

    Please join us (either again, or for the first time) in not only making calls, but telling as many people as possible to do the same. The call is free, and our system automatically connects you to one of your senators, once you provide your state name.

    The number is (866) 281-7219. That line is open on June 4, from 9 a.m. to 6 p.m. EDT.

    These calls are working; Sen. Kennedy and the Senate Committee on Health, Education, Labor and Pensions (HELP) recently included language on long-term services and supports in a briefing paper about health care reform. We anticipate this paper will serve as a foundation for the committee’s bill.

    This is amazing news. We’re closer than ever, which means it’s more important than ever for us (you, me, our families, friends, co-workers, etc.) to make sure the rest of the Senate knows how important these services are for older Americans and people with disabilities.

    I hope you’ll take a few minutes to help. Make some calls. Plan a call-in day event. Post a blog. Send some emails. Our last call-in event generated just over 7,300 calls. On Thursday, June 4, 2009, we want to achieve 10,000 calls.

    I’ve included a sample script. If you need more information or help/ideas planning an event, please visit http://www.aahsa.org/callcongress.aspx.