Don't Leave Medical Reimbursement Money on the Table

Catherine New
Updated
Medical Bills
Medical Bills

Bridget Queally's manila envelope taunted her. It was overflowing with medical insurance claims, bills, receipts and other health-care related paperwork. Every month, it seemed to get a little thicker as she postponed dealing with it.

"I left it to the very last minute every year because I just didn't want to look at it," the mother of three teenagers told DailyFinance. "I knew that I was leaving money on the table and I felt badly." Like many women, Queally, 47, manages her family's household budget, including all the paperwork associated with medical care from at least six different doctors, both in- and out-of-network.

Queally is far from the only person overwhelmed by dealing with medical insurance administration. Now, a new company, Off Your Desk (offyourdesk.net), is offering to solve the problem for them.

Queally signed up for the service last November, using the company's pre-paid envelopes to send in her paperwork to a personal representative. Today, Queally says she has "complete confidence" she is getting the money she is due. Off Your Desk says on average, they get $2,200 per client in reimbursements.

Part concierge-service and part accountant, the claims specialists of Off Your Desk manage your health-care related paperwork and recover all the money you're due from your insurance company or special savings accounts. For people who just want to get current on their insurance paperwork, the company offers a one-time service for $295. For those who want someone to handle on-going claims and reimbursements, the cost is $65 per month.

Amy Keohane, CEO of Off Your Desk, says the company has received everything from crumpled, soda-stained forms to duffel bags stuffed with papers. Nothing fazes her experienced claims team, she says. "They know how to interpret paperwork, know who to call and know very quickly how to fix these problems."

Hundreds of Millions of Dollars Lost

Off Your Desk is one of a growing number of third-party companies focused on helping consumers maximize their medical dollars, whether recouping insurance money or spending for specialized pre-tax accounts. Every year, an American family of four leaves an average of $3,000 on the table that they are owed by the health insurance companies, estimates Off Your Desk.

FSAStore.com is another company aimed at helping consumers make the most of their flexible spending accounts. Jeremy Miller, founder of FSAStore, says there is a lot of confusion over what is and is not allowed under FSA guidelines. It's estimated that another $400 million was forfeited in flexible spending accounts by consumers last year, according to Miller's company. The store only sells approved products so that consumers don't let these tax-free dollars go to waste.

Why are Americans walking away from so much money? For starters, the insurance industry mis-processes 20% of claims, totaling around $15.5 billion every year, according to the American Medical Association. Another factor is the shift by employers to high-deductible plans that leave an increasing number of consumers paying out-of-pocket, and who must file for reimbursement for out-of-network benefits or pay for care with a tax-advantaged savings account. Complicated forms, timing issues relating to claim-filing, and lengthy appeals processes aggravate the problem. Changing rules over what products do and do not qualify for spending with special savings accounts continue add more confusion for reimbursements.

"One of the biggest issues we see is that customers just don't understand how their plan still plays a part if they go out of network," says Carrie McLean, a consumer specialist with ehealthinsurance.com. The result is that many people would rather walk away from money than deal with the headache of sorting out the insurance paperwork and submitting receipts.

McLean offers these tips to help save you money before you get a bill that surprises you.

  • Check your plan and see what you are and are not covered for.

  • Don't assume that a referral doctor is in network. Call the referral and ask if they are a "preferred provider" for a specific network.

  • Even if a doctor is listed on the literature from your insurance, call the office and confirm that you are covered.

  • If you really like an out-of-network doctor, ask your MD if he or she is willing to join your network.

  • Double-check your explanation of benefits. Be proactive in making sure that the codes and services match up.

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