SongOfRuth's dashboard

Matt Mueller, an employee of change:healthcare, inc., replied on January 01, 2008 14:17 to the idea "Display "Billed Amount" instead of "Total Insurance Benefit" on listings for EOBs" in change:healthcare, inc.:

SongOfRuth,

A scanned EOB would be great! If you could just black out your personal information we would appreciate it :). We are working towards building a system where the field names when entering an EOB match your paperwork (based on the insurance you select), and your scanned EOB will put us one step closer.

So far it has been tough getting insurances to provide us with sample EOBs, but with help from users like you we are slowly moving towards having a decent database.

Fax number: 615.523.1255

Thanks again!

caparks, an employee of change:healthcare, inc., replied on January 01, 2008 14:05 to the question "Confusion re open versus closed balances?" in change:healthcare, inc.:

Your right! I often tell people to use tags as a was to group things (like multiple items, providers, etc that are associated with one episode of care or event... like a car accident or long hospital stay + associated home health). Very creative using "C#:xxxx" as a way to group and sort claims... you could even go with "eob-c#:xxxx".

The gang here have already been prompted to add "Claim #" as a new field though I also like your creative solution!

SongofRuth - You are our new Rock'n Power User. THANKS!

Matt Mueller, an employee of change:healthcare, inc., replied on January 01, 2008 14:00 to the question "Confusion re open versus closed balances?" in change:healthcare, inc.:

Exactly why we added the tag field, great usage of it. I assume you know too that you can then view all items with a given tag in the transaction log. Good to see you coming up with creative solutions that work for you!

SongOfRuth replied on December 31, 2007 23:19 to the idea "Display "Billed Amount" instead of "Total Insurance Benefit" on listings for EOBs" in change:healthcare, inc.:

For the bills/EOBs I receive, I believe that "Totalled Billed" is the most consistent number. There may be some providers who don't format their bills this way, of course.

In my particular case - esp. those blood tests I've mentioned - I pay the full amount. Which means I end up with several entries with an insurance benefit of $0 - all for the same date and the same provider which makes them all look the same.

If you like I could fax you some of these EOBs if that would be of help.

Take care,
Melody

SongOfRuth replied on December 31, 2007 23:15 to the question "Confusion re open versus closed balances?" in change:healthcare, inc.:

I know that on my EOBs there is a claim number. So all entries for that EOB (which of course now are listed as individual EOBs when I enter them) have the same claim number. Currently I put this in the TAG field. It just occurred to me that one thing I could do is to use "C#:xxx", where xxx is the claim number, to differentiate this particular tag. In this way things actually currently sort of can be grouped.

Matt Mueller, an employee of change:healthcare, inc., replied on December 31, 2007 20:57 to the idea "Display "Billed Amount" instead of "Total Insurance Benefit" on listings for EOBs" in change:healthcare, inc.:

SongOfRuth,

This is a great point. Ideally we hope you will be able to match up EOBs/Bills via date, reason for visit, provider, etc.

However I do understand how it could be confusing to see the insurance benefit amount as opposed to one of the other amounts. If we were to change the amount, would you find it easiest to match on "Total Billed" or "Amount Allowed?" Which are the fields/numbers that you most identify with/match on from your EOBs?

Thanks for all your great feedback so far.

Matt Mueller, an employee of change:healthcare, inc., replied on December 31, 2007 20:51 to the question "Confusion re open versus closed balances?" in change:healthcare, inc.:

SongofRuth,

Although I didn't get in on this conversation I reply appreciate the feedback re: multi-line EOBs. That is something we have been discussing of late, trying to settle on the best way to handle it. Although we may not get it out to you immediately I promise that this feature is high on our priority list and we will get to it soon!

Matt Mueller, an employee of change:healthcare, inc., replied on December 31, 2007 20:45 to the question "Pre-Tax Accounts" in change:healthcare, inc.:

Hi SongofRuth,

Sorry for the tardy reply, the holidays have been a bit hectic :)

Let me do my best to answer your questions.

1) No, payments act as withdrawals from your pre-tax account. Whenever you enter a payment associated with a pre-tax account, that payment amount will be subtracted from your balance.

To enter deposits you edit the "estimated savings" amount in the pre-tax account itself. You can do this when you originally create the pre-tax account (i.e. if you know both you and your employer have deposited a given amount for the time period), or you can constantly change it via the edit command. This will adjust the balance accordingly, etc.

2) See above.

3) This is a good question that we have been talking a bit about lately. This may be the best way to deal with the circumstance: originally enter your payment without an associated pre-tax account, this will leave your pre-tax account balance unchanged. Then, when your reimbursement comes in, go in and edit this payment, selecting the pre-tax account appropriately. This will then subtract the reimbursed amount from your balance, just as if you had paid out of that account from the very beginning.

Thanks for the questions, let us know if you have any more :)

Matt Mueller started following the idea "Display "Billed Amount" instead of "Total Insurance Benefit" on listings for EOBs" in change:healthcare, inc..

SongOfRuth shared an idea in change:healthcare, inc. on December 29, 2007 05:45:

Display "Billed Amount" instead of "Total Insurance Benefit" on listings for EOBs

The "Billed Amount" is not currently shown on differnt listing screens (such as Transaction Log). Instead "Total Insurance Benefit" is shown. However, "Total Insurance Benefit" may not appear on patient documentation (bills, EOBs). (At least it doesn't show on any of my documentation.)

Consequently, matching up a bill I just received to the correct EOB that I've already entered into MBM is a bit of trial and error to find the right EOB.

Alternately, perhaps there could be a selectable option to allow choice of which amount to show.

Thanks!

SongOfRuth replied on December 29, 2007 05:36 to the question "Confusion re open versus closed balances?" in change:healthcare, inc.:

On the EOB side, I had upped my confusion factor by linking several EOBs together. They weren't actually separate EOBs but rather the different multiple lines of the same EOB so I had linked them. Unfortunately that kept any specific EOB (of that group) from moving to the Closed Balance side.

It will be great to be able to enter multi-line EOBs.

SongOfRuth replied on December 29, 2007 05:33 to the question "Confusion re open versus closed balances?" in change:healthcare, inc.:

That worked just fine. In fact, now that I have the swing of things re pharmacy purchases, I'm baffled how you folks are going to improve the process. ;)

Tink, an employee of change:healthcare, inc., replied on December 28, 2007 23:29 to the idea "Copy EOB info to new EOB" in change:healthcare, inc.:

SongOfRuth,

This is great feedback! These are things we have been discussing as we begin organizing the details of the new site.

What I am gathering is that it would be helpful to enter or add a multiple line EOB. It would probably be additionally helpful to enter a "super bill" or a bill that distinguishes between charges.

These are things I will make notes about and bring them up in our next organizational meeting.

Please feel free to continue to provide feedback. Your thoughts are appreciated!!

Thanks!

caparks, an employee of change:healthcare, inc., replied on December 28, 2007 19:52 to the question "Confusion re open versus closed balances?" in change:healthcare, inc.:

ok... part two. This is GREAT question to something that isn't so obvious... Change the bill amount to $100... because that is the amount that the doctor billed somebody (in your case, he billed the insurance company so the combination of your $15 co-pay and the insurance EOB should net the balance to zero).

It's weird, i know - but you really didn't get "billed" when you made that co-pay. It was merely a payment of $15 while you were there towards a total bill of $100.

And don't worry about the order of data entry. It shouldn't make any difference to MBM what order you put things in.

Let me know if that takes care of it for you and thank you so much for asking.

caparks, an employee of change:healthcare, inc., replied on December 28, 2007 19:45 to the question "Confusion re open versus closed balances?" in change:healthcare, inc.:

First thing... we've made entering prescriptions a little easier [though in the next release in February (2 months from now) it will be super simple with a new Rx button :) where you'll be able to pick/search from the actual prescription name etc]
In the meantime, though, now you don't have to enter an offsetting bill for a prescription. Simply enter a new payment and as you are inputing your payment -- UNcheck the checkbox next to "will bill?" By unchecking the box, MBM will auto create a phantom off-setting bill so that you do not have an outstanding pharmacy balance.

That should make entering prescriptions easier (until we go live with the new enhancements)

Whew! let me take a brake for a sec and i'll answser your other question :)

SongOfRuth replied on December 28, 2007 18:59 to the idea "Copy EOB info to new EOB" in change:healthcare, inc.:

I found that shortcut and do find it useful.

I guess where the Copy idea would really come in handy is when there are several charges on one EOB. For instance, so far as I can tell all I'm doing when I go to the doc is going for an office visit along with somebody sucking blood out of my arm. But that one visit generated 3 EOBs and each EOB had multiple items. I'd just enter all the totals except that when I get billed by this same doc the bill always separates out all the individual charges so keeping them separated makes it easier to double-check for errors.

caparks started following the question "Confusion re open versus closed balances?" in change:healthcare, inc..

Matt Mueller started following the question "Confusion re open versus closed balances?" in change:healthcare, inc..

SongOfRuth asked a question in change:healthcare, inc. on December 28, 2007 18:55:

Confusion re open versus closed balances?

I go to the drugstore and buy $15 worth of prescription drugs.

I create a Bill of $15. I have an Open Balance for the drugstore for that purchase.

I create a Payment of $15. I now have a Closed Balance for the drugstore for that purchase.

However...
I go to the doc. He has a copay of $15.

Perhaps the problem is because I did this backwards.

First I created the EOB...
$100 Charge
$75 Allowed
$60 Paid

This created an Open Balance of $15 (in red).

Then I created the Bill for $15.

Then I created a Payment for $15.

But now I still have an Open Balance of $-85 (in black).

I'm thinking that somehow after all this I should have ended up with a Closed Balance (since this doc visit is now fully taken care of). But I'm not sure how to get there... whether I entered a piece of info I shouldn't have or put something out of place.

SongOfRuth replied on December 28, 2007 18:26 to the question "Pre-Tax Accounts" in change:healthcare, inc.:

1. Are you saying that I would enter a "Payment" to record deposits into my pre-tax account?

2. How do I record withdrawals From my pre-tax account?

3. How do I handle the case of my paying a copay myself, then getting reimbursement from the pre-tax account?

Thanks!