Friday, June 09, 2006

The Check's in the Mail (Dumbass)

[This was yesterday's post... but a busy schedule and an ill-timed Blogger outage kept it from hitting the airwaves].

I've written before about how "Consumer Directed Health Care" will be soon sweeping the nation (if it hasn't hit you already). Basically, the idea is to turn formerly cost- and quality-oblivious patients into consumers who are engaged in the financing and decision-making of their care. This is done by providing employees fixed amounts of funds to cover routine health insurance costs. These funds come in a variety of different mind-numbing tools, including Health Savings Accounts (HSAs), Health Reimbursement Arrangements (HRAs), Flexible Spending Arrangements (FSAs), and Medical Savings Accounts (MSAs).

The basic concept is that if I have limited funds to spend over the course of a year, I'll start asking questions about how much things cost, and whether certain tests and procedures are necessary. I might even chose to go to see a Nurse Practitioner rather than a Board Certified Family Practice Physician to stretch my dollar, or elect to receive generic prescriptions rather than name-brands. This, in turn, will theoretically spur competition amongst healthcare providers to ultimately lower costs and increase quality.

So here's my first foray into the HRA and FSA world...

At the beginning of the year, my employer put $400 in an HRA which would be used to pay for all of my medical/pharmaceutical/chiropractor/etc. bills throughout the year. Based on last year's expenses, I decided that wasn't enough, so I opted to include an FSA in which every pay-period I put pre-tax dollars totaling an additional $500 into an account to be used just like the HRA.

So far this year I've had some fairly expensive claims--shoulder problems, a minor surgical procedure, a couple of visits for colds, etc. While I thought all this would be covered with my ample and prudent $900, I've been getting some pretty outrageous bills from my providers. $219 here, $147 there, 98 here and several others. I was confused, so today I called my insurance company to figure out what was going on. I was certain there'd been some mistake.

I spent the better half of two hours on the phone with a helpful and friendly young lady that meticulously went over every single one of my claims with me. We walked though how the $400 was drawn to zero, and then how the $500 was nearing a goose egg, too. Soon, we figured out that the claims had been submitted, and checks were being cut, but the doctor apparently wasn't getting them--he was still sending me the bill.

It took the two of us the entire time to figure out that while the HRA paid directly to the provider, the FSA checks were being mailed directly TO ME. Somewhere in the house, I had tossed over $425 worth of checks in the stack of endless "Benefits Statements" and "Account Balance Statements" that I'd been letting pile up, un-opened in my in-box on the desk.

And in a uncharacteristically lucky move on my part, I went home at lunch and found every single one of them. Hallelujah! Ain't modern healthcare grand?


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