This is a repost with a few additions and revisions of my earlier post in a different topic.
These are my initial reactions after preliminary review of the program.
First, thanks for all the hard work developing and testing the new version. It's definitely a big improvement (mostly). The improvements in multiple payments, OOP tracking, etc are excellent, as is the new reminder feature. Also, the correction of "small" usability issues (such as having Clear All and Select all in the filtering reports) are very helpful and make the program much easier to use.
That said, I am a bit surprised at how many things weren't improved that to me at least seemed pretty important. I have previously suggested all of these through direct feedback, but not here publicly and perhaps others have not also requested these changes. I'm going to repeat them here so that you can gauge whether others feel similarly.
1) Biggest "issue" is that handling of co-pays seems to have actually taken a step backward. Previously, entering copays was pretty straightforward, and the program reported OOP $ both with and without copay included, so you could choose what was applicable. Now, you seem to have removed the ability to exclude copays from OOP and deductible calculations, unless you use the workaround of creating a separate service that doesn't get covered by an insurer. Why ? In addition, I cannot find any info in your documentation on what happens if you check the copay box on a payment. If copays are always included in ded and OOP calculations - what is the difference between checking and not checking that box? Does it do anything?
The solution seems obvious - why not do for copays exactly what you did for deductibles? Have an option in insurer details to indicate if copays should be included in a) deductible and b) OOP. THEN it would make sense to have a line item where checking copay alters the algorithm according to Insurer set up.
Also - what happens during conversion to new version to payments previously entered as copays?
2) The check box for in-network for a provider should be part of Provider details, rather than entered in expense dialog. If a provider is in network, then that would always be the case. Theoretically, I guess they might be in one network and not the other for multiple insurers - I guess Provider setup could allow indicating in/out of network for each insurer.
3)Interface/usability - program is still very un-windows like - there is no right click context menu in list view, which would be an obvious way to change a status (mark submitted or reimbursed). THere are absolutely no keyboard shortcuts for frequently used things, again, such as marking submitted, pending, FSA status, etc. There is no way to select multiple expenses, and simultaneously mark them as having been submitted to insurer or FSA.
4) There is no way to do a global edit - for instance, change all instances of a particular service to a different term.
5) There is no way to mark date a claim was sent to an insurer or date was sent to FSA for reimbursement. You can put in notes, but if there was a field, you could quickly find all the items you sent to blue cross on January 20th, for example.
6) There is no way to make simple batch revisions - eg select several expenses and mark them all as paid, and change the date paid for all of them.
7) The multiple payments feature is great for situations with a big expense that you pay against in installments. But this doesn't cover situations with multiple visits that are invoiced periodically (eg biweekly physical therapy visits with monthly billing) and paid against the statement rather than a visit. RIght now, you would have to split your big payment up among all the visits it covers. Here is how I would see this working: you enter a separate record called a payment record. You indicate the provider. The program pops up a list of all expenses for that provider that are not fully paid, and you check off the ones the payment should apply to. A simpler way would be for the program to just apply the payment chronologically to open visits until it runs out of payment. Somewhere, it should then show current balance for that PROVIDER - rather than just for a single expense.
I guess you could work around this by entering all those visits in one expense record as separate services, but then you could have visits spread over time showing up as a single item - which is not right.
8) FInally (!), would really help to be able to batch expenses together as going into one claim. Having a field for "date claim sent" gets you part way there. The more elegant way would be to enter a "claim item" and then check off expenses included, from the list of all expenses marked "to submit", and enter the date of that claim in that record.
I don't mean to throw cold water on this - the upgrade is very nice, and certainly a great improvement (except for the copay handling) - but I had hoped there would be a bit more substance. But perhaps others don't share these needs. Reactions from others will be helpful.
All that said, it is a great program, and answers a huge unmet need, and I remain grateful to Intuit and your team for your attention and interest in user needs!
Thanks and sorry for this very long post!
Additional comment after reading response from Tony to my original post:
If most of your claims are submitted by providers, then several of my suggestions would not seem valuable: selecting multiple expenses for changes to status, adding a claim date, and creating a "claim" record to bind together several expenses.
However, in my family, the majority of our medical expenses are actually out of network with providers that don't submit for us - I submit the claims to blue cross myself. So I regularly batch together a dozen or so statements and bills from multiple providers, and send these on one claim form. That's why those features were important to me.
And here's one additional feature request that I did not previously post:
For my version of blue cross, there are several services that have a cap on number of visits, not cost - and that number varies with the service. For instance, speech therapy for an ongoing condition has a max of 100 visits per year. Occupational therapy same limit. Other kinds of therapy have different numbers of visits. So, it would be great if in defining a service (eg speech therapy), you could indicate a max visit number tied to an insurer. Or perhaps this would be set up for the insurer along with deductibles and OOP max. In either case, the OOP/deductible report could become an insurance limits report and could also indicate how many visits you had remaining for any services with caps on no. of visits. Of all my suggestions, I think this is probably the simplest to code- just have to count visit dates for each service and subtract from the defined limit.
Re: QMEM2: Reactions and Suggestions Feb 02, 2006 12:26 am
My comments are documented elsewhere so I won't bore people by repeating them. However, I was surprised to see point 4 still on the list.
4) There is no way to do a global edit - for instance,
change all instances of a particular service to a
different term.
Does my suggestion of editing the service in the service list <or any list item in their respective lists> not work for some reason for you? I know its not very Windows-like, nor does it allow for partial mass edits, but it does solve the global edit problem.
Re: QMEM2: Reactions and Suggestions Feb 02, 2006 01:44 am
1) I agree that this needs work. Setting up a "Copay" service and entering it a separate item is not an elegant solution at all.
2) I'm undecided about that at this time.
3) UI's in new software always need work. They'll get it as long as we make reasonable/clear suggestions. Plus "You never please everyone all of the time", so as long a I can do some key things like tabbing from fields I'll be pretty happy. But I will continue to make suggestions. ;-)
4) Name changes work globally, but you may be referring to something else. I'm still a little perplexed that you can't delete a Service/Provider/Insurer once you save one. You can only Hide it (and it still shows up in certain report listings), or rename it to a correct one.
5) I very much agree with this one. There needs to be a way to track when a claim has been sent. Sometimes they take months to process something and they always say that it will take AT LEAST 30 days. Well if you get enough of those 30-day items in queue then it get pretty hard to keep track of them when they are falling behind reimbursing you. Same for FSA's, only they tell that the maximum wait time should be 15 days instead of 30 days.
6) That would be nice, but I would rather see them add a status of Unpaid/Rejected, or make payment/status fields editable.
7) I'm not sure how to address this, but it does need to be addressed. Those weekly/biweekly therapies really add up fast. We had that problem when we would get a quarterly statement for therapies from three different departments and it was a nightmare to track them.
8) Yes, I agree that there need to be a way to assign a searchable claim number. In fact the search function needs to be expanded over all. One can still not search with Note fields where a great deal of valuable information is now be placed by QMEM users.
All that said, it is a great program, and answers a
huge unmet need, and I remain grateful to Intuit and
your team for your attention and interest in user
needs!
Yes, it has already opened my eyes to how much my family is spending on medical services every month. I cringe to even think about it! It should be a HUGE help come tax time. Unfortunately I'm a new user so it probably won't help much with my 2005 taxes.
For my version of blue cross, there are several
services that have a cap on number of visits, not
cost - and that number varies with the service. For
instance, speech therapy for an ongoing condition has
a max of 100 visits per year. Occupational therapy
same limit. Other kinds of therapy have different
numbers of visits. So, it would be great if in
defining a service (eg speech therapy), you could
indicate a max visit number tied to an insurer. Or
perhaps this would be set up for the insurer along
with deductibles and OOP max. In either case, the
OOP/deductible report could become an insurance
limits report and could also indicate how many visits
you had remaining for any services with caps on no.
of visits. Of all my suggestions, I think this is
probably the simplest to code- just have to count
visit dates for each service and subtract from the
defined limit.
Thanks,
Michael
Michael, you are right that most insurance companies limit the "number" of therapy visit rather than solely the amount in dollars (insurers actually limit both). This really does need to be addressed and tracked in QMEM. I'm sure that more and more boomers will be having things such as knee surgeries/replacements, etc. that will require some PT afterwards and it will be important to not go over what your insurance allows.
Thanks for the input and allowing other QMEM users to comment with you.
Message was edited by
LanMan
I'm not sure why the system crammed all of my paragraphs together, but I can't get it to display them the way that I wrote them. Sorry that it's so hard to read.
Re: QMEM2: Reactions and Suggestions Feb 02, 2006 01:14 am
To LanMan RE: Formatting.
The "paragraph crunch" in your post occured because you used the buttons to supply the bold formatting to the word "nightmare". If you replace the angle brackets around the b and /b to square brackets, like this it will format correctly. Reply to this post and click "Quote Original" to see what I mean.
I didn't reply to your post directly so that you could still edit it.
Re: QMEM2: Reactions and Suggestions Feb 06, 2006 10:41 pm
Great suggestions. I had actually sent feedback on many of these myself before I found the forums. Right now, the one that would most benefit me is the ability to apply a payment to multiple visits.
I also end up doing most of my own billing due to out of network providers. So I tend to spend a lot of time figuring out when I sent a claim and how soon to follow up with the insurance to find out when they are going to pay. Fortuantely, the one insurance company we had that was notoriously bad at paying claims without a phone call is gone, and I think this won't be as much a problem this year. But I would like to be able to select multiple expenses and indicate that I submitted a bill for them on a particular day and to then be have a reminder set for all the expenses at the same time for a month away so I get prompted to follow up if they don't pay.
Re: QMEM2: Reactions and Suggestions Feb 08, 2006 12:29 am
Hi michaeljasper, lanman, apwilhelm and phyllish,
Great comments here! Thanks.
Briefly -- for grouping a number of expenses together into one claim, have you tried making up an appropriate Reason... which could even be the claim number?
This way the expenses can still be seen on their own (by service date), but you can group them together in Cost Calculator.
It would also be a little easier to change each of them if need be.
If you wanted to track payments independent of the individual expenses, you could add a separate line item for a service called e.g. Payment where you enter as many installment payments as you want (under the same Reason).
And the Cost Calculator view of that Reason:Claim Number would show you My Responsibility and My Payment totals, to let you know where you stand against that Claim Number. Fair enough?
- Bruce
(The "Reason" is up to you, do what you want with it...)
Message was edited only to ask -- "Does this meet your needs?" Quicken Bruce
Re: QMEM2: Reactions and Suggestions Feb 09, 2006 12:24 am
Hi Bruce-
Thanks for your response.
Unfortunately, the answer to your final question is "no" - this does not meet the needs. It is an awkward workaround with serious flaws.
First, doing what you suggest, means you no longer can use the "reason" field for what it was intended - a reason for treatment! You can't use it to tie together multiple expenses with different services for one reason, and also use it to tie together expenses batched in one claim.
As far as the suggestion around payments, nope - that doesn't work either. If you only put expenses from one provider/service into each claim, then this could work, albeit with the problem above. However, as I have many expenses for different services/providers that I need to submit for reimbursement, my claims typically have many different "accounts" involved. So, if I turned Reason into Claim Number, it could not also serve as a way to tie payments together.
I appreciate your attempt to come up with a quick way to handle this - but both of these need to be addressed for real. As I said originally, adding a "claim date" field would at least allow you to filter on that. But for payments, you need to have a way to track amounts due and payments by provider, not just by expense.
Re: QMEM2: Reactions and Suggestions Feb 09, 2006 08:35 am
Are we not saying that there is a need for diagnosis codes - required by line item rather than visit. For instance, husband went to doctor. Reason 1, but usually is given Dx 1 and Dx 2. OV is for Dx1 and Dx2. He had bloodwork done. BW1 and BW2. BW1 was Dx1 and 2, but BW2 was only Dx2.
Or, I go to the doctor b/c of a chronic condition - in fact I have 3 diagnoses. But any treatment may only apply to one of them at any time, or even to another diagnosis like the time I got poison ivy.
So, it would seem a Reason code for a global tracking, but a diagnosis code added to the line items might resolve some of these problems being discussed? Comments please.
Re: QMEM2: Reactions and Suggestions Feb 09, 2006 11:24 am
My opinion is that dx codes would be benficial for patient history not for claims - at least for chronic issues. For acute claims don't think it's necessary to track to same degree (unless family has many claims). I'm less concerned about running the kids to the pediatrician for a strep test & having that as a dx code. If it's positive, the strep dx code doesn't do anything for me. I'll have that covered in the provider & reason info anyway. Insurance works with CPT codes which I do keep track of in the medical notes section but more for important claims not for the strep test. I have the dx code for my oldest's disability; the CPT code for various therapies, etc.
I'd rather have date of service, date claim submitted, date claim paid, etc. Someone else mentioned it someone on these boards. Having multiple date fields with drop-down choices so we can enter what is most important to us.
