The product would be truly be enhanced if you could log EOBs and Invoices separately and "assign" an EOB to an invoice. This would allow you to track duplicate invoicing from a provider to your insurer and ensure you are not overcharged on co-pays and deductibles.
In the claims detail you should include the following fields to help track/resolve disputes:
Claim #
Insurer Receive Date
EOB Date
Insurer Reason Code
Provider Invoice #
I find it hard to believe that this was developed by someone trying to track medical expenses and these key fields were left out. I downloaded this product an hour and a half ago and am already disappointed.
Dechevar, I'm sorry you're disappointed, but I thank you for the suggestions. Does the Billing Notes field help you track the additional fields you mention? That was the intention behind it. Not everyone wants to track exactly the same things, so that field is open to be used in whatever way works for you. Please let me know whether that's useful.
I hope you'll continue using QMEM, but if you find it doesn't serve you well, you can of course return it for a full refund within 60 days. To do that, keep your order number and contact us through the <url=https://quickenmedical.custhelp.com>Customer Care site.</url>
'Tis been a long time since you posted, but, if I understand you right, you need to tie the invoice to the EOBs.
My situation may be simpler than your, but here's what I've been doing for some 4 yeas now (on an spreadsheet before MEM). I use the service date, which is common to the bill, and the EOB and enter the EOB's date on the date paid field in the insurance screen. I then file the EOB in date sequence.
For the OP's comments to really make sense, you have to recognize that he was using v1 which didn't have the insurance screen.
Additionally, his key point seemed to be matching up multiple invoices to an EOB, which I don't see how your method would address.
Also, considering the OP's original word choice and overall behavior <not bothering to fill out his user profile and posting exactly once>, it seems unlikely he was here for answers.
Which is unfortunate, for if he had arrived with something closer to your attitude, he probably could have provided some highly valuable insights during the v1 to v2 transition period.
understand you right, you need to tie the invoice to
the EOBs.
My situation may be simpler than your, but here's
what I've been doing for some 4 yeas now (on an
spreadsheet before MEM). I use the service date,
which is common to the bill, and the EOB and enter
the EOB's date on the date paid field in the
insurance screen. I then file the EOB in date
sequence.
I do the same with the Medicare Summary Notices.
HTH
Fernando
Fernando,
I use the same general procedure as you describe.
When there is an office visit or procedure, I use the date of service to post the event in MEM and flag it "Pending: Insurance." If there is a visit or procedure related piece of paper it goes into a temporary file folder marked "waiting on EOB."
When the EOB arrives, it may reflect one or multiple dates of service. I enter the EOB information into the Details section of the appropriate date(s)of service and flag the date of service as "Pending: Provider." The EOB hooks up to other temporary file folder stuff with the same date of service and is marked "waiting on invoice."
When the provider invoice arrives, I check to make sure it conforms to the EOB for any relevant dates of service and enter any necessary info in MEM. Any necessary payments are made and the date(s) of service are flagged as "Paid."
If Medicare is involved, there is another "waiting on Medicare Summary" step.
I use a procedure that's a slight variance from what's been described.
I first need to describe our insurance, and our main provider's billing policies, which appear to be different from others described here.
The big difference is that pharmacy expenses are treated like any other medical expense ... that is, whether insurance pays or not depends upon whether we, separately, have satisfied the deductible for the year. The deductible that we pay is also our "out of pocket max", so satisfying the deductible also satisfies "OOP". After that, all expenses -- medical & pharmacy -- are covered 100%.
The upshot is that while our providers submit their own claims to our insurance, we have to pay upfront for pharmacy and submit claims -- which are typically paid within a week.
SO, I have slightly differing procedures for pharmacy vs. other medical expenses. For pharmacy, I record the purchase in QMEM with a status of "Pending:Me" until I submit the claim, at which time I change the status to "Pending:Insurance". Assuming that there's no problems, the insurance screen gets updated appropriately, and the record marked "Paid", when I get the EOB and any reimbursement check.
The other difference is that, for a typical office visit, we incur two separate sets of charges: 1 for the MD, from the "medical group" and another, for labs/chemo/etc., from the "medical center".
For the medical center, I record the event as "Pending:Provider", because I know that they frequently don't submit claims for a month or so. When I receive the EOB, the status stays as is (because, now, I'm waiting for the provider to post the EOB). When I observe on the medical center's secure web site that the EOB has been posted, the status is changed to "Pending:Me" -- if our deductible hasn't been satisfied -- or "Paid" if it has. If I need to make a payment, I change the status to "Pending:Provider" at that time, until they post the payment.
Meanwhile, for the medical center, I've ususally gotten a bill while I'm awaiting the EOB. This gets filed in the "Waiting" folder until the corresponding EOB comes in. For the "group", I usually don't receive a bill until after an "I owe money" EOB has been received ... and if I don't owe, I'll never receive a bill (which makes sense, from a cost of postage & effort perspective). So, EOBs for doctors frequently go straight from the "Waiting" to "Paid" folders with no invoice attached. I can, however, get the necessary info from the secure web site.
db
THINK IT THRU! Have you explained your issue so that someone who knows nothing about you, or YOUR Quicken setup, can understand what your issue is? Are you using standard Quicken terminology, particularly with respect to FILES, ACCOUNTS and CATEGORIES?
Hey, db. It's amazing how systems vary. This is the stuff that probably drives Quicken Bruce and the other MEM folks nuts. ;-)
Prior to Medicare, my system was fairly similar to yours. Drugs were paid up front and submitted for reimbursement. Doctor visits and procedures had an up front co-pay followed by an EOB from the insurer and an invoice from the provider. Fortunately, "most" providers did not invoice until they received the EOB ... at least the ones in the PPO network.
I'm finding MEM to be very flexible ... it just takes a little creativity to make the pieces fit together for each individual situation. :|
One of the values of this forum is it provides an opportunity for LOTS of folks to discuss their particular situations ... so that others can realize that they're not alone.
This is the
stuff that probably drives Quicken Bruce and the
other MEM folks nuts. ;-)
I'd say "nuts-er". Everyone in the software business is nuts ... myself especially included.
Prior to Medicare, my system was fairly similar to
yours. Drugs were paid up front and submitted for
reimbursement. Doctor visits and procedures had an up
front co-pay followed by an EOB from the insurer and
an invoice from the provider.
I don't have an upfront copay, but otherwise OK
Fortunately, "most"
providers did not invoice until they received the EOB
... at least the ones in the PPO network.
I'm finding MEM to be very flexible ... it just takes
a little creativity to make the pieces fit together
for each individual situation. :|
Besides creativity, it also takes some thought of "what's happening here". Knowledge that other's have already been in one's situation is a significant benefit of these fora.
db
THINK IT THRU! Have you explained your issue so that someone who knows nothing about you, or YOUR Quicken setup, can understand what your issue is? Are you using standard Quicken terminology, particularly with respect to FILES, ACCOUNTS and CATEGORIES?