professional to help organize medical expenses tracking?

[Anonymous]

Are your children able to help you?

I got good at paperwork because my mother asked me for help with my parents' taxes when I was in 10th grade. She wanted someone to read the booklets and concur with her understanding. Also to tell my dad what could and could not be deducted.

If your children are able to contribute organization and printing and managing receipts related to their care, I suggest you enlist them.

Apologies if that's not a possible solution.

[Anonymous]

21:49 again. Actually for you I might suggest a regular credit card to help you track. Use that card only for all medical (or all the ones you're likely not to know the amount for at the point of service - rx at least for us never changes from what gets charged at the pharmacy, hence it's a good service to use the FSA card for) then it can be easier to reconcile to the transactions you downloaded from insurance. You will have to track refunds, but it might help.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Our FSA limit was easy to fill with dentist and pharmacy copays so when we deducted medical expenses in a few years when we had expensive surgeries with out of network surgeons, I just ignored those.
All you save is some income tax on the margin. It your expenses are that big you could bag the FSA but then have even more receipts to log.
Even with an accountant or bookkeeper you still need to give them the receipts.
I am not sure you need to hassle the portals because you only need what you pay, presumably there is a bill or invoice they send you or give you. That's what you deduct.

What I am dealing with right now is that we do not get sent any invoices. For instance, my son has a therapist who bills me (charges my credit card on file) and then as a courtesy files with my insurance company. Insurance company sends me a small check for the part that they cover. Insurance EOB has all the numbers on it but they add extra numbers so it isn't immediately apparent (to my FSA) exactly what I paid out of pocket. Because insurance has their "allowable amount" and "part you are responsible for" (but since therapist is out of network, I'm responsible for more than just that if that makes any sense.

I don't actually see a bill from the therapist. There is an online portal but I just checked and there isn't any receipt there that I can print out. I think I have to call the therapist and get them to send me a year's worth of receipts...It's stuff like that.

But I can see that even trying to get this all organized for some online bookkeeper to help me out will be a lot of work; if I am going to go to all that effort I probably should just take a day off of work and sort it through myself. I'm sure I can do it, I just really really don't want to.

OP, I dread task organization like that too, but after I do it I feel so good. If you get a system started it should be easy for you or a personal assistant to fill in. Once you know how much you spend, you can ask your accountant about the best way to tax advantage.

There are organizers on Etsy. I was recently looking for a financial one and came across some for health management - which I also need a better system for. Here are some I bookmarked, but I haven't used any.

https://www.etsy.com/listing/1853253375/medical-expense-tracker-google-sheets?ref=user_profile&pro=1
https://www.etsy.com/listing/1805235807/hsa-expense-tracker-google-sheets?ls=a&ref=listing_page_ad_row-3&pro=1&dd=1&plkey=LT861e2b9048e861f0b6f13a17e7489a3a62d973ae%3A1805235807&listing_id=1805235807&listing_slug=hsa-expense-tracker-google-sheets
https://www.etsy.com/listing/4367938856/medical-binder-printable-chronic-illness?ls=a&ga_order=most_relevant&ga_search_type=all&ga_view_type=gallery&ga_search_query=health+tracker&ref=sc_gallery-1-2&sr_prefetch=1&pro=1&sts=1&dd=1&nob=1&plkey=LTead19292ca5ec9a8d10bea0b762c3f89a8e8da54%3A4367938856

[Anonymous]

Anonymous wrote:
If you tell us the column headings you see, maybe we can tell you which ones mean what.

This is the thing that has me tripped up right now. Here's just one example... it is repeated many times per year, for both me and one of the kids. It's for therapy/medication management that is not with an in network provider. I pay the provider directly and then my insurance reimburses me a little bit.

Submitted charges $145
Plan Allowance $94.20
CoInsurance or Copay $32.97
What we paid $61.23
You Owe the provider $145

Note: I PAID the provider $145
BCBS sent me a check for $61.23 (what they were willing to cover)

My FSA looks at this and thinks I paid only $32.97 so that’s all they will allow me to get back from them.

I want $83.77 back from the FSA. That's $145-$61.23 which is what I paid out of pocket.

Two things I should have done:

1) Given the provider my FSA card to charge instead of my cerdit card. That's apparently what I did last year.
2) Gotten an invoice from the provider for each service.

What I have noticed: Last year, I think I got back the full amount from my FSA for what I paid the provider, even though it was reimbursed partially from BCBS. That's my worry/concern - I think I am doing things slightly wrong. I wish I could have someone sit with me and look it all over.

[Anonymous]

Anonymous wrote:Your husband's costs are more than 7.5% of AGI after Medicare and his insurance? Is part of it prescriptions?

Yes. It's for home health care aides. He needs someone with him 8 hours per day so I can work. It's very expensive, and not covered at all by Medicare or other insurance sadly. It's about $1400 per week, so yeah it adds up. About $60,000 to $70,000 annually.

If you are severely disabled, such that you cannot perform 2+ daily activities of living, you can deduct the entire cost of home health aides from your taxes, over and above 7.5% of your AGI.

According to IRS publication 502 these expenses should be deductible as they are a type of Long Term Care called "maintenance and personal care services"

page 10: https://www.irs.gov/pub/irs-pdf/p502.pdf

Long-Term Care
You can include in medical expenses amounts paid for qualified long-term care services and certain amounts of premiums paid for qualified long-term care insurance contracts.

Qualified Long-Term Care Services

Qualified long-term care services are necessary diagnostic, preventive, therapeutic, curing, treating, mitigating, rehabilitative services, and maintenance and personal care
services (defined later) that are:

1. Required by a chronically ill individual, and
2. Provided pursuant to a plan of care prescribed by a licensed health care practitioner.

Chronically ill individual. An individual is chronically ill if, within the previous 12 months, a licensed health care practitioner has certified that the individual meets eitherof
the following descriptions.

1. The individual is unable to perform at least two activities of daily living without substantial assistance from another individual for at least 90 days, due to a loss of functional capacity. Activities of daily living are eating, toileting, transferring, bathing, dressing, and continence.

2. The individual requires substantial supervision to be protected from threats to health and safety due to severe cognitive impairment.

Maintenance and personal care services.[i][u]
Maintenance or personal care services is care which has as its primary purpose the providing of a chronically ill individual with needed assistance with the individual’s disabilities

[Anonymous]

We only ever use FSA card for things not covered by insurance at all or for in network providers that want copays and for drugs at Safeway.
You have to pay back reimbursements.
Also FSA and IRS go on allowed charges. Not whatever they charged you for
So there was an Allowed $94.20. Insurance sent you $61.23 of the $94.20. FSA sent you the copay. The insurance and copay equal the allowed cost.
If you paid $145 well they aren't participating providers and you don't get made whole.
I am not sure what you did last year worked out right. DH got balance billed in advance for an MRI, put on his FSA. We had to write a check to FSA to repay that because provider was in network and got paid in full by insurance and our copay was $20. It took 5 months to get the refund from provider for what was basically double billing.

[Anonymous]

Anonymous wrote:We only ever use FSA card for things not covered by insurance at all or for in network providers that want copays and for drugs at Safeway.
You have to pay back reimbursements.
Also FSA and IRS go on allowed charges. Not whatever they charged you for
So there was an Allowed $94.20. Insurance sent you $61.23 of the $94.20. FSA sent you the copay. The insurance and copay equal the allowed cost.
If you paid $145 well they aren't participating providers and you don't get made whole.
I am not sure what you did last year worked out right. DH got balance billed in advance for an MRI, put on his FSA. We had to write a check to FSA to repay that because provider was in network and got paid in full by insurance and our copay was $20. It took 5 months to get the refund from provider for what was basically double billing.

Sorry, can you explain that bodled part?? Are you positive you are correct?

I don't think you are.

"Allowed charges" is between you and your insurance company. If they don't choose to cover a procedure, you still haev the expense and still can use your FSA to pay for it.

[Anonymous]

Anonymous wrote:We only ever use FSA card for things not covered by insurance at all or for in network providers that want copays and for drugs at Safeway.
You have to pay back reimbursements.
Also FSA and IRS go on allowed charges. Not whatever they charged you for
So there was an Allowed $94.20. Insurance sent you $61.23 of the $94.20. FSA sent you the copay. The insurance and copay equal the allowed cost.
If you paid $145 well they aren't participating providers and you don't get made whole.
I am not sure what you did last year worked out right. DH got balance billed in advance for an MRI, put on his FSA. We had to write a check to FSA to repay that because provider was in network and got paid in full by insurance and our copay was $20. It took 5 months to get the refund from provider for what was basically double billing.

Yeah, that's what I am worried about - I feel like I am totally screwing things up here. I am very confused and I don't understand what I am doing!

(LOL to a PP, no my children would be worse than no help.)

[Anonymous]

Ok I am the one who did the text that got bolded. I msy be wrong.
For us, most FSA use was for things covered by in network providers so as in your example OP we never would have paid the $145 we would have paid a copay and been done. I thought I remembered being limited to the copayment in our FSA.
I also thought that when we claimed the medical expenses for our surgery we had restrictions but I may be wrong, sorry.

[Anonymous]

Anonymous wrote:What kind of person can help me organize my recordkeeping in this situation?

I have a family of 4 - one very disabled adult who has a lot of medical costs - so much so that his expenses alone exceed 7% of our AGI. So we can deduct ALL our medical expenses above that threshhold from our taxes.

My two adult children (under 26) and I are both covered under his health insurance from work. He has Medicare as primary and his insurance as secondary. Kids and I have a decent amount of medical and dental issues with various doctors and dentists and therapists - all have their own billing system online. For dental coverage, my husband's insurance covers some and then I have insurance that covers some.

I have an FSA set up as well. So I just have a lot of bills and reimbursements and checks and deposits to manage - money is coming in and out. I can NEVER understand the EOB I get sent- can't figure out exactly what my FSA should reimburse or what I can list as a tax deduction at the end of the year.

I don't think I need a tax accountant for this, but some kind of bookkeeping help? I need to create some kind of workflow or process to track all bills, reimbursements and payments from the different insurers and the FSA to track out-of-pocket expenses versus reimbursed expenses. I'm worried about having proof in the event of an audit.

(It doesn't help that the kids are both still on our insurance but over 18 so I need them to print out documents and bills from their patient portals!)

I am really disorganized but trying to do my best but it would be great if someone knowledgable about both medical bills and taxes could help me get on the right track. Any suggestions?

I used these people on rockville for something else that was similar but not ongoing. It was helpful.
There are probably others who do this work locally too.

Expert Money Managment - Maryland and DC https://share.google/s8OfhyBHed5KkSQx8

[Anonymous]

Anonymous wrote:

Anonymous wrote:What kind of person can help me organize my recordkeeping in this situation?

I have a family of 4 - one very disabled adult who has a lot of medical costs - so much so that his expenses alone exceed 7% of our AGI. So we can deduct ALL our medical expenses above that threshhold from our taxes.

My two adult children (under 26) and I are both covered under his health insurance from work. He has Medicare as primary and his insurance as secondary. Kids and I have a decent amount of medical and dental issues with various doctors and dentists and therapists - all have their own billing system online. For dental coverage, my husband's insurance covers some and then I have insurance that covers some.

I have an FSA set up as well. So I just have a lot of bills and reimbursements and checks and deposits to manage - money is coming in and out. I can NEVER understand the EOB I get sent- can't figure out exactly what my FSA should reimburse or what I can list as a tax deduction at the end of the year.

I don't think I need a tax accountant for this, but some kind of bookkeeping help? I need to create some kind of workflow or process to track all bills, reimbursements and payments from the different insurers and the FSA to track out-of-pocket expenses versus reimbursed expenses. I'm worried about having proof in the event of an audit.

(It doesn't help that the kids are both still on our insurance but over 18 so I need them to print out documents and bills from their patient portals!)

I am really disorganized but trying to do my best but it would be great if someone knowledgable about both medical bills and taxes could help me get on the right track. Any suggestions?

I used these people on rockville for something else that was similar but not ongoing. It was helpful.
There are probably others who do this work locally too.

Expert Money Managment - Maryland and DC https://share.google/s8OfhyBHed5KkSQx8

Omg this looks perfect, thank you!

[Anonymous]

Anonymous wrote:

Anonymous wrote:
If you tell us the column headings you see, maybe we can tell you which ones mean what.

This is the thing that has me tripped up right now. Here's just one example... it is repeated many times per year, for both me and one of the kids. It's for therapy/medication management that is not with an in network provider. I pay the provider directly and then my insurance reimburses me a little bit.

Submitted charges $145
Plan Allowance $94.20
CoInsurance or Copay $32.97
What we paid $61.23
You Owe the provider $145

Note: I PAID the provider $145
BCBS sent me a check for $61.23 (what they were willing to cover)

My FSA looks at this and thinks I paid only $32.97 so that’s all they will allow me to get back from them.

I want $83.77 back from the FSA. That's $145-$61.23 which is what I paid out of pocket.

Two things I should have done:

1) Given the provider my FSA card to charge instead of my cerdit card. That's apparently what I did last year.
2) Gotten an invoice from the provider for each service.

What I have noticed: Last year, I think I got back the full amount from my FSA for what I paid the provider, even though it was reimbursed partially from BCBS. That's my worry/concern - I think I am doing things slightly wrong. I wish I could have someone sit with me and look it all over.

Thanks. I agree you should get $83.77 from the FSA. I would escalate that with the FSA people.* Or else just use the FSA for more straightforward in network or Rx claims.

*I have have to email my FSA provider and escalate when even the first email response was wrong. My issue was different, but they ended up agreeing with me and reimbursing the correct amount. I think some of the claims are read by AI now? Are you submitting a claim for $83.77 or just uploading the EOB? Agree that you need the receipts (superbills) that you paid the provider $145. You can still request the invoices now and resubmit the claims (or submit supplemental info). They can probably give you and annual superbill.

What I would not do as I said yesterday is use the card for the whole $145 because then you're fraudulently counting the $61.23 twice.

[Anonymous]

Anonymous wrote:

Anonymous wrote:We only ever use FSA card for things not covered by insurance at all or for in network providers that want copays and for drugs at Safeway.
You have to pay back reimbursements.
Also FSA and IRS go on allowed charges. Not whatever they charged you for
So there was an Allowed $94.20. Insurance sent you $61.23 of the $94.20. FSA sent you the copay. The insurance and copay equal the allowed cost.
If you paid $145 well they aren't participating providers and you don't get made whole.
I am not sure what you did last year worked out right. DH got balance billed in advance for an MRI, put on his FSA. We had to write a check to FSA to repay that because provider was in network and got paid in full by insurance and our copay was $20. It took 5 months to get the refund from provider for what was basically double billing.

Sorry, can you explain that bodled part?? Are you positive you are correct?

I don't think you are.

"Allowed charges" is between you and your insurance company. If they don't choose to cover a procedure, you still haev the expense and still can use your FSA to pay for it.

I agree with you, OP. I don't think that poster is correct about FSA using only insurance "allowed charges." As long as the therapy is medically necessary, you can get reimbursed for what you actually paid.

[Anonymous]

Anonymous wrote:

Anonymous wrote:We only ever use FSA card for things not covered by insurance at all or for in network providers that want copays and for drugs at Safeway.
You have to pay back reimbursements.
Also FSA and IRS go on allowed charges. Not whatever they charged you for
So there was an Allowed $94.20. Insurance sent you $61.23 of the $94.20. FSA sent you the copay. The insurance and copay equal the allowed cost.
If you paid $145 well they aren't participating providers and you don't get made whole.
I am not sure what you did last year worked out right. DH got balance billed in advance for an MRI, put on his FSA. We had to write a check to FSA to repay that because provider was in network and got paid in full by insurance and our copay was $20. It took 5 months to get the refund from provider for what was basically double billing.

Yeah, that's what I am worried about - I feel like I am totally screwing things up here. I am very confused and I don't understand what I am doing!

(LOL to a PP, no my children would be worse than no help.)

That PP's husband's case is different though. It's equivalent to you paying the provider the $145 and the provider refunding the $145-94.20. That's correct for in network because the provider ends up with $94.20 and it was the office that billed the MRI wrong. OP's case is different because the therapist actually gets paid $145 because they really are OON and therefore permitted to balance bill. So OP paid a net of $83.77, all of which can be reimbursed by the FSA.

If you can't get the FSA provider to fix it, you could deduct the $87.33-32.97 from your taxes.

Also in general don't forget to deduct or claim to the FSA for mileage.

[Anonymous]

You could find others by searching for daily money managers. Here’s a trade group with a search option

https://secure.aadmm.com/find-a-dmm/