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.)

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.

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.

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

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?

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.

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.

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

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

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.