How best to track medical expenses and medical records?
June 24, 2014 8:18 AM   Subscribe

Can you give some advice on how to document/archive medical expenses and medical records? My wife and I are particularly meticulous filers, but I don't think we've found our best practices for the medical stuff. Details inside.

We've got good systems for things like account statements and taxes, etc., but the medical stuff is throwing me a loop. We need both a system to track both records and open billing items.

Generally, everything is scanned and filed on the computer. We don't keep paper long term, other than documentation we'd need originals for.

We have your usual medical and dental plans, though our medical plan is a high deductible plan with an HSA (we also have an FSA). We are trying to leave the money in the HSA so that it can grow, so we need a system that allows us to keep track of our past medical expenses for reimbursement in future years (5, 10, 25 years later, whatever); the FSA, which just covers vision and dental, we draw from as soon as we spend the money.

Meanwhile, the insurance company will send us EOBs that relate to claims for services that we need to keep track of (and often, double check). E.g., an EOB will arrive with an unfamiliar service provider, and we have to confirm it was the nurse who saw me for a clinic visit, or the EOB will say the provider can bill us $211.41, but we received a bill only for $123.21 (or no bill at all) and we want to stay on top of what we could be charged. We use a shared Googledoc for this now, but it's hard to keep current.

As for medical records, rather than billing records, we have your typical lab results, prescriptions, etc.

Do you have recommendations about how best to organize these materials? For instance, I can't tell if it makes more sense to file all of the billing records by year, or by which of us was the patient. For medical records, do I file by year or by complaint? Or broken down by complaint by year?

Not having a great system in place has meant that these records are scattered in a few places, and the Googledoc is out of date, and I'd like to fix that.
posted by Admiral Haddock to Grab Bag (5 answers total) 12 users marked this as a favorite
Microsoft HealthVault -

cakehealth -

There are others out there but the above 2 are the only ones I have experience with.
Google had their own PHR (personal health record) application but they killed it a couple of years ago.
posted by eatcake at 8:28 AM on June 24, 2014

So I'd be inclined to go with one of eatcake's suggestions (or similar), but if you prefer to do this on your own:

For instance, I can't tell if it makes more sense to file all of the billing records by year, or by which of us was the patient.

I think you should sort by both. I'm thinking a GoogleDoc spreadsheet with one tab for each of you, with individual items on each tab organized by date (ascending/descending, whatever floats your boat). And then two folders (one for each of you) for PDFs of supporting documentation.

For medical records, do I file by year or by complaint? Or broken down by complaint by year?

Both can be helpful in different circumstances, so make both pieces of information readily available. For example, you could have columns in your GoogleDoc spreadsheet for date and complaint, then your PDFs of supporting documentation could be namely thusly: "2014-06-24 PATIENT NAME twisted ankle" or "2013-11-19 PATIENT NAME tonsillectomy"
posted by schroedingersgirl at 8:59 AM on June 24, 2014

My system is: Excel spreadsheets - one sheet for office visits and one for prescriptions. There is one row per billed service by the provider, and I input them chronologically by date of service. Into each row's columns, I gradually input information about the original billed fee, the payment negotiated by the insurer, the payment made by the insurer, and any payment made by me, as that correspondence rolls in. I take notes about correspondence with the medical office/insurers in columns of the spreadsheet. I do have to stay on top of entering new correspondence (EOBs, bills) into the spreadsheet, which is tedious.

At the end of the year, I can easily sum up the column of payments made by me for use in my federal taxes. It's also easy to see when the insurer has been delinquent and misplaced a claim. Since I enter the amount the insurer pays, or negotiates down the initial bill from the medical care provider, I can also do some cost-benefit calculations about my insurance plan.

Additionally, I keep folders of lab tests results organized by complaint (e.g. one folder for a certain surgery, another relating to migraines), and an additional folder for general primary-care lab results (e.g. yearly garden-variety blood analysis) organized by date.
posted by scrambles at 11:34 AM on June 24, 2014 [1 favorite]

I've got to second the idea of rolling your own spreadsheet for this. I had to work through about $100,000 in billed medical expenses from 2012 (pregnancy, birth, RSV, helicopter ride to children's hospital, week in ICU...).

I break it down by Patient then complaint and then provider.
posted by Broken Ankle at 1:32 PM on June 24, 2014

You say you don't keep paper for long, but I keep paper for as long as that specific incident is still open. All the paperwork for the incident gets paperclipped together with a cover sheet stating what is inside the clip, and notes stating who I've spoken to and what I'm expecting next. The clipped files are all in the same folder labeled "open medical". Once it's all paid and settled, then I log it or scan it or whatever.
posted by CathyG at 8:34 PM on June 24, 2014

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