Medical Bill Mysteries: New Tool

Stethoscope with a $100 bill

For the past year-and-a-half I have joined others in being surprised, frustrated and horrified by the “Bill-of-the-Month” news stories presented cooperatively by National Public Radio (NPR) and Kaiser Health News (KHN). The NPR/KHN team receives real bills from real people across the U.S., for treatments ranging from a cat bite and a knee brace to spinal surgery and stroke.

In every case, the consumer submitted the bill because it either seemed outrageously high or it just didn’t make sense. The investigative reporters dug into the issues, usually gathering information from the medical provider and the insurance company as well as the consumer. Sometimes they found errors that could be corrected to reduce the bill; more often, they uncovered prices that were simply inexplicably high. Sometimes, but not always, shining the light of publicity on the situation led to a reduction or elimination of the bill.

Last month Kaiser Health News launched “Your Go-To Guide to Decode Medical Bills.” This new tool includes three components: 1) Pro Tips for Navigating Surprise Medical Bills; 2) a helpful Glossary; and 3) an example of a medical bill and corresponding insurance documents, with notes highlighting key items to pay attention to. The guide is not a magic wand – it doesn’t make navigating difficult medical bills easy. But it does point consumers in the right direction, so we can get started advocating for ourselves and our loved ones.

The guide reminds us that our consumer options begin even before we seek medical treatment – with a set of items to check on before going in or making an appointment. If, despite advance preparation, you end up with a surprising medical bill, a key step is to request an itemized bill. Medical providers are required by law to provide this if consumers request it. Along with other tips, the guide identifies two websites that can help you compare the price you were charged with prices of other providers: Health Care Blue Book and Fair Health Consumer.

As consumers we need to be our own advocates. It helps to have some guidance on how to do that effectively!

Barb Wollan

Barb Wollan

Barb Wollan's goal as a Family Finance program specialist with Iowa State University Extension and Outreach is to help people use their money according to THEIR priorities. She provides information and tools, and then encourages folks to focus on what they control: their own decisions about what to do with the money they have.

More Posts

Navigation Apps- Failures

View of a car's dashboard, steering wheel, and street ahead.

My glove box is full of printed maps and I carry a road atlas with me on vacations. Even when my car was equipped with a navigation system, I still planned my trips with the aid of a printed map.

My experience using electronic navigation aids has been mixed. In the very early days of the programs, our home address was entered on a road one mile south of its actual location. Delivery van drivers had to be warned not to rely on them. We Extension field staff frequently have programs in unfamiliar locations and the apps have been helpful, but I’ve also had experiences with closed roads and wrong locations. This lack of reliability has taught me to allow ample time to search again when I land at the wrong place and ask a local resident for directions.

When it comes to travel, understanding how navigation systems work can help you pick the best one for the job. Examples of features that improve their guidance would be using traffic congestion to direct you to routes that are longer, but less likely to result in a white knuckle drive or traffic jams. Several commercial sites are available that rate the apps and share details about their operation.

Using navigation apps to locate specific nearby businesses and repair services has its own set of problems. One major navigation app has recently come under fire for a serious flaw in its program. Fake business listings are hijacking the names of real businesses, and then providing a phone number that calls a scam artist. The scammer is able to enter the fake business in multiple locations, making it more likely to appear early in the search results.

In the spirit of “buyer beware” it makes sense to use personal sources whenever possible for reliable contact information. Confirm business numbers by cross checking in a local directory or phone book. The Better Business Bureau or local Chamber office is also a source to confirm a location and phone number. Use the police department’s regular phone number if you can find no other source to confirm your information. IMPORTANT NOTE: 911 should only be used for an emergency.

Joyce Lash

Joyce Lash

Joyce Lash is a Human Sciences Specialist in Family Finance who wants to keep you ahead of the curve on financial information.

More Posts

Peak Alert

Peak Energy Alert

I love the fact that our home has hot-water heat. As a person with allergies, I am not overwhelmed in the summer or winter when the central-air or furnace blows the collected dust out of the vents. But with hot water heat, there’s no option for central air conditioning; I would have to say that this week I would give almost anything to have central air! As I write this during a heatwave, it is expected to hit 95 degrees today with a feel-like temperature of 103 degrees. I can only imagine how widespread the brown-outs will be with everyone retreating to their air-conditioned homes and places of employment.

So, what about those brown-outs? In visiting with my co-worker (who has central-air) I have learned that our local energy-provider has a program called Appliance Cycling. This program will not only reduce the amount of energy used by the homeowner, which will reduce their cost…but the homeowner will also be compensated with a credit of $8/month for participating in the program.

When you sign up for the program, a technician will come to your home and install a small radio-control switch on or near your outdoor central air conditioner at no cost to the homeowner. 

If the demand for electricity escalates to a critical point, a “system emergency” or “peak alert” is announced, and a radio signal is sent to activate the switch on your air conditioner. Your outdoor cooling unit will then cycle off while the furnace fans continue to circulate the cooler, drier air already in your home. 

The program runs from May to September and the cycling events typically occur Monday through Friday from 1 PM – 7 PM…never on weekends or holidays.

My co-worker says she notices a slight difference in the temperature and humidity in their home during peak alerts but nothing that a box fan or ceiling fan can’t make up for. Do you have a similar program in your area?  What has been your experience? As for me…I think I will plan on supper at a restaurant!

Brenda Schmitt

Brenda Schmitt

A Iowa State University Extension and Outreach Family Finance Field Specialist helping North Central Iowans make the most of their money.

More Posts

To Buy or Borrow?

My family just returned from a camping trip in the mountains of Montana. Our decision as to where to camp was determined by the fact that not all campsites would allow soft-sided tents and campers because of bears living in the area. We drove up into the mountains to picnic, visit sites and see the wildlife…including bears. Those that were serious hikers wore bells so bears would hear them coming; as to not surprise the bears that might be along the path. Hikers also carry BEAR SPRAY…a kind of “pepper spray” to temporarily blind a bear, giving a hiker a chance to escape, if they did come upon a bear. This product was sold in all the shops for more than $50 for a small spray can…OR you could rent a can. If you were a visitor to the area, and would not have use for the spray once you returned home, renting was a good option. At $10 per day rental, you would have to spend more than 5 days hiking to justify buying the can of spray.

Our son almost purchased a family pass at their local pool because that is what they had always done. At the last minute, he changed his mind and decided to buy a couple of punch cards. They have hired a high school girl to watch their oldest child for the summer, and wanted their daughter and the sitter to be able to spend time at the pool. The family pass would not cover a caregiver…only family members. When he added up the number of times they visited the pool, divided that into the cost of the family pass, it made more financial sense to buy the punch passes instead of the family season ticket.

I can think of many times where a decision to rent or borrow was a better financial choice…like borrowing an expensive tool that you would only use once or twice. I can also think of times where I mindlessly purchased something rather than looking for a more economical way of doing something…just because it was easier, faster or just “the way I’ve always done something.” How about you? What are some ways you have accomplished something without actually buying something?

Brenda Schmitt

Brenda Schmitt

A Iowa State University Extension and Outreach Family Finance Field Specialist helping North Central Iowans make the most of their money.

More Posts

Retirement: Longevity vs Life Expectancy

When planning for retirement, we often look up our life expectancy. One good source of life expectancy information is the Social Security Administration.   Among the many tools they offer is a life expectancy estimator. I looked up my own life expectancy.  Assuming I live to retirement age (67), the average life expectancy for a woman my age is 87. So that means I should plan for retirement to last till 87, right? Not so much. Remember: life expectancy information gives the average.  (I might not be average – what about you?)

I recently discovered a tool called the Longevity Illustrator, offered by the Society of Actuaries.  Why is this different than a life expectancy estimator? Because longevity is not the same as life expectancy! Longevity is broader — it addresses the likelihood that a person will live to various ages.

The Longevity Illustrator provides insight into possibilities — what are the “odds” that a person will live to extremely advanced age, for example? Again, I used myself as an example; remember that my life expectancy, assuming I live to age 67, is about 87. The longevity illustrator points out that there is nearly a 50-50 chance I’ll live to age 90, a 28% chance I’ll live to age 95, and a 10% chance I’ll live to age 100!!

What does that mean for our retirement planning? The longevity illustrator explains that each of us needs to decide what level of certainty is important to us. For me, they pointed out that:

  • If I am comfortable with a 25% chance that I might run out of money, then I might plan for a 28-year retirement.
  • If I want more security — perhaps only a 10% risk that I would outlive my funds, then I should plan for a 33-year retirement.

Anytime our decisions involve unknowns, like retirement does, we need to prepare for some complex thinking. We need to consider a variety of possibilities, and recognize that there will be no certainty; instead, we need to think in terms of probability. We also need to be prepared to be flexible. It’s a challenge, but having good tools can help.

Check out the Longevity Illustrator from the Society of Actuaries and see how it can inform your retirement planning decisions!

Barb Wollan

Barb Wollan

Barb Wollan's goal as a Family Finance program specialist with Iowa State University Extension and Outreach is to help people use their money according to THEIR priorities. She provides information and tools, and then encourages folks to focus on what they control: their own decisions about what to do with the money they have.

More Posts

Coupon Scams

It’s time to buy picnic supplies, watermelon, hotdogs, and buns for the 4th of July.  Shopping with a list and a coupon or two would lower the grocery bill. Maybe that is why the $80 HyVee coupon scam is circulating again.

The coupon looks authentic and so does the web page where you land to retrieve your big bargain. In a congratulatory invitation, victims are asked to answer a “customer survey” that gathers their name, birth date, telephone number, and email address.  Sharing a social media link is required, expanding the circle of individuals exposed to the scam.  The personal information is then used for other scams or sold to scam operations.

The Coupon Information Center lists on their counterfeit notification page over 19,000 fake coupons.  Fake coupons are more likely to offer free items or high dollar values. They are also common in bulk coupon sales offers. (Manufacturer’s state on most coupons that the sale of their coupon is a violation of use.)

It’s illegal to modify coupons or use them for products other than identified by the manufacturer.  “Limited offer: one per customer” means just that, using multiple email addresses to receive online offers or making photo copies is a violation of law.

Remind yourself when you see a coupon with a value of $80 of the old saying: “IF it’s too good to be true, it probably IS!”

 

Joyce Lash

Joyce Lash

Joyce Lash is a Human Sciences Specialist in Family Finance who wants to keep you ahead of the curve on financial information.

More Posts

Check Before You Go

Several years ago, my brother, his son and my son took my dad on a fishing trip. Dad insisted on taking his fixer-upper boat with its fixer-upper motor on his fixer-upper boat trailer…all of which he acquired for free or next-to-nothing. He had been working hard to get ready for this trip and was excited to see how seaworthy his equipment was. Dad prided himself on recycling and upcycling stuff and he was quite good at it. At the time, dad was in his early 80’s and was in the beginning stages of Alzheimer’s…which looking back, should have been a red flag that someone should double check dad’s work.

My son loved spending time with his very patient grandpa in an amazing, well-stocked shop, where one summer he learned to weld as he created his first meat-smoker.  Their motto was, “Beat it to fit; paint it to match.”  The fishing trip turned out to be an opportunity for my son to repay his grandpa with time and a great deal of patience…as the boat, motor and trailer all failed in epic fashion…wheel bearings seized, motors died in the middle of the lake and the boat ended up with a huge hole in it.

My son recently purchased a fixer-upper popup camper which he is checking over before we head out on a 10-day camping trip to Montana. When I saw him last week, he shared his to-do list with me which would ensure he would “not repeat an adventure like the one he had with grandpa.”

As you head out for adventures this 4th of July weekend, you may want to check out this list by Consumer Reports.

Brenda Schmitt

Brenda Schmitt

A Iowa State University Extension and Outreach Family Finance Field Specialist helping North Central Iowans make the most of their money.

More Posts

5 Ways to Retool Your Retirement

NONE OF US HAD THE perfect career, family or life. Why should retirement be any different? You will face problems and issues that limit your ability to enjoy retirement. You will need to shift your thoughts and energies to the people and activities that bring you a sense of satisfaction and hope for the future. Here are five tips to improve your retirement:

Manage Expectations

The media, along with our own fantasies, push us to envision an ideal retirement basking in the sun on a beach, or wandering over pristine golf courses. There’s nothing wrong with this dream, but it can dampen the satisfaction you get from real life. When something doesn’t measure up to your expectations, you might become frustrated.  Focus instead on creating your own version of retirement that has meaning for you.

Accept the Things You Cannot Control

Most people end up making compromises and adjustments as they get older. Sometimes your happiness depends on whether you fight or accept the changes as a part of life you cannot control. You can’t change the weather, but you can choose where you live and how much of your retirement savings to risk in the markets. You can’t change your genes, but you can adjust the way you feel about yourself.

Hold No Regrets

By the time you’ve retired you have probably experienced some failure, loss or heartbreak. But the ghosts of the past will haunt you only if you let them. Remember that the best revenge is living well.

Focus on Others

As you age, you might shift your attention from your own needs to the needs of others. Retirement is a stage of life when many people can focus on family and what they can do for the next generation. You may spend more time with relatives or friends.

Appreciate the Small Things

Maybe you don’t have the financial resources or the physical stamina to fly to Peru and hike up to Machu Picchu. That doesn’t mean you can’t take a walk in your community park, visit a museum in a nearby city or plant a garden in the backyard. After you retire, the symbols of success often mean less than small personal pleasures. You no longer worry about what your colleagues and competitors think.

With this last blog post, I will retire end of June – Thanks for your interest in Money Tips financial topics.

Susan Taylor

Susan Taylor

Resources are important whether you are looking to rent your first apartment, pay your bills, buy your first home or send your child to college. There are many ways to save money to reach your goals, and hopefully ISU Money Tip$ will be one of them. I enjoy traveling, needlework and am a novice gardener.

More Posts

Insurance Claim Denied? Appeal!

Stamp: Denied They are words we hope we’ll never hear: “your health insurance claim is denied.” It happens, though – millions of times each year. Sometimes a denial is legitimate – the treatment truly is not covered by the insurance policy. But at other times the claim was denied in error.

A recent study by the Kaiser Family Foundation revealed that, when faced with a denied health claim, fewer than one percent of consumers appeal.* The study did not explore why consumers don’t appeal. It is likely that sometimes they don’t appeal because they are so busy dealing with all their health problems and don’t have the energy to deal with it. In addition, I can imagine that consumers may be intimidated by the complexity of the insurance world; I can also imagine some people may not even realize that appealing is an option.

When I read how few people appeal, I was concerned. I want consumers to know they can appeal, and that they should appeal if they believe a medical treatment should have been covered by their policy. NOTE: insurance companies generally allow a specific window of time in which to appeal – probably 2-4 months – so try to deal with it fairly speedily.

Knowing you have the right to appeal is the first step. Contacting the insurance company to request a written statement explaining the reason for denial is step two.

From there, options vary. You may be able to enlist support from your medical provider to justify the medical necessity or clear up any coding errors. Beyond that, ask the insurance company to outline its appeal process, and follow it carefully, keeping copies of all correspondence. If your appeal is denied by the company, ask about an external appeal process — some types of plans include provisions for external review.

If you are not satisfied with how your appeal is handled, consider a complaint through the Iowa Insurance Division. ISU Extension’s Iowa Concern Hotline (800-447-1985) is another resource when you don’t know what steps to take next; their staff attorney provides legal education and may be able to help you identify additional options.  

*Note: the data used in the KFF study was limited to plans offered through the healthcare.gov Marketplace; it is possible that appeals rates might be different for other plans, including employer-sponsored plans.

Barb Wollan

Barb Wollan

Barb Wollan's goal as a Family Finance program specialist with Iowa State University Extension and Outreach is to help people use their money according to THEIR priorities. She provides information and tools, and then encourages folks to focus on what they control: their own decisions about what to do with the money they have.

More Posts

TCJA and Estate Planning

Office file folder in a business. Legal will for inheritance

The Tax Cuts and Jobs Act was passed in 2017. The legislation increased the amount that is exempt from federal estate taxation.  Between 2018 and 2025 the amount exempt from taxes is $11,180,000 for singles (more than $22 million for couples) and is adjusted for inflation each year after 2018.  In 2026 the amount will fall back to $5,400,000.  A majority of individuals will never exceed either amount; however, estate planning is more than avoiding estate taxes.  Some decisions about property transfer can have other tax consequences. Changes in tax law can make old estate plans obsolete.

One important element of estate transfer is the “step up” in basis of real estate and other property that has gained value over time.  An acre of ground purchased for $200 (original cost or basis) in 1984 could have a value of $4000 or more in 2019.  If the property were sold it would be subject to capital gains taxes on the $3,800 of appreciated value. If the property is inherited, it passes without taxation and the basis is reset to the market value the day the owner died.  This “stepped-up basis” is a key consideration when decisions are made about gifting property, setting up trusts, and developing other estate transfer plans. Example: suppose you gave your daughter that acre of land today. Upon selling the land, she would owe income tax on the $3800 capital gain; if she had received it as an inheritance after your death, the sale would involve little or no capital gain, saving her the tax bill. 

Transfer of wealth through estate plans has also resulted in new requirements for reporting and keeping records on appreciated property (real estate, stocks, etc.) with a stepped up basis.  New IRS rules define the property subject to appraisal, steps to ensure accuracy, and required reporting to the IRS and beneficiaries.  Executors are responsible for date of death appraisals. Appraisals must be kept by the beneficiaries and used if the property is sold.  It is wise to complete the date of death appraisal promptly; the IRS is more likely to question an appraisal that is completed a long time after the death of the owner. Details are included in IRS Form 706.

Ag Decision Maker is an Iowa State University Extension source of additional estate planning resources and information.  Scroll down the page to find estate planning publications.

 

Joyce Lash

Joyce Lash

Joyce Lash is a Human Sciences Specialist in Family Finance who wants to keep you ahead of the curve on financial information.

More Posts

    

Subscribe to “MoneyTip$”

Enter your email address:

Delivered by FeedBurner

Archives

Categories