Medical billing is complex and paper-intensive in normal times. Due to the pandemic, it’s become even worse for some people. The New York Times reported on the medical debt many people are facing after COVID-19 treatments. Many clients have leaned on us for years to organize and maintain medical and health records and bills. Here’s what you need to know to manage and organize your medical bills.

How to Get Help with Medical Bills Of All Types

1. Open every piece of mail. Even if or especially if you hate mail, letting it pile up will only increase the amount of mail, since unpaid bills will be re-issued and re-sent. When that happens, it’s hard to keep track of what’s new, and you might feel like you owe more than you really do.
2. Get organized. Gather all of your paperwork together in a system that works for you. Usually, a simple filing system is a great place to start. A filing cabinet drawer or an inexpensive filing bin from an office supply store with file folders can help you organize bills and correspondence from different offices, along with Explanations of Benefits (EOBs), prescription information, and passwords for medical account websites.
3. Clear a space. Don’t let medical paperwork take over the tops of your tables and counters. Put it away when you aren’t working on it. Having it out in plain view can contribute to feelings of chronic stress.
4. Get help. If you aren’t normally organized, hire a Certified Professional Organizer at NAPO.net. They can work with you in-person or virtually to make sense of your medical billing. They can create a tracking spreadsheet for you. They can also guide you through the process of contacting medical offices or scheduling payments.
5. Assume there are billing errors. Don’t take unreasonable bill amounts at face value. Ask questions to find out what was billed and why.
6. Carve out time for phone calls. It’s unfair, but this can feel like a part-time job. Schedule time when offices are open to make the calls to dispute bills and ask for billing adjustments.
7. Expect delays. It can take days and weeks to hear back on inquiries and appeals. This is another reason to stay organized. Keep good records of who you talked to, when you talked, and when they will respond. Mark those dates on your calendar, and follow up if you haven’t heard about your inquiries.
8. Pay a little, even if you can’t pay a lot. If valid charges are too large to pay all at once, pursue a payment plan with the provider. If you can’t meet those obligations, continue to pay some small amount, even as little as $10 per month, to keep your account out of collection agencies.
9. Separate records for the departed. If you’ve lost someone due to COVID, you might be dealing with their medical debt. Keep their records separated from your own, so their estate can dispute and clear their debts separate from your own.
10. Take care of yourself. Medical debt can be completely overwhelming, even if you are in great health. When you are sick or bereaved, it can just feel like punishment. Be kind to yourself. Eat well. Protect healthy sleep routines. Exercise when you can, which might mean taking a notepad on walks so you can exercise while being on hold or talking with medical providers. Ask for help when you need it. You can only help yourself or others by taking care of yourself.

How to Get Help with COVID Medical Bills

1. Learn your rights. Some states already have laws against medical surprise billing. The federal No Surprises Act passed in 12/2020 is still so new that how it applies to old, current, and new medical bills is still being worked out. Read up on the No Surprises Act of 2020. Most provisions don’t actually go into place until 2022, but that shouldn’t stop you from asking from relief from surprise bills. The new law prohibits this practice in the future, but it shouldn’t be happening today.
2. Ask questions, respectfully. The billing rep that you reach on the phone probably doesn’t have all the information about your case, and their answers might change based on recent laws. You might need to ask the same question more than once, of more than one representative. Here are some starting questions:
   • Is the medical procedure code that was billed the right one?
   • Does that medical procedure code indicate that this was COVID-related?
   • Is there another medical procedure code that would be covered by insurance?
   • Is this charge an in-network or an out-of-network charge, and is that correct?
   • Since this is a COVID-related treatment, is it covered by the No Surprises Act of 2020?
   • If it were covered by insurance as an in-network procedure, how much would it cost, or what would be covered?
   • If you don’t know, who can I speak to?
   • Can I appeal the charges with the medical provider or insurance company? What is the process to do that?
3. Get help. Organizing the bills, recording payments, and keeping notes of conversations with medical providers can be overwhelming, especially if you are still sick or bereaved after losing a loved one. Ask a trusted friend or relative to help you organize paperwork, email statements, and online medical portal accounts, using computer spreadsheets like Microsoft Excel, Google Sheets, or Airtable. Spreadsheets are easy to update and are much more useful over weeks and months than handwritten notes. If you don’t have help, you can hire a professional organizer at NAPO.net.
4. File a claim. Work with a consumer assistance program (CAP), established under the ACA, to file a claim with the National Association of Insurance Commissioners (NAIC). Get a list of consumer assistance programs operating in various states here.
5. Get legal advice. It may make sense to hire a lawyer to contest bills that are technically valid but seem overblown or would potentially be covered by the No Surprises Act in the future.
6. Tell your story. You aren’t alone. Contact your local media and report your struggles. Media attention on unreasonable billing practices and overwhelming debt is leading to change in the legal landscape. Have a Coronavirus bill to share? The writers at the New York Times want to hear about it. 
7. Contact your local, state, and federal elected representatives. They may be aware of aid programs to help you understand, negotiate, or pay bills.

Unfortunately, there isn’t a magical pot of money to pay large medical bills. The American healthcare system still leaves many people uninsured, underinsured, or surprised by treatments not covered even by good insurance. I hope this list gives you strategies to manage your medical bills and reduce your stress level.

Do you know someone who has been sick lately? They are probably overwhelmed with medical bills. Please share this article.