Wednesday, October 24, 2018

Actually Getting Reimbursed from Liberty…It Takes a While

Our medical visits thus far have included wellness visits for each of our boys and my wife and a couple of other fairly standard office visits (but not wellness visits). In all we had 7 visits requiring medical billing. As of this date in October of 2019 we have only been reimbursed for one of our medical expenses. This was for our 9 year old’s annual wellness visit. This bill was submitted on May 29 and paid July 17. Not bad for this one. The rest have been caught up in the Liberty blackhole.

As a reminder, one annual wellness visit per person is covered as part of your Liberty membership (up to $400). This means you should be reimbursed for this visit as opposed to it just going towards your Annual Unshared Amount (AUA). So as of this entry we are still waiting for 3 visits to be reimbursed. Two of those bills were submitted in July and one in August. We finally called last week to ask what the delay was and Liberty indicated they were surprised the bills hadn’t been processed and would expedite them. At this point, we are just hoping they are paid in the current year. It’s also important to remember we paid for these visits well before the actual visits, probably in the late Spring/early Summer. Thus, you’ll need the cash savings to take on these types of expenses up front and wait for reimbursement (thankfully our costs were relatively modest).

The other very confusing part of the reimbursement process is the relative radio silence from the time you submit the bill to when you are reimbursed. From time to time, you will get a notice like the one below related to your bill (this is an example of a notice we received recently after we called Liberty).


 
However, when you click on your ShareBox to understand what has occurred the status of your bill is very ambiguous.  Here are a few of our current statuses and my interpretation:
Bill Created – I think this is the status it goes to once they review your bill submission and formally create a bill to be reimbursed. It sits here a while.

Submitted for Sharing | Reimbursed to Member – I am not sure what this means because I can tell you the bill with this status was not reimbursed to me. I would assume it means it’s going to be reimbursed at some point once the sharing is identified.

Completed | Reimbursed to Member – I am not sure what this means because, again, it wasn’t reimbursed to me.

Completed – One of our bills is in the plain Completed status. It is a bill that goes against our Annual Unshared Amount so I assume it just means it won’t be reimbursed (which would be correct).

Paid by Members (Check #XXXX) | Paid: July 17, 2018 | Reimbursed to Member – This is the status for the one bill that was actually reimbursed.

When you click on the e-mail notification from Liberty you need to locate the bill the e-mail relates to and review the status. I suppose as you gain more experience you would start to understand what the status is, but often times we didn’t even know what the status was before…let alone what the new status means. It’d be far more helpful if there was a description of the status so you didn’t need to call to understand it.


Liberty has stated in their monthly newsletter that they implemented a new billing system and are working on improving operating efficiency. It was clear they knew they were struggling a bit. That said, we’ve found the reimbursement process to be inefficient overall. People have been nice when we call to check-in but it’d be nice to not have to call at all. We will let you know if we get reimbursed before the end of the year. Fingers crossed!

4 comments:

  1. I agree. The information they give you about submitted medical bills is far less than useful. I would think a small company would be better at that. I assume they use some kind of database and they must type in comments somewhere. Why can't those comments be shared with us?

    I wonder if some of the other healthshares are better? I chose liberty because they offer the potential to have the bills submitted directly from the medical provider. But I'm not sure that will happen anyway.

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    1. I'm curious if you will have better luck when the bills are submitted directly to Liberty. I was skeptical that my medical providers would do this so I'm glad I called first and at least knew going into it they would not do that and would treat me as self-pay. If they go directly to Liberty perhaps it will be less of an administrative nightmare. As an aside...we are still waiting for 2 checks Liberty claims were sent to us in early November! I guarantee that unless I stay on them they will never be sent to us.

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    2. We currently have BC/BS through my wife's work. I bought liberty for the interim between retirement and medicare. I have not had any bills submitted directly to Liberty.

      I recently manually submitted bills with horrible results. Like you I couldn't tell what the status was. Through talking to a rep I was told that the EOB's I submitted from BC/BS didn't have enough information. I need to submit the actual bill.

      It's all a little spooky to me. I thought I had planned. Now we have pre-existing conditions so your new solution won't work.

      I looked at the company you're going with for 2019. They said I could only get insurance for 364 days. I take it they don't have that limitation for the Ohio plans?

      Jim
      jyh@fastmail.us

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    3. Hi Bill - I do have the 364 day limitation in Ohio but I'm comfortable with that. We signed up January 1 so if we get a pre-existing condition, that would preclude us from renewing our short-term plan, we would sign-up for an ACA plan for next year. Our short term expires on December 30 and our new plan would start on January 1. Thus, there's one day we could potentially be without insurance under this scenario. That's a fair risk to take in our view. Under the old rules these short-term plans would expire every 90 days or so. Thus, if we got a serious illness and couldn't renew for another 90 days we'd be stuck for up to 9 months before we could get an ACA plan - that was an unreasonable risk for us so the duration being 364 days is quite reasonable. Hope that answers your question.

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