More than billing frustrations: Resources to help

Navigating medical appointments, bills and filling out important paperwork can be hard for anyone. But so many times for brain injured people, it can be impossible.

My journey through successfully finding resources this week.

When a brain injured person, much less many others, receives a bill, big or small, they often sweat it out wondering how they will be able to pay it. In just the past week, I have had to navigate this situation. The difference is, when I receive a bill and don’t think I owe it, I am a good advocate for myself. Many brain injured people would look at this bill and automatically think they have to pay it. That is not always the case.

First, I received a bill for $864 from my psychiatrists office. I knew this had to be a mistake because they have my debit card number on file to pay my copays for every appointment I attend. It was the first of it’s kind of bill sent to me and it said it was 121+ days overdue. Many people’s first instinct is to panic. My husband’s first thought is, if they turn it into collections, there goes our credit score.

As a brain injury survivor, we cannot always think of what to do or say to get to the bottom of some of the situations we are presented. I know this, but as Veronica’s caregiver, I have had a great deal of experience in this area. I have learned what to do through many difficult lessons.

I called the office’s billing section and the lady said, “We can either add this amount to your debit card, or we can put you on a payment plan.” Many brain-injured people would take this information at face value and become very upset because they do not have that kind of money laying around to pay a bill like that.

I said, “Absolutely not!” and explained that they have my debit card on file and that there is no way I should owe anything if my bill is being paid every time I attend an appointment.

 She transferred me to someone else. I repeated my story. She said that sometimes we owe more than the copay when insurance gets done. Again I said that there was no way I owe anything and we need to figure this out. She did explain to me that the 121+ days comes from the day of the first appointment, not for how long the bill has been outstanding. That was a relief because it turns out that it won’t affect our credit for such a longstanding unpaid bill.

Then, that lady sent me to someone else.

I once again needed to explain my situation, and she said I did not owe that money and that it was a mistake. She said she would get ahold of the insurance company to have this corrected, and they would be in touch with me.

The second outstanding bill I received this week was for $3,750. But where most people may panic, I knew just what to do.

This bill came from a neuropsychological exam I took four months ago.

This situation took even more phone calls to resolve. I spoke to five different people/places this time. I phoned the place where I had the appt. They told me to call billing. Billing told me their records showed I had two insurances, but I didn’t, so they couldn’t pay and I needed to inform Tricare. I began taking notes. This was aggravating. Tricare said I needed to fill out a special form and to call billing about it.

I called billing. Billing told me they had no idea what that form was and that I needed to call Tricare again. Mind you, getting ahold of Tricare was a problem in itself. On my fifth call, which was to Tricare, I had to enter my social security number three times before it was recognized. It was an automated system, and I had to say I wanted to speak to someone five times before I was able to speak to a person. Then they said they could email me the form I needed, but I had to either go to an office to return it filled out or I could fax it back. I do not have a fax machine but luckily our friend did so we faxed it from his house. Now we will wait to hear from Tricare to know whether the bill has been paid or not.

Once done, I was angry! I was spent! I was frustrated, tired, and overwhelmed!

Navigating medical bills, appointments, and many other types of paperwork can be so overwhelming for brain injured and elderly people that it does not get done.

There is hope.

I am here to share what I have found by doing some very successful research. I wish I had known about these places early on in our journey. I really needed that kind of help.

RESOURCES that you may contact to find a solace advocate: a professional healthcare navigator-typically a nurse, physician, or pharmacist-who helps patients manage complex medical situations, coordinate care, and resolve insurance and billing issues. Often at no out-of-pocket cost to the patient.

• Most insurance companies can provide solace advocates. So, call your insurance company to find support. Unfortunately, Medicaid does not supply this support at this time. They plan to in the future.
• National Alliance on Mental Illness (NAMI): Mental health support resources. 1-800-950-6264.
• Local City Hall & Social Services: Often offer free programs or resources that are not widely known. It’s worth checking out.
• Healthcare Ombudsmen: A free, independent advocate who helps patients understand their rights, resolve complaints, and navigate care-related issues. They work confidentially and are available in all 50 states.
• Calling 211: free 24/7 service that helps you find local resources like food, housing, healthcare, and crisis support.
• Findhelp.org: goes by zip code to find local programs for food, housing, medical care, transportation, etc.
• Gna.org: (gnanow.org) can help fill out complex paperwork such as insurance forms, medical bills, and navigating healthcare logistics.
• Independent advocates: GNA provides a directory of independent, certified patient advocates who work directly with patients and their families to manage tasks like scheduling, insurance, and medical documentation. They handle complex paperwork.
• Veterans & Spouses-VetAssist helps veterans and surviving spouses apply for VA Aid &Attendance and receive in-home care right away. They provide an interest free loan to cover care costs until VA benefits begin.
• Private-pay Option-Great National Advocates: Private pay service for those with financial means who want professional advocacy support. They offer personalized assistance navigating healthcare and related systems.
• SSI or SSDI: find a lawyer to present you that does not require pay until you win your case. They can help fill out the paperwork.
• Disability Information and Access Line (DIAL): 1-888-677-1199 Monday -Friday. (9 a.m-8 p.m. Eastern Time) provides comprehensive support, connecting individuals with disabilities to community resources.
• Area Agency on Aging (AAA)