How should I handle my late mother's medical bills?

Q. My mom recently passed away and I'm anxious about her medical bills. How do I figure out what to pay—and can I question any of the charges? Her Medicare statements are confusing (she had a supplemental Select plan) and I have no idea what procedures she was actually given. The thought of blindly paying every bill seems crazy.

A. I'm going to assume your mother was single at her death, and that her estate has enough assets to pay her medical bills. From how you worded your question, it sounds as if you are the estate's executor.

Your instinct is right on: don't even think of "blindly" paying bills as they come in, because if you do you may end up paying for services that are covered by your mother's Medicare and Medigap plans. You can take your time reconciling the various statements you're likely to get from your mother's insurers and health-are providers as long as you don't let the paperwork pile up for months on end.

Your first step should be to get a copy of your mother's Medicare supplement plan so you can see what services are covered and what she might owe out-of-pocket. The nonprofit Medicare Rights Center offers an overview of the Medicare Select plan you mentioned.

Hold on to all the bills you get from her health-care providers as well as the statements you get from Medicare and Medicare Select saying how much they paid for various services. Medicare.gov has a helpful online guide on how to understand these claims notices, called Explanation of Benefits (EOB) notices or, in the case of Medicare, Medicare Summary Notices.

Before you pay any bill from a provider, wait to find out what Medicare and the supplement paid for the service. By law, all providers who participate in Medicare must file claims with Medicare for all the services they gave your mother, and in most cases, once Medicare has paid its portion, it will automatically forward the information to the patient's supplemental plan without your having to file a claim. The Medicare Rights Center has details about how this works.

The fact that your mother had a Medicare Select Medigap policy means that you may owe more out-of-pocket for services, if any, that she received outside the Select plan's network.

If, after you've gone through all these steps, you still have provider bills that are more than you think you owe, or that you can't match up with the claims notices you've received, follow these procedures suggested by the Medicare Rights Center, starting with making sure the service was coded and billed correctly.

Throughout this process, keep a record of all correspondence and, for phone calls, notes on the conversation and the name and contact information of the person you talked to.

If your mother had extensive medical care and you run into lots of billing headaches, it may be worth hiring a medical billing professional to help. The Alliance of Claims Assistance Professionals and Medical Billing Advocates of America are two groups that can help you find a billing specialist in your area. Pat Palmer, founder of MBAA, said members typically charge 25 to 35 percent of whatever amount they help a client save, or a service fee that ranges from $85 to $175 an hour.

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Sources
The Medical Bill Survival Guide: Easy, Effective Strategies for People Experiencing Financial Hardship

Alliance of Claims Assistance Professionals

Medical Billing Advocates of America

—Nancy Metcalf