After hours of preparation (and “losing my balance” during submission), I tested my Upload-Your-Claim Preparation Guide to offer you. All the preparation ahead of time, and the steps in the guide, made for a smooth-enough manual claim submission with P&A. I was happy with how quick the submission was.
The next day, despite all my precautions, I discovered I had submitted the wrong total. I contacted P&A, asking them to change the total for my claim. Nope. Their solution is to reject my claim. I had to resubmit it. The plus side to this unhappy step backward is I took a screenshot of my submission. Also, my files are well-named and filed, so they’re easy to pull up again.
I want to help you make it to the “top of the cliff” for a P&A manual submission. It’s discouraging to go back to the bottom because of something you forgot. Get your gear together. Let’s submit your manual claim.
Submitting a P&A Manual Claim
I’ve created a free Upload-Your-Claim Preparation Guide for you. It will help you know if you have all the scanned documents you’ll need to complete your climb, er, claim. No need for a sherpa. This post and the guide will equip you.
Submitting claims will be easier the more you have to do them. I’ve worked through over 300 lines in my reimbursement spreadsheet, so I’m a seasoned climber.
(As you know, approving an EOB is different from a manual claim. Make sure the amount is correct before you click on “approve.” Verify the amount on BlueCross or MetLife.)
The following habits will help prevent “falls.”
Consider What Expenses Will Be in Your Claim
Avoid the confusion of having your claim broken down into several checks. Limit your manual claim to one or two types:
- EOB mileage (see further down in this post)
- Health Reimbursement Arrangement (HRA) expenses
- Medical necessity letters and expenses
- Mileage (see further down in this post)
When I put every type of expense in my claims, P&A broke one of them into seven smaller checks. It took a while to figure out all the bank deposits. (This also happened at least twice where the amounts didn’t add up.)
Let’s look closer at the different types of expenses for manual claims.
What Are HRA Expenses?
Retroactive to January 1, 2020, we can reimburse everyday medical items (antihistamines, bandages, contact lens solutions, diaper rash ointment, ear wax removal kits, first-aid cream, and so on). Reimburse your mileage for these items as well. See page one of this StaffWeb brochure for a list of eligible expenses. Under bandages and braces, I reimbursed an ankle brace, elastic bandages, and KT tape.
You may have noticed HRA purchase totals listed below the total on an Amazon invoice or an “H” code on a cash register tape. P&A should recognize that these are your HRA items. This benefit is relatively new, so I’ve also had HRA-eligibles NOT flagged on a receipt. (See “miscellaneous” in this section.)
Contact P&A if you need to verify if something is HRA-reimbursable.
Sometimes when I didn’t ask about an item, I received a rejection letter in the mail three weeks later. I prefer to ask first now. (I recommend reaching P&A through the chat instead of phoning them.)
Prescriptions and Medical Necessity Letters and Expenses
Prescriptions are straightforward for a claim. (Don’t forget to reimburse the mileage for a pharmacy trip.)
I buy a lot of vitamins and minerals in the medical necessity category. Two doctors have written letters for me. The form is available on the P& A site.
See page two of this StaffWeb brochure for a list of eligible expenses your doctor can request for you. Again, ask P&A if you need to verify an item. For instance, the list has a humidifier, but we bought a dehumidifier. P&A confirmed it’s eligible.
Mileage, Parking, and Tolls
As I mentioned, you can reimburse mileage to the doctor’s, to the pharmacy, to a lab, and to a store (to pick up HRA or medical necessity items).
Because of this, it’s easiest to upload the mileage for your doctor’s visit or pharmacy trip in the same claim. You already uploaded the EOB or receipt for your expense, so add the information for your mileage, parking, and tolls.
Another option is to wait until you’ve made several trips and then create a manual claim only for mileage expenses. This helps you avoid very small bank deposits.
You also have two ways to submit mileage. One method may work better for you than the other at different times. Explore the Upload-Your-Claim Preparation Guide to discover the documents you need for either submission type.
EOB Mileage, Parking, and Tolls
(UPDATED: 06/22/22) You’ll need to submit a manual claim for EOB mileage, parking, and tolls. Save PDF scans of EOBs to reimburse the mileages. Use the Medical Mileage Worksheet with addresses and the EOBs as “receipts.” worksheet here. (Go to StaffWeb/Healthcare Reimbursements/Tools for the latest medical mileage rate. It changes every year.)
Recently, I submitted a claim for abut $6 of mileage to doctors’ appointments. The processor saw the EOBs and deducted $85 from my claim. After almost an hour phone call (that includes waiting and talking), I got someone to understand. She resubmitted. I’m expecting to receive an $85 check.
I want to avoid this in the future, so I recommend including a PDF note that the EOB is a “receipt.”
I recommend thinking ahead. If you submit everything “as is,” will the claim processor know what you’re claiming?
For instance, Wal-Mart receipts look like gibberish. Would your processor know what an EQ OMEP CAPS is? This product does have an H after the item number, which may be good enough.
Recently we bought seven items; two were unrelated to a claim; one needed a letter of medical necessity; four items were HRA expenses. One of the four didn’t have an H indicated. I wrote descriptions on a sheet of paper of what I bought and how much I was claiming, which was 1/3 of the total spent. I placed this sheet under the receipt and scanned them together for submission.
Another thing I’ve done is to write a Word document explaining my purchase or claim. Recently, I was in the middle of submitting a claim and realized I hadn’t converted the Word document to a PDF file. I quickly converted and uploaded it. I had my eye out for the time-limit pop-up warning, too. I had to click on it for more time to finish the claim.
You’re Ready to Submit Your Manual Claim
Using this post and the free Upload-Your-Claim Preparation Guide, you’re ready to submit your P&A reimbursement claim.
Be prepared before you strap into your harness and put your anchors in place for your manual claim:
- Keep track of dates, addresses, and other information about medical expenses.
- I recommend my free reimbursement spreadsheet.
- Follow a naming and filing system to help you retrieve files easily at submission. See Organizing Reimbursements.
- Follow my tips from previous blog posts (see NOTES)
It’s time to start your ascent:
- Use the free guide provided with this post.
- Limit the complexity and size of a claim.
- Keep a claim small for complex situations.
- Double-check your total before starting.
- Upload your documents in a logical order.
- Space your claims apart by about five days or more.
- Make a screenshot of your submission.
In case you slip:
- It’s discouraging to start over, so:
- If you have a lot to upload or need to make corrections to your documents during submission, you’ll probably see the warning about timing out. Stop what you’re doing to click for extra time.
- Make sure your total is correct before starting. The Upload-Your-Claim Preparation Guide has more advice about this.
- If P&A rejects an expense because you forgot an invoice or a map or something, it’s easy to resubmit your correction.
- For clearing a rejection, have everything you need scanned and ready. Go to P&A. Click on Upload Claim/Documentation and Claim Response.
No matter how prepared I’ve been, I make a mistake about 80% of the time. More than half of these I correct while submitting. I’ve had to start over for the others. Don’t be discouraged if you forget a receipt, have the wrong total or have some other problem. If you’ve done all the careful steps, you should be able to correct or resubmit easily.
Free P & A Uploads for You
I have lots of help for you to manage your data for manual claims on eQuipping for Ministry. You might not want to start out solo. Find help from the Benefits Forum on Workplace or your staff team.
See the notes for more helpful links or click on over to:
- Your Reimbursement Workflow and Free Checklist (This blog post summarizes the three-part series below.)
Thanks for “hanging” with me for this post.
- I started writing about managing a reimbursement workflow in this three-part series:
- The first post, Organizing Reimbursements, offers a way to organize and name your files.
- Staying on Track with a Free Reimbursement Spreadsheet will help you use a spreadsheet to track your expenses. I include steps to approve an EOB.
- Your Reimbursement Workflow and Free Checklist offers a workflow to stay on track for submissions.
- The first rock-climbing photo is by Maja Kochanowska on Unsplash.
- The second rock-climbing photo is by Omid Armin on Unsplash.