Managing Treatment

Tracking Medical Expenses

How to organize medical invoices and insurance paperwork — and save a little too.

Medical expenses and managing money & pills
Medical expenses and managing money & pills

Being treated for attention deficit hyperactivity disorder (ADHD) brings enormous benefits — and an enormous pile of paperwork. Each round of psychological testing, each doctor visit, each ADHD prescription (which the doctor must renew on a monthly basis) adds to the paper trail that links you, your health-care provider, your insurance company, and, perhaps, the I.R.S. Keeping track of all these documents can be an onerous task, especially if you have ADHD.

Why Track?

Is it really so important to hold on to all those invoices, receipts, and so on? Can’t you just write the checks and chuck the paperwork?

Alas, no. If you want to be able to fight back against an insurer that rejects a legitimate claim or insists that you’ve failed to meet your deductible for the year, you’ll need copies of just about everything. The same is true if you want to make the most of a flexible spending arrangement (FSA) or to itemize medical expenses on your federal tax return (see Good Records Help You Save Money). Otherwise, you risk leaving hundreds or even thousands of dollars on the table.

That’s the bad news. The good news is that it’s easier to keep track of your medical paperwork than you might imagine. I’ve found that the following system works even for individuals with severe organizational problems.

Filing the Paperwork

Don’t let receipts and other bits of paper accumulate in your wallet or pile up in a drawer. File everything right away in a single accordion file folder (Pendaflex makes a variety of durable folders). An accordion folder is too big to be easily misplaced, and less likely than a set of manila folders to “leak” papers during the year. (If you insist on using individual manila folders, stick with those that have enclosed sides.)

Your accordion folder should include the following labeled sections:

Medical bills
This is the place to stash receipts for co-payments or other fees paid to doctors and psychologists. Doctors’ bills typically note the doctor’s name and address, the date of the visit, the patient seen, the reason for the visit, and the fee charged. If any of this information is missing, jot it down on a sticky note and post it to the bill before filing it. Also, note the date that you paid the fee.

Prescriptions
File credit card or cash receipts for all prescribed medications as soon as you return home from the pharmacy.

Medical insurance
File receipts for all premiums that you pay. File pay stubs, too, to document payroll deductions for medical coverage.

Educational expenses
If your child attends a private school on the recommendation of a physician, because of ADHD or learning disabilities, file the tuition and room and board expenses here. Tutoring services prescribed by a physician can also be considered a medical deduction. File tutoring bills here.

Legal fees
Sometimes, you may need to involve the law to get appropriate treatment authorized for ADHD or another mental-health condition. The good news is that any fees incurred as part of such an effort are considered medical expenses. File these bills here.

Medical conferences
Include a receipt from any conference you attend that is related to your medical condition or that of your child.

Transportation/mileage
If you take a bus, subway, or taxi to or from the doctor’s office, ask for a receipt, and file it here. It could be reimbursable. If you drive, file receipts for parking, tolls, and so on.

You can claim either out-of-pocket gas expenses for travel to and from medical care (you’ll need receipts), or take the standard mileage rate. To calculate this, log on to MapQuest.com, and enter your address and the address of your doctor’s office. Multiply the total mileage to and from the office by the standard rate designated by the I.R.S.

Eyeglasses? Dental care? Hospital stays?
Create more sections, as appropriate, for any additional major categories of medical expenses incurred by your family.

If you prefer a high-tech method of tracking medical expenses, consider Quicken Medical software. Designed to help individuals with ADD and other chronic conditions, the program lets you keep insurance information, provider information, exam histories, payments, and disputed claims for each family member in one place. In addition, the program automatically calculates reimbursable mileage, tax deductions, and FSA contributions.

As the year ends and tax time approaches, you’ll have everything you need on file and readily accessible — whether you use a paper folder or an electronic one. And that’s not all. People who use my system tell me it gives them peace of mind — the feeling that their finances and their health are in good shape.

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