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A Family Caregiver’s Guide to Doctors, Prescriptions and Hospital Bills

Tips for being an effective health care advocate

Pill bottle and bills

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En español | As our parents and loved ones get older, it takes a lot more time — and attention from a lot more people — to maintain their good health.  Managing doctor appointments, refilling prescriptions and tracking insurance bills can be overwhelming for patients and caregivers. A trusted family member or friend can be an effective health care advocate. If you’re taking on such a role, or need to in the future, here are some things to keep in mind:

Doctor Visits

First, gently ask your parent whether he or she needs or wants your help communicating with the doctor. If your parent agrees, talk to each other about what questions to ask the doctor before the appointment — and write them down. During the visit, let your parent take the lead in talking to the doctor. If a question is overlooked or not answered, then follow up. Ask for an explanation of unclear terms or direction. Take notes or, if the doctor allows, record the conversation.

Prescription Safety Check

Some 1.5 million people are injured by medication errors each year in the U.S. Caregivers can stop a disaster before it happens by double-checking every new and refilled prescription.

  • Have the pharmacist compare past records with the refill order. (If medications arrive by mail, compare the new bottle with the old one.) If there’s a discrepancy in dose, amount, strength or directions, call the doctor.

If the prescription is new or you are uncertain about the medication, do the following:

  • Ask about side effects, adverse reactions, precautions and warnings.
  • Check the brand name against the generic name.
  • Ask if the pill can be crushed or split.
  • Read all included information.
  • When prepping pills at home, review instructions. It’s easy to misremember directions.
  • Consider putting daily pills in a compartmentalized box so you, or anyone filling in for you, will know if the daily dose has been taken.
  • Store medicine as directed.
  • For additional information about a particular drug, check out the AARP Drug DirectoryInteraction Checker, and Pill Identifier

Hospitalization

When your loved one is hospitalized, even for a routine procedure, have a written game plan to help ensure that nothing is overlooked. Here’s what you need to know. 

Step 1. Make sure the procedure is covered.

  • Find out what Medicare covers. Enter the procedure, surgery or treatment to find out.
  • If the patient is a Medicaid recipient, see what Medicaid covers. 
  • If covered by private insurance, call customer service to confirm the hospital accepts your loved one’s insurance and the doctor performing the procedure is in network. If the hospital is in network and the doctor is not, ask if the company will cover the doctor’s fees.

Step 2. Find the right doctor and hospital, then:

  • Contact your loved one’s insurer for preapproval.
  • Ask for a confirmation number.

Step 3. Contact the doctor’s office a week before the scheduled admission.

  • Go over instructions. These may include fasting requirements; temporarily discontinuing aspirin, blood thinners or other medications; and what to bring to admissions.
  • Confirm length of expected hospital stay.

Step 4. Check in. Bring a to-go bag, containing your loved one’s:

  • Legal, current photo ID
  • Insurance, Medicare, Medicaid cards
  • List of all medicines currently being taken, including vitamins and over-the-counter drugs, with doses noted
  • List of questions and observational notes
  • Names and contact information of doctors
  • A short health history
  • HIPAA agreement (This form allows hospital staff to share the patient’s medical status with you or another trusted person.)

Step 5. During hospitalization:

  • Keep a journal to record your loved one’s condition, changes, appetite and mood. Note dates and times.
  • Remember that every patient has a right to review his medical records and have terms explained clearly.
  • If concerns go unanswered, contact the hospital’s patient representative.

Step 6. Check out. Before leaving, ask:

  • What is the expected recovery time?
  • What are the possible side effects?
  • Are you prescribing new medications?
  • Should the patient continue taking medication prescribed before hospitalization? Prescriptions? Vitamins?
  • Will this be followed by patient rehab, physical or other therapy?
  • When is the next office appointment?

Track and Pay the Medical Bills

Keeping tabs on the hospital tab is essential. Mistakes happen, and when they do, the claim will likely be rejected. These tips will help you track down and correct the error.

  • Keep all medical receipts.
  • If insurance, Medicare or Medicaid rejects a claim, call the business office for the provider, service, clinic or hospital. Ask for copies of medical records.
  • Compare records with bills. Make sure your name, insurance number and the services provided are correct.
  • Report unexplained or mistaken charges to the business office and ask for an explanation. Take notes. Include the date, time and name of the person with whom you spoke.
  • If the issue is resolved, ask for a new statement.
  • If the provider checks the medical coding, dates and services rendered but is unable to resolve the issue, contact the office that rejected the claim.
  • If there is a discrepancy between the provider and the insurer, request that customer service set up a three-way phone call that includes you and the provider.
  • If the issue remains unresolved and they believe their decision was correct, file an appeal.
  • If paying the bill will create a hardship, ask if it can be adjusted and request a payment plan.

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