Guava for Medicare HD Plans

[sengsational]

Has anyone used guavahealth app to reconcile their Medicare billing? I don't know much about it, and haven't used it, but I got interested in it because it's approved to access CMS (Medicare) claims, and it also is supposed to have the ability to access billing data from many thousands of healthcare providers.

One of the reasons people give for not using high deductible Medicare plans is the billing can be insanely complicated. I've run into situations that, if I had a high deductible plan, I would probably have paid, but really it was the hospital "forgot" to include that in their Medicare submission.

There's a free version, so you're the product, I guess, and I don't know how they make money off of that, and a paid version, which includes more features (typical business model).

I personally am not worried about my medical history being known. I care. My doctor cares (for the 10 minutes he reviews my case and talks to me, then no longer cares). My wife cares. My siblings and kids maybe slightly curious. Possibly morbid curiosity from friends and acquaintances (wow, he's got a lot of old man issues), but no one else in the universe cares. I'm pretty sure I could make a web site with my medical records and there would be zero hits. I don't get the whole medical privacy thing. But I digress.

I was actually going to write an app. Nothing so huge as Guava! The app would have been just for myself, to reconcile medical bills with Medicare. Something where you could share your PDF medical bills and share your Medicare claims file, and it would match things up and give you a tidy view of things. But I think Guava Health might already do that. I already do a lot of what Guava Health does on my desktop computer with spreadsheets, but my stuff looks pretty primitive and is highly manual.

If you use it already, I'd be interested in hearing about what you think about it. If I end-up using it, I'll try to come back and tell you what I think.

 

[sengsational]

This application doesn't look promising as a way to track billing / insurance issues. I linked LabCorp and Medicare to see if it could spot a recent Medicare rejected blood test. I found the lab test entry where LabCorp was the source, and it had all the individual test results, but no billing and no insurance info. And no way to get from the lab test entry to the insurance entry. I was able to fumble around a while and find a separate Medicare claim that included the LabCorp service. It did not have a link to to the lab test entry. The claim just showed what I already can get from Medicare (each of the blood tests, prices, approved amounts), but didn't highlight the blood test that was rejected.

Highlighting things that didn't get paid, for whatever reason, is what I really want, and it appears Guava doesn't do that. I don't see any provider billing information at all, so if a provider "forgets" to enter a procedure code when they file the Medicare claim, this application won't help you find things like that.

So it's a bust for insurance / billing, but might be helpful for people that want a place to aggregate medical information. I didn't experiment with any of that.