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Why don't bills go directly to my HRA?
So, via DH's HI we have an HRA (it's becoming an HSA next year, but that's another discussion topic). Anyway, we had to take DD to the ER in mid-December (she's fine.). At the time of the visit, when the lady came in to get our insurance info, we mentioned our HRA. She said that the hospital just runs the payments and it's up to the insurance company to deduct the money from the HRA. Fine, understandable.
My question is, why doesn't our insurance company use our HRA? They never do unless we ask them to after the fact. We have money left in it at least enough to cover this ER visit. It seems like they create more work for us and themselves by not directly using it.
I called the hospital this morning. I know our amount due, but the bill is coming to us to be paid out-of-pocket. Now, I'm going to have to call the insurance company to get them to reprocess the invoice.
Re: Why don't bills go directly to my HRA?
Has your husband checked with his HR or benefits administrator? There might be an extra form to fill out to make the process smoother. Or this just might be the process.
I work for a health insurance broker and have experience in administering FSA and HRA accounts. It all depends on how the health insurance plan is set up between your HRA, your husband's employer and the insurance company. Most HRA, FSA and HSA plans are set up so that you receive services, the provider submits the claim to the insurance company, the insurance company tells the provider what to charge, and then you receive the bill from the provider. You can then submit the bill to your HRA administrator as a claim and receive a check from the administrator with which to pay the bill. Or, if you have to pay up front or choose to pay before receiving your HRA reimbursement, you can just pay yourself back in essence with the HRA reimbursement.
There are some instances where insurance companies are set up to feed claim information to the HRA admin and then provider or yourself (again, depending on set up) would automatically receive a check without having to fill out any paperwork. From what I've seen, this isn't typical, however. Generally the insurance company themselves doesn't care if you have an FSA, HRA or HSA. They collect premium from the employer (or member directly, depending on the plan) and tell the providers what they can charge. They aren't responsible for collecting the payment that you owe the provider.
Does your insurance company also administer your HRA? Or is there a separate administrator for that account? Again, the insurance company really doesn't care if you have any kind of reimbursement account, and neither does the provider - your provider just wants the bill to be paid. It can be a hassle to have to wait for the invoice from the provider to then submit to your HRA, only to wait to get reimbursed to then pay the provider but as long as you understand the process, it gets easier. HSAs are a different beast.
When we had an HRA, the insurance would automatically deduct from it as needed, but the HRA was managed under the same benefit plan.
Now we have an HSA and we have to pay the bills and then get reimbursed. Aside from the slight annoyance, this could work out slightly to your favor. You can put the charges on your credit card and get the points.