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Tom Galli



Treatment for lung cancer was, hands-down, the hardest thing I ever endured.  What’s the second hardest?  Without a doubt, it is settling treatment bills.  After nearly 13 years, I still get them.  Despite all of the advances in information technology, medical invoices, including medical insurance invoices, are the most unnecessarily complex documents ever created.  Their level of useless intricacy bests even lawyer generated minutiae.

I've got a method, a foolproof way to organize, understand, and pay.  This avoids both double payment and long periods on hold listening to elevator music while waiting to talk to someone who knows absolutely nothing about your problem.  Here are my ten steps to winning the lung cancer treatment billing battle.

1.    At your time of treatment, ask the treating physician to tell you the treatment code or codes to be reported on your medical record.  Write this information down, including the date of service (DOS) for each code.  A smart phone calendar application is the perfect way to capture this vital information. Just put the codes on the calendar.

2.    Also ask if a third party provider (someone outside your doctor’s practice) will provide lab or diagnostic work.  Get the names of these providers and treatment codes used for their services.

3.    Build a record of information for data captured in steps 1 & 2.  I use a computer spreadsheet but an old-fashioned pencil and paper ledger will work just fine. Here’s an example:


DOS - Date of Service, PC - Procedure Code, PROV - Provider, MS - My Share, PD BY - Paid By, PD DT - Paid Date

4.    As bills come in, add new information to the spreadsheet. I record as I open so I don’t miss anything.  Highlight the DOS and PC on each bill with a bright colored highlighter, then staple or paper clip together by DOS.

5.    On arrival of your insurance statement, update your spreadsheet adding INS ALOW, INS PD and MS. Don’t worry about amounts insurance reduced or denied.  If your provider accepts your insurance carrier, they must abide by insurance allowable charges. Attach the insurance claim to bills by DOS.  You may need to make copies because insurance claims often cover multiple DOS.

6.    Do not pay anything to anyone (exception COPAY) until your insurance pays.  Then only pay (MS) and complete PD BY and PD DT on your spreadsheet.

7.    Keep all this paperwork together in a single manila folder.  I keep mine on my desk along with a supply of paper and binder clips to keep things together.

8.    I use this method for hospital bills but there could be pages of procedure codes covering several dates of service. Make an entry for each DOS and record all the PCs per DOS. You’ll need to mine this information from the statement because hospital visits often consist of many dozens of PCs.  Consulting doctors who treat you in the hospital must cite DOS and PC on their invoice. You may never meet these doctors (radiologist, pathologist and etc) but you’ll track them to the hospital stay by matching up the DOS.

9.    Hospital invoices take months to arrive while attending physician invoices take weeks. Match them up and wait for the insurance claim before paying anyone. 

10.  This method simplifies claiming federal income tax medical expense deduction. Come tax time, filing will be a snap.


I’ve paid thousands of medical bills. The only thing worse than the assault of bills is assault by bill collector.  In the days before organization, I’d hunt through piles of paperwork and bank records trying to find information on a bill I know I paid.  Not being organized means I likely paid twice just to stop the telephone calls.  I recall the day I received a bill collector call after I stood my method up.  My data shut him down.  I went from hello-to-cancelled-check-to-good-by in seconds. It felt so good!


Stay the course.


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