Friday, August 18, 2006

Quicken Medical vs SimoHealth: Billing software smackdown

I have an entitlement complex about software. The universe of applications is so vast these days, and the barriers to creating new ones so low, that I expect some clever programmer to have solved pretty much any problem I can dream up. So when I have a problem that seems ideally suited for a software solution, but can't find a good application, I get vexed. Vexed and cranky.

Right now, the gaping void vexing me is software for tracking medical expenses. I take a fairly laid-back approach to budget administration in general. I use PocketMoney on my Palm for day-to-day tracking of money flowing through my checking account. That's all. I have about six regular bills I pay each month in a batch when I get my mid-month paycheck, and it's easy enough for me to remember to do it. My bank information and my regular bills (cable, student loan, credit cards, etc) are all available online. My own personal budgeting approach doesn't demand a Quicken or Microsoft Money; I have little enough to track that I can keep it in my head, and I don't care about the detailed data like "how much did I spend on entertainment last month?" that such programs would offer.

However. I do care about that data mining when it comes to medical bills, now that we have so many. In past years, we've incurred one or two doctor co-pays annually; now we've got a dozen every two months, along with regular prescription costs. We've also got a stack of hospital bills -- one hospital stay, I've learned, can incur at least a half-dozen separate invoices, which show up sporadically.

Our medical paperwork is still not so out of control that a really good tracking system is mandatory -- I've been processing things manually, and everything that needs to get paid is getting paid. I have a good memory for what I've already taken care of, so we're not overpaying. But this is bringing out the information-freak in me. This time, I do want to data-mine the details and have lots of fancy spreadsheets I can run reports against to find out exactly what we're spending, what our insurance company is spending, etc.

Medical bills have lots of specialized wonky wrinkles, like the pile of EOB "this is not a bill" statements they bring in their wake that require tracking and reconciling against the actual, separately mailed billing invoices. The wonkiness means regular budgeting software isn't ideal. So surely some clever programmer has coded up a nifty program tailored for medical bills, right?

Read my first paragraph again. *Sob.*

I can find precisely one major commercial application: Quicken Medical Expense Manager. It's expensive -- $50 -- but if it were fabulous, I'd suck it up, pay, and be happy to find what I was after.

It's not fabulous. Quicken doesn't offer a free trial, so I can't offer a firsthand report, but I probably wouldn't download the trial even if there were one, because user reviews suggest it would break my computer. It seems Quicken Medical doesn't play well with the .Net framework changes in Windows XP SP2.

There's probably a workaround to the .Net issue, and I'd chase it if Quicken Medical had good feedback on its functionality, but it doesn't. The screenshots don't thrill me, and the reviews I've read paint it as an obviously version-1.0 product with a number of gaps and annoying details. I'm not inclined to pay $50 for software I won't love.

However, I'll settle for software I don't love if it's free. Much bashing on Google and Nexis turned up only one serious alternative to Quicken Medical: SimoHealth, a free desktop application from a start-up company funded by Steve Case's Revolution Health. It looks like Simo Software's vague plan is to sell its application to employers and insurers. The company seems pretty dormant at the moment, and I don't know if the application is being supported or maintained, but it's available for free at

I spent about six hours last weekend entering our medical paperwork for the year into SimoHealth. This is not for the fainthearted. The software lacks modern niceties like import and entry-cloning tools; it feels like a version-1.0 GUI slapped over a spreadsheet backend. If you have the same appointment every week, you'll be entering all the details for it 52 times. I didn't run into any glaring bugs, but there were a number of rough edges. Most problematically for me, I couldn't find an obvious way to handle bills incurred over multiple visits but settled all at once. I kluged my way around it, but my solution is an ugly hack that wrecks the elegance I'm seeking from a software solution in the first place.

Still, at the end of my labors, I had data-mining opportunities my paper solution doesn't offer. I can use SimoHealth to quickly total what we've spent to date, and to parse that spending in a few different ways. Keeping it updated will be annoying, given the program's clunkiness, but for me, it's probably worth the pain.

I could do much of this myself in Excel, but I'm a UI snob, and even SimoHealth's basic interface is better than what I could throw together for myself in Excel. But it's a shame there isn't something better out there. (And if you've read this far and know of something better I've missed, please, speak up!) Sod privacy; I think most of us who deal with stacks of medical bills would welcome a Web 2.0ish (aiee, I can't believe I voluntarily typed that) online application for tracking and reconciling medical bills.

I and my entitlement complex look forward to the day when I can settle down at my PC with a bowl of soup, which I will enter in Meal Bandit, and catch up on my medical paperwork with Billing Bandit.