10 Tips for Negotiating & Navigating Medical Bills
Last updated: January 2017
1. Find out what the test or procedure will cost up front. Knowing what the hospital charges before you have the procedure allows you to ask if you can pay up front in cash for a discount or if they can negotiate a lower rate for you even if you can't pay up front.
Just think: We would never have a car repair done without asking about the cost. It isn't always possible to do that in an emergency, but when you can ask up front, why not arm yourself with that information?
2. Ask for the Medicare rate. Depending on who is paying (Medicare, Medicaid, private insurance, self pay, etc.) hospitals and doctors offices have many different rates for the same procedure or test. It can't hurt to ask if they can make an agreement with you for a better price. If you can pay that amount in cash, they may be even more likely to strike a deal with you.
3. Read your statements and look for possible mistakes. The people who enter the data for your care providers are human, and sometimes they make mistakes. Be sure you're not being charged for something you didn't receive. If you're confused about what something means, call and ask for clarification.
4. Ask for an itemized statement. Make sure you have an itemized bill so you can look at each line item and determine whether the charge is correct. If you didn't get an itemized bill, call the billing office and ask for one.
5. Follow up to make sure your insurance company pays. Unfortunately sometimes your insurance company doesn't follow through and pay for a procedure, test or visit that is covered by your plan. If they are not willing to correct the mistake, you may have to file an appeal.
6. Don't wait to make contact and find out what your options are. Your options will start to decrease quickly if you allow your bills to become past due.
7. Ask about programs for low income families. If you have a limited income, you should call the billing department and ask if they have any programs to reduce bills for people in your situation. Some institutions, particularly community hospitals, will work with you in reducing your bill according to your income.
8. Ask for a payment plan. Call the billing department and explain your situation. Negotiate a monthly payment you can afford and make those payments on time until you get the bill paid off.
Billing offices are more than happy to work with patients in this way. Payment plans save them the expense of using collection agencies to get paid.
9. Utilize a state health care or insurance advocate. Many states have health care advocates or representatives in the state insurance office available to anyone who needs help dealing with a doctors office, hospital or insurance company. They can help you negotiate a plan that meets your needs at no charge to you.
You can find these offices by searching online for the name of your state and the kind of advocate you need.
10. Be polite. It's good to be direct about your needs, but always remember to be polite, too. Being rude or short tempered never made anyone more likely to correct a mistake or do you a favor.
Do you have questions or concerns about how to deal with medical bills? Please share them in the comments.
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