Top Tips For Medical Bill Negotiation | Ask a Health Advocate

Top Tips For Medical Bill Negotiation

Medical bills affect everyone, whether you require a procedure or someone you love does. So seeing a bill that is out of your price range is distressing. But, it is not hopeless. Many people are unaware that medical bills can be negotiated to a reasonable price through a few simple steps and a basic knowledge of the medical bill collection process.

Find Common Mistakes

The first step you need to take when you receive a bill is to request an itemized bill. This lays out all of the treatments and costs for your visit. You need to audit your bill and search for common medical billing errors. This is money you never owed in the first place. Here’s what you are looking for in plain English:

  1. Upcoding – This is a medical bill that is improperly charged as a more intense treatment. This is most common when a name-brand medication is billed for a generic medication, pinning you with a more expensive bill.
  2. Unbundling – This is where services that should be packaged together are split and billed apart. This leads to increased costs. This is common when multiple medical tests are ordered, but all relate to one condition.
  3. Duplicate Billing – This is more common than you would expect. This is where you are billed multiple times for the same procedure. This may happen when a nurse and doctor both input a code into the system without checking with each other.
  4. Mismatched Coding – This is where the treatment code does not match the diagnosis. In this situation, the insurance company then denies the claim. The bill is sent back to the provider and may be sent down to the patient with the error.

It is well worth your time to be a detective, because you never know what you will find. If you do not understand a charge, it is your right as a patient to know what you are paying for. Be inquisitive and question everything. You will be surprised what you dig up. Plus, if you find errors, it completely changes the tone for negotiating down the outstanding leftover balance.

Negotiate! Do Not Be Pushed Around.

Yes, medical bills are negotiable. The ability to negotiate comes easy to some people, and terrifying to others. I empathize with you if this sounds terrifying.

To start, state that you are willing to pay something, but unable to pay the full amount. Then, your health care provider will understand your situation and see you as a cooperative and solution-oriented patient. A reasonable offer based on my experience is 60% of the original bill (a 40% discount.) That’s not to say you cannot get more (or all) of the medical bill written off. The more cash you are able to offer up-front, the greater discount you will receive. Of course, 60% of $10,000 is a lot of money to pay up front, so your situation will depend on the size of your medical bill and your financial situation.

As an alternative to an up-front payment, you can set up a monthly payment plan. If you do this, request for the payment terms to be as long as possible. Generally, you will have a maximum of two years from the billing date to pay off the medical bill. Request that the outstanding bill be held without interest applied to the balance. Avoid “low-interest medical-credit” plans. In reality, these are just credit cards for your health care providers which now turn your healthcare provider into your banker.

Advocate for Hidden Discounts

It is not well known, but there are discounts available to help with medical bills. They are not advertised, so you need to advocate for yourself by asking the right questions. Ask if there are any financial assistance programs or “charity-care” available to you. Certain providers are even required to tell you about these programs. You will likely need to fill out an application verifying your income. While the application is being completed, ask for a hold on your bill until you hear back, meaning the provider will wait for your response before continuing any collection activity.

Remember, this whole process is about you. o not let yourself fall into financial trouble because you were afraid to stand up for yourself or you just did not know where to start. I am confident you can advocate for yourself!

Want to ask David a question about additional medical bill negotiation? Email him.