Tuesday, May 26, 2015

7 Steps to Negotiating a Hospital Bill

I was recently contacted by someone about the posts I wrote regarding a hospital bill I received for $61,000 back in 2013. I have had many others ask me about that and I really feel like my experiences have helped people in a boat where they are having a hard time navigating the waters of excessive medical bills.
 
Last week, I received a bill from the hospital where I had my hernia repair surgery. I had this surgery last February and just received a bill. It cost me $25 out of pocket the day of the surgery and I haven't seen another bill since. I finally received the bill and it was $2,600, the remaining amount after insurance had paid their portion. I knew that they tried to charge my insurance upwards of $100,000 for my surgery and that the insurance paid more than they should have for this procedure, because I had been discussing the bill with my insurance when I started seeing the Explanation of Benefits come through in the mail. I wasn't happy with this amount. Knowing that my copay for a hospital visit was $500, and that they'd previously lowered my amount owed before, I decided to take matters into my own hands and write them a letter about what I was going to offer to get the account settled. This is what I learned and I hope it helps you as well.
 
1. Keep all explanation of benefits that come in the mail. We have a tendency to toss them in the trash because they say "this is not a bill!" but don't. This gives you documentation on what they attempted to charge the insurance and what the insurance actually paid. If the insurance personally only paid a small portion of the amount the hospital attempted to receive, this tells you that the amounts the hospital is attempting to charge are excessive. This allows you more wiggle room with negotiations.
 
2. Know what your insurance plan pays and hold them accountable to that. If you are only supposed to pay a $500 copay, then don't let them talk you into paying more if your plan says otherwise. Contact your insurance if needed to verify.
 
3. Ask to see your itemized bill for review. I always like to say that I am going to be sending this to a billing advocacy group that will be checking the charges against other hospital's current charges to see if there are any discrepancies. Often, just the threat of this of this will be more than enough motivation for the hospital to negotiate pricing, but I have actually sent my bills to a group before and it was incredibly worth it and helpful.
 
4. Do what you can to lower the amount, especially if you really can't afford to pay it back fully or it will break you financially to make payments of large amounts to the hospital. Put it in writing and plead your case to the billing department. I sent back my invoice and let them know that previously, I know they negotiated my bill down and I am prepared to pay $600 for the surgery I had. She replied back, pretty much immediately, that she accepted that settlement offer. If they don't agree, try again. Just because they are the hospital doesn't necessarily mean their "prices" or "bills" are set in stone.
 
5. If you can't pay the full amount, request a payment plan. Find an amount that won't break your bank and derail other financial plans you have. It's silly to pay all of your money for a future down payment on a house just to pay off a medical debt, especially if you can send smaller increments and still pay your debt. Once you come to an amount you can both agree with, find a payment amount that you can comfortably send in monthly, then send it in every month and don't forget!
 
6. Do not ignore it and hope it will go away. This is my suggestion for ALL debts and collections. It's better to work it out and come to an agreement that all parties can work with than just ignore it because you can't afford it.
 
7. Persistence is the key. It's annoying and time consuming to write letters and discuss these matters, but in the end, if it saves you $1,000s then it's worth it. I basically just saved myself $2,000 by arguing the amount. To me, the few hours it took me were totally worth it.
 
If you have any other stories, comments or suggestions, I am all ears!

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