How to Negotiate Your Medical Bills

According to a study conducted by The American Journal of Medicine, around 60% of personal bankruptcies are caused by overwhelming medical bills. The fact is, if you’ve been sick or severely injured, medical bills can add up fast. Even if you have health insurance, there is a good chance that you will be left with sizable medical bills.

The good news is that patients can actually negotiate their medical bills, but many never do. The amount that you are originally billed is not always the amount that you absolutely must pay. While negotiating won’t work in every case, the majority of patients can negotiate their bill. Here are six tips to help you negotiate your next medical bill.

1. Be proactive.

If you know that funds are tight at the moment, let your doctor or healthcare provider know before any testing or procedure has been performed. Ask the physician to quote the price of a procedure, then ask if there is anything he or she can do to lower the cost. If you’ve recently been laid off or you don’t have health insurance, make sure that your doctor is aware of your situation. Believe it or not, there is a lot of flexibility in pricing.

If your doctor won’t lower the price of a procedure, ask if you could receive a discount for paying in cash. This is where having a health savings account can come in handy. If the doctor won’t offer a cash discount mention you may switch to another doctor that does. If you don’t have health insurance, always make sure to shop around for the lowest prices before undergoing any procedure if you can.

2. If you’ve already received the bill, figure out the fair market price of the procedures you received.

The fair market price is the price that insurance companies are asked to pay for different medical procedures. This is usually the same as the Medicare rate, as Medicare prices are the standard that many insurance companies and healthcare providers go by.

To find these prices, reference the Healthcare Blue Book, which lists the fair market price of most procedures. Once you know how much an insurance company would be expected to pay, you’ll have an idea of how much room you have to negotiate.

3. Contact the billing department and ask to speak with someone who can help you with your bill.

Contact the billing department and politely ask if there is anything that can be done to reduce your bill. Make sure to speak with a person who actually does the billing and not a receptionist, since he or she will be unable to make any changes to your bill. Explain that you simply cannot afford the bill, due to your low income, a period of unemployment, or another financially difficult situation. Be as calm and polite as possible throughout the entire conversation, as this will get you the best results. Again, it’s one of those situations where you won’t know unless you try and the worst that can happen is they aren’t able to do anything regarding your bill.

4. Carefully go through your bill and ask which, if any, charges can be billed differently.

Sometimes medical bills can be reduced by billing procedures a bit differently. Medical billing and coding is a tedious, detail oriented job. Each procedure has a very specific code which dictates its price. Your bill may be able to be reduced if the billing professional is willing to change the billing codes to less expensive, but comparable procedures.

I had a situation like this a few years ago with some eye exams. I had to go see a specialist for some testing on one of my eyes and when the bill came it looked like I owed over a thousand dollars because insurance didn’t cover these specific tests. So I went back to the doctor and inquired about how these couldn’t be covered and they went back to the insurance company and billed the tests as medically necessary, which meant the health insurance kicked in and covered them. Had I not asked I may have just thoughtlessly paid the bill even though I didn’t need to.

5. Request a new bill that lists the changes in price.

If your bill has been reduced, ask that the updated bill is sent to you. It’s important to keep a copy of this bill just in case you are again asked to pay the original price. If you don’t have a copy of the new bill, you will have no proof that your bill was reduced. And if you’ve ever worked with insurance companies before, you know very well how information gets lost or comes up “missing.”

6. If all else fails, ask for a payment plan.

Sometimes there really is nothing that can be done to reduce the price of your bill. While this is unfortunate, it can and does happen on occasion. If, after negotiating to the best of your abilities you are still required to pay the full price, ask for a payment plan.

Let the billing professional know what you can realistically afford to pay and when you can make payments. Do not agree to terms that are above your means, even if you are pushed to do so. As long as you make the required payments, you will be able to keep your bill out of collections and on its way to getting fully paid.

Again, this is a strategy I’ve employed on a few occasions. Namely, the bills associated with the birth of our children. Even after insurance picked up most of the tab we were left with a few thousand dollars in co-insurance and deductibles. Rather than writing a big check I called the billing department and let them know I couldn’t pay in full. To my surprise they immediately granted me a interest free payment program. That’s right, no interest charged for making payments over time! Talk about leveraging your money.

Author: Jeremy Vohwinkle

My name is Jeremy Vohwinkle, and I’ve spent a number of years working in the finance industry providing financial advice to regular investors and those participating in employer-sponsored retirement plans.

7 comments
kshaw3060
kshaw3060

I had negotiated payments at the local hospital for 3 different medical bills for me and my kids over a period of time.  I had received 2 monthly bills related to the last date of service and paid the negotiated amount as expected and then never received another bill for a year.  I remember that at that time they quit billing me, I had finished paying for the other 2 dates of service.  Because they quit billing me, I assumed that I was finished paying.  Now, a year later, I received a bill from a debt collection agency.  Do I still have to pay the bill even if they quit billing me?

HIPPA compliant
HIPPA compliant

Nice....Really  a good news for that patients can actually negotiate their medical bills..Medical billing and coding is a tedious, detail oriented job.If Sometimes there really is nothing that can be done to reduce the price of your bill Then ask with the payment plan..Great post and gives many tips about how to negotiate our medical bills..

chicagosunday33
chicagosunday33

I was nowhere near bankruptcy luckily, but I still had a largish overdue medical bill. I had a company http://www.klfinancialservices.com assist in negotiating my medical bill. They were able to get a 50 percent reduction off of my bill. It was amazing how many overcharges/errors were on the original bill.

Brian
Brian

I currently negotiated a seetlement were wellstar took 50 percent payment saved me 2108.20.But now they are driving me crazy about other bills I have a lot of doctor bills have concsider bankruptcy but I hate to do this over doctor bills any suggestions.

Leonardo
Leonardo

the healthcare blue book link is golden! great post! i am running into this issue now - being unemployed and with medical bills for a 10day hospital stay is extremely tough.

hospitals don't seem to negotiate at all, but individual doctors and clinics are more likely to do so. thing is, they haven't changed their price much at all because they have many patients who have no insurance and dont pay anything. i find this helpful to use when i speak with them "i'm not someone who doesnt have insurance, i will pay something, it's better than nothing, let's work it out."

if you really have no money to pay (like me), a payment plan is the best way - but also it helps just to wait. it's puts the burden on them to call you and write you letters. Now, i did put money upfront immediately, as in what it would have cost if they were covered by my insurance. however, these sharks want it all. so im waiting on them, asking for more time. it has allowed me to save up some so now i can negotiate better payment plans.

note: there are services out there that negotiate discounts for you, but they seem to be a complete rip-off for savings you can negotiate on your own.

p.s. that writing letters idea is great! i'll have to try that

Charlie
Charlie

We are currently negotiating the four medical bills associated with the birth of our son. My wife and I decided to write letters to the doctors to negotiate the amount owed. I believe there are two advantages to this approach. Since my wife and I are both pretty soft-spoken people, it allowed us to be “tougher” on paper than we would be on the phone, we find it easier to negotiate on paper rather than on the phone. Secondly, the billing office has to respond to you in writing. This covers you if there is any discrepancy that might arise between your phone conversations; you already have their response, with a name, in writing. Of the four letters we have sent out, we have received one letter back and they agreed to settle our debt for a discount of $121, or 20%. If that is the only settlement we get, we will still have saved $121, just for writing some letters.

Jessica Bosari
Jessica Bosari

In many states, it is illegal to bill an individual a different amount than you bill an insurance company. So the doctor cannot bill you less. Remember, however, that doesn't mean the doctor cannot accept less money to cover the bill. You shouldn't have to pay any more than the insurance company would, but many doctors offices confuse the billing issue thinking that accepting less is the same as billing less. Keep asking till you get a billing person who understands that.

Jeremy
Jeremy

That's a great idea, Charlie. A lot of people may be intimidated by using the phone so writing a letter can be just as effective and provide a paper trail like you suggested. But congrats on the savings so far. Hey, $121 just for spending a few minutes and the cost of a stamp is a pretty good deal.