20 Ways to Negotiate Your Bill
Simple, easy ways that anyone can use to lower a surprise medical bill.
Posted on June 25th, 2019
By: Joseph Paturzo and Sarabeth Coatney
Every medical bill is disputable. Due to the lack of billing transparency, Americans are often being charged egregious prices for common medical services, such as $600 for a Band-Aid or $9,000 for a CT Scan. With the consultation of industry experts, patients, doctors, and hospital leaders, Restoring Medicine has put together this proven patient toolkit to fight against overcharged medical bills.
1. Ask for an itemized bill:
80% of medical bills contain an error. Review the services and let the hospital know of any that were not rendered. Look for duplicate charges. Hospitals will often delete line items when patients report inaccuracies. Use this tool to translate medical procedure codes and medical diagnosis codes into plain language so you can understand your bill.
2. Find the fair market price:
You can find out the average price for a medical service by looking up what Medicare would pay and what a commercial insurance company would pay for the same service. Another tool that can enable you to find average prices is healthcare bluebook. Some states also have reference pricing information such as Florida and New Hampshire. Even better, you can show the hospital what other centers charge for the same service such as, Oklahoma Surgery Center and Texas Free Market Surgery.
3. Call your insurance company:
If you have insurance, check your explanation of benefits (EOB) to see if the services you are being charged for should be covered. If you believe that the bill should be covered according to your EOB, but the insurance company is refusing to pay, contact the National Association of Insurance Commissioners. These are tools to contact your state and an example of how to file an appeal.
4. Contact the hospital’s financial aid office:
All hospitals are required by law to have a financial aid program. Some hospitals forgive or reduce bills of patients who are below 200% of the federal poverty line. Most hospitals offer payment plans, however, beware of payment plans that offer a small discount on the total bill. A payment plan on an inflated price is not real relief. The payment plan should be based on fair market prices.
5. Contact your doctor:
Most doctors are unaware that their patients struggle with their medical bills, even to the point of collections or court. Explain to your doctor how much you were charged and request that they help to negotiate a fair price on your behalf. For bills from private practice physicians, you can explain your financial hardships and ask for help.
6. Address out-of-network services:
If you received an out-of-network charge at an in-network hospital for non-urgent care, you should have been warned that you may receive a surprise bill. 57% of Americans have received a surprise bill.
7. Get Help:
There are free services that can help, such as The Patient Advocate Foundation. If you can afford it, there are groups such as, Medwise Insurance Advocacy, Systemedic, and Medical Cost Advocate, that are for hire and may be worthwhile.
8. Know your rights:
For any emergent condition for which you go to the hospital, you are absolutely not required to provide a credit card or other financial information, including insurance status. By law, hospitals are required to take care of all urgent patients who present to an emergency department regardless of their ability to pay. Don’t be fooled into thinking a hospital must have this information in order to treat you. If they insist, you can cite the EMTALA law.
9. Call your hospital’s leaders:
If you truly believe that you have been unfairly charged for services not rendered or massively overcharged for services received, and none of the above have produced results, then contact the hospital’s leaders. You can call the hospital’s CEO’s office through the hospital’s operator and the CFO’s office. If these efforts are not successful, and the bill is truly egregious, contact the hospital’s board members through their offsite office. Many hospital leaders are reasonable, but unaware about how extreme their billing systems can be.
10. Post a review:
Draft a review and share it with the hospital and billing department and before posting allow them to review it to see if they think your review is fair. If publishing a review, post it to multiple sites. Be sure to be factually accurate and civil.
11. Engage with your hospital[i] on social media:
Lookup your hospital on social media. Tag them within your posts or directly message them to share your situation. Hospital administrators are likely to respond to patient feedback if made public.
12. Call your local news source:
Lookup your local news outlets on the internet. Find their contact information and share your story with them. Local news stations want to be more aware of what is going on within their community.
13. Submit your bill to national media outlets:
There are plenty of news sources that are willing and happy to tell your story of injustice. Find out who covers the healthcare industry for your local paper and send an email detailing your story. This will give you the platform to be heard on a larger scale. Below are a few news companies and how to contact them.
14. If all else fails:
With today’s social media presence, you not only can have your story heard, but can more easily fundraise money to help you better pay for medical bills. It is important to note that this should be a last-resort effort if you were not able to bring your medical bills down to a reasonable cost. Below are a few websites for fundraising.
15. For emergency transport:
Many emergency transport vehicles, air or ground, are privately owned. For air transport, call the company Sentinel Air. They will find a fair price for your transportation. Ask the company that billed you if they would match the price given by Sentinel Air. For ground transport, call individual companies and ask for their prices. Ask the company that charged you if they would match the lowest price.
16. Contact your state’s attorney:
Reach out to him or her explaining your situation. With this explanation, ‘cc the hospital that billed you and a news source.
17. Demand to see the contract:
If collectors are calling you insisting that you pay for an unfair bill, insist they provide you with the contract obligating you to pay. Without a written agreement that you owe money, you have no legal obligation to pay. If someone mows your lawn without a contract and bills you for a million dollars, you would not legally have to pay this inflated amount. Collectors are generally unable to provide documentation. Financial agreements coupled with consent to treat forms when you are under duress are legally invalid.
18. Contact your employer’s head of Human Resource department:
156 million Americans receive their health insurance through their employer. By reaching out, heads of HR departments can advocate for you regarding your medical bill.
19. Don’t pay for inappropriate care:
If you received inappropriate care or had an avoidable complication, request that you not be charged for these services. In a study regarding patients in the state of Washington, over 600,000 patients underwent unnecessary medical care.
20. Pay in cash for a fair price:
Offer to pay in cash if the hospital will accept the Medicare allowable amount. Often hospitals will offer a big discount for an instant, big payment.
[i] Also includes medical or physician group
For more resources, visit pratter.us.