Medicare mandates what physicians and hospitals are allowed to collect for procedures. Private insurance companies negotiate what they will pay with hospitals, physician co-ops and participating providers. It really doesn't matter what the "bill" says, $100.00, $1000.00 or $10,000.00, some number cruncher has set a fee for service and that's what will be paid, period. This disparity does have a negative trickle down effect on the policy holder. If you are responsible for a 20% co-pay you could be billed for $20.00, $200.00 or $2000.00. It makes a difference.
It's worse if you are the hapless patient who is uninsured. This is the person who is not curious to see their statement, they are scared to death! Of course we are all expecting Obamacare to remedy this inequity but, so far, it is not working out so well. In a 2013 government study it showed that in some cases costs can drastically vary. A case in point, three hospitals in and around the Denver suburb of Aurora, Colorado charged an average of $97,214, $46,457 and $28,237, respectively, to treat a respiratory infection with complications. Was the care these patients received really that different?
Until the Affordable Health Care Act is fully implemented, what is a person to do?
Come on down!
Most large hospital systems now offer discounted prices even to uninsured patients, and many have realized it is better to send a realistic bill that has a realistic chance of being paid. Hospitals will negotiate discounts for prompt payment or commitment to a payment schedule. It is advised, however, that you not ask for a discount AFTER you have proffered any kind of credit card payment. Doctors' offices are more and more willing to discount fees to patients paying "out of pocket." However, there is a more intimate relationship with the doctor's billing clerk ( who very well might be a spouse) than an impartial hospital staffer in Accounts Receivable. The discount seeker might practice their best "garage sale" bargaining style: "I don't know if you realize it but I am totally responsible for this fee. Do you think there is any way Dr. Legree could help me out?"
Medical Billing Advocates of America have seven suggestions for negotiating lower medical bills. Here they are with my slant added.
1. Know the real or competitive cost of a procedure. Do your homework. Call nearby facilities armed with procedure and diagnosis codes. Check with websites like Healthcare Blue Book.
2. Use the right language. Be polite. Don't act offended at the size of the bill. Surprised? That's okay. Ask if there are financial assistance programs available.
3. Ask if your procedure can be done as an outpatient.
4. Be a tough negotiator. Don't take no for an answer. Go up the chain of command, at least in the hospital setting. Make notes. Know to whom you spoke. A 10 % or 20% hospital bill discount is not enough. Make an offer. Have you ever bought a used car? Deal!
5. Don't pay with a credit card. Once swiped there is very little likelihood of getting a refund. Furthermore, you will incur interest charges on unpaid balances. Most likely, if you pay the hospital over time there would be no interest charged.
6. Arrange that no interest payment plan. Pay faithfully. When you have made a good dent in the balance, approach them again. Point out how reliable you have been and ask if they might reduce or cancel the balance of the debt.
7. Call in the pros, like Medical Billing Advocates of America. For a percentage fee they will work on your behalf to lower your medical bills. The Access Project will assist you and advise you for free.
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September...
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