How to Reduce Your Medical Bills

by Annie on October 2, 2009 · 10 comments

in Healthcare & Health Insurance

I am pretty frugal by nature.  I love shopping with my coupons and negotiating for bargains at appropriate moments.  Never pay retail is my motto when it comes to shopping.  And I tend to approach my health care with the same frugal manner.

This article is a discussion on how to reduce your medical bill by negotiating before and after any major medical procedure. Negotiating medical bills are especially important if you do not have adequate health insurance or are un-insured.

Does negotiating your medical bills mean that you will get sub-standard health care?

2/3 of the people filing for bankruptcy often listed medical bills as the top reason for their financial insolvency.  Even with affordable health insurance, it is no guarantee due to the rising cost of out-of-pocket expenses and inadequate health insurance protection.

We shop around for laser eye surgery and stomach stapling.  It does not make any sense for us to go into a doctor’s office without any idea of how much a procedure is going to cost.  And it especially makes no sense if you are uninsured and paying for the procedure directly out of your own pocket.

As for sub-standard health care, it never hurts to ask for a discount on your medical bill.  If you don’t ask, the answer is always no.

How do I comparison shop before a procedure to reduce my medical bill?

As notes in Getting Health Care without Health Insurance, some doctors are willing to reduce your medical bill for prompt payment if you are uninsured.  You can only get financial assistance for medical bill if you ask.

Hospital billing offices have more than 20 different insurance contracts and just as many rates that are charge to them.  And this does not include the inflated list price charge to patients without health insurance.  Sometimes even doctors do not know what rates are charged for a medical procedure!

So how am I suppose to know whether I am charged the correct amount for a medical procedure on my medical bill?  You can try one of these four websites to get a ballpark price on your medical bills:

Healthcare Blue Book

This website tells you what health insurance plans are paying in a given area code.

Change: Healthcare
You need to sign up in order to use their online tools for managing your healthcare.  However, their search function seems open to everyone.

Out of Pocket

There is some advertising on this site, so be careful of where you click.  But it gives a range for the cost of health procedures.

My Health Score

Pricing information in the 3rd column on the right.  This website is not as fancy as the others.

When comparison shopping for medical procedures, remember that the cost of drugs, lab work, imaging, and anesthesia are often billed separately from the hospital billing.  If you used any of the previously listed services, you will receive a separate medical bill later (which you can also reduce by negotiating with their billing department).

How do I reduce my medical debt after I received a bill?

Before negotiating to reduce your medical bill, ask for an itemized statement.  Double billing on a hospital bill is common.  Look out for the following common double billing line items:

1.  Check to make sure that you are not double billed for a hospital room and its standard amenities like a toothbrush or sheets.

2.  Keep an eye out for “kits” or “trays” in your itemized medical bill.  Check them against the individual charges for specific surgical instruments.

It is not unusual to get a 30% discount from just going through your itemized hospital bill to make sure that you are billed properly for the items that you did use during your stay.

How to negotiate a reduction on your medical bill

However, hospitals generally do not want to go through your itemized hospital bill by individual charges.  Instead, they prefer to give a percentage discount off the hospital bill.  Cash paying patients can get up to a 40% reduction off the inflated medical bill simply by asking.

Are you armed with your itemized medical bill?  Have you done your research to figure out what other patients are paying for similar medical services? Check out the websites I listed above to get this cost information.  If you have no idea how much the medical procedures typically cost, how do you know what you are overpaying on a medical bill?

When negotiating to reduce your medical bill, be confident and follow this script:

1.  Ask the billing department “Are you authorized to give me a discount for this medical bill?”

A.  If the answer yes, follow up with “What kind of discount can you give me?”

B.  Then ask “Who is authorized to give me a bigger discount?”

C.  Follow by “Can I get a bigger discount for paying with cash?”  If you do not have cash, you can charge it to your credit card.  But don’t charge it if you cannot pay off the balance when your credit card bill is due.  It would be stupid to pay finance charges that are larger than the amount you will be saving.

D.  If you can afford to, ask “Is there a discount for paying my medical bill in full?”  Most billing representatives assume that you will be paying installments on a medical bill.  If you can afford to pay the entire bill in full, ask for a discount for prompt payment.

2.  If the answer is no, then ask “Who is authorized to give me a discount?”  Then ask to speak to that person.  Follow with Questions A-D from above.

Sound firm and in control.  If you hesitate the billing representative either will brush you off or give you the smallest discount.  Don’t settle on a 10% discount.  That is just breadcrumbs to get you to pay the huge inflated cost.

But I am the non-confrontational type!  I need medical bill help!

If you cannot negotiate a reduction in your medical bills, then it is time to get medical bill help.  You can check out these two companies:

Medical Cost Advocate

Medical Billing Advocates of America

Typically companies will charge up to 30% of the savings to help you negotiate a reduction on your medical bills. This form of compensation gives these companies an incentive to get the maximum discount for you.

It is no surprise that doctors and hospitals do not like people who negotiate a reduction in their medical bills.  As matter of fact, they prefer we pay what they ask.  But with rising out-of-pocket expenses and deductibles, can you afford to pay medical bills without asking any questions?

Until next time and thanks for stopping by Small Steps to Health.

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{ 7 comments… read them below or add one }

Dr. J October 2, 2009 at 1:22 pm

I like this post! I have often found ways to help patients pay less, or find funding where the bills were not in my control.

I recently had a surgical procedure, and I was very cost conscious with the whole system, and it cut my expenses dramatically!

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Diane Fit to the Finish October 2, 2009 at 6:12 pm

This is so true. Here’s a little story for you. My son cut his chin when he fell. I was concerned so I took him to the doc. They looked at it and put a little bit of that glue to hold it together. Doctor’s time spent – 3 minutes. I go to pay (we have a big deductible) and she said, $313.53. I said, “For glue?” She told me to wait a minute, and went back and talked to the doctor. When she came back a few minutes later, the bill had miraclously reduced itself to $98.00. Curious isn’t it?
.-= Diane Fit to the Finish´s last blog ..Why Are You Saving Those Old Clothes? =-.

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asithi October 2, 2009 at 9:50 pm

Diane – That is a huge reduction on your medical bill! Maybe enough people pay their medical bill without question for the doctor’s office to think that you will too.

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Mona Lori October 3, 2009 at 12:16 pm

This is great advice for consumers. Thanks for sharing these tips on how to reduce your medical bills.

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Leia July 19, 2011 at 7:15 pm

I see cash patients pay full price at the pharmacy all the time. The patients that have a good relationship with their pharmacists usually gets the best discount because we know their financial situations usually. The pharmacist has the authority to price match another pharmacy or have resources to discount cards that can generate a lower discount. If any patient asks I always do my best to help decrease the cost or contact the physician to change the medication to a less expensive alternative.

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asithi July 19, 2011 at 8:04 pm

Leia – that is especially true for independently owned pharmacies. Thanks for the tip.

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Erica Johnson February 29, 2012 at 4:33 pm

@Diane, it is true. I used a professional service that negotiates on your behalf. they negotiated my bill from $1400 to $450, I was astonished at how high the original bill was.

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