High Medical Bills: How to Negotiate a Lower Cost

January 7, 2020 in Health finance  •  By Miles Varn, MD
high medical bills

If you’re having trouble paying high medical bills or are faced with unexpected medical costs, you may want to consider negotiating with your healthcare providers to reduce the amount you owe. High medical bills and medical debt are problems a growing number of Americans of all ages are facing. According to data collected by the Kaiser Family Foundation, 67% of Americans are either very worried or somewhat worried about unexpected medical bills. In addition, the credit bureau TransUnion reported that an analysis of data showed that 68% of patients failed to fully pay off medical bill balances in 2016, with that number projected to grow to 95% by 2020.

Unpaid medical bills may be turned over to collection agencies or providers may sue, which can have a negative effect on your credit score, not to mention the stress the debt creates, which can negatively impact your health.

One option that can help you better manage high medical bills and unexpected medical costs is negotiating a lower cost. These strategies can help you get started.

  • Check your bills for errors. Bills include a surprising number of errors that can add up to significant amounts. Some experts note that between 30% and 80% of medical bills contain errors. And an audit by credit rating agency Equifax found that for hospital bills totaling $10,000 or more, there was an average error of $1,300. Common errors to be on the lookout for include being charged twice for the same service, charges for tests or procedures that were cancelled, balance billing for in-network care, and providers failing to submit their charges to your health insurer.
  • Make sure your health insurer covered all the charges it should have. If the amount your insurance paid the provider left with you a large balance due, contact the insurer and ask why they paid the amount they did. Find out if the care wasn’t considered medically necessary, why, and what information would change that decision. You can appeal your insurer’s coverage decision in some cases, so ask how the appeals process works.
  • Ask about financial assistance. If your bills are from a hospital, contact the billing department and ask if they have a financial assistance policy. This can be especially helpful if you’re uninsured, have a health plan with a very high deductible, the bill includes care not covered by your plan’s benefit structure, and when care is out-of-network. Even if you don’t qualify for financial assistance or the hospital doesn’t offer it, you may be able to get the hospital to set up a no-interest plan that will allow you to pay over time.
  • Request to pay at the rates insurers pay. Insurance companies often pay less than individuals do for the same services, so look up the fair market costs for the services you received on a resource like FAIR Health Consumer and negotiate with the provider’s billing department, requesting to pay the lower amount.
  • Find out if there’s a discount if you pay cash or pay upfront. Some providers will accept a lower fee if you pay your portion of the bill (what’s due after insurance) in cash. If you have a flexible spending account or health savings account, you can use the money in your account to do this. Some also discount bills if you’re willing to pay your balance within a short period of time, usually within days or weeks. This is known as a prompt pay discount.

All of these steps may help you cut costs when faced with high medical bills, but if your bills are particularly complex or large, you may want to consider working with a medical billing advocate who will review your bills for you and negotiate with providers on your behalf.


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