Subscribe to this BlogStrategies to cut your medical costs
I recently wrote a short piece for Money magazine on surprising bills you can haggle over, which included specific negotiating strategies. But one of my sources chided me for not going far enough with the advice on how to lower medical bills with doctors and hospitals. “Medical debt has its own rules and almost no one is expected to pay list prices,” says Andrew Cohen of the Access Project, a national health-care research and advocacy group. “People have every right to negotiate medical bills, whether they have insurance or not. But negotiating is just one step.”
With the ranks of uninsured and underinsured rising and health costs fast outpacing inflation, I thought it was worthwhile to go deeper into advice on how to lower your medical costs upfront. You probably already know that uninsured people pay some of the steepest prices because they don’t benefit from the volume discounts that insurance companies negotiate for group plans. But since even people with insurance are facing higher out of pocket costs for premiums, deductibles and co-insurance (where the insured pays a percentage of the bill instead of a flat-fee co-pay), it’s good for everyone to know how to lower healthcare expenses.
First, know that doctors and hospitals are very open to negotiating – they do it all the time with insurance companies. Just by paying upfront, you may be able to knock 10% to 20% off your bill. Many hospitals and health care providers offer these so-called prompt pay discounts if you pay a portion or the whole bill upfront, even if you’ve got insurance. But don’t stop there, says Cohen: “You’re probably still overpaying."
Of course, a key part of knowing how much room you have to negotiate is understanding what's a fair price. But that is difficult to determine when it comes to healthcare, since costs vary widely by where you live, where you get treatment and what insurance you have. A new website may help: started by a doctor named Jeff Rice (after he said he was charged ten times more than he should have been for a lab test), Healthcarebluebook.com is a free consumer pricing guide that provides the price that PPOs pay their doctors, hospitals and other services. You can search by zipcode to find the costs of a wide variety of procedures, from hospital surgery to dentistry and cosmetic care to lab tests, and print out a detailed pricing agreement with the estimated cost. Other places to look for pricing information are the websites of large insurers.
If you negotiate a lower price and are still struggling to pay, talk to the patient billing account office and ask for a payment plan that doesn’t charge interest. You might also be eligible for a public program to pay off your bill, says Cohen. “Charity care isn’t just for poor people. There are a lot of people, even middle income people, who struggle with medical bills.”
Have you negotiated down a medical bill successfully? Share your story here.
- Donna Rosato
Looking at your chart it is simple to see that the best way to lower one's medical cost is A PUBLIC OPTION that forces insurers to lower their cost to compete. Simple look at 2009 and the insurance companies are upping their rates even as the inflation rate is negative. So much for private industry helping out Americans. My brain is simple, but I know when I am being taken advantage of by private companies. VOTE FOR PUBLIC OPTION FOR ALL AMERICANS!!!!!!!
Cut your healthcare costs by taking care of your body. Treat your bocy like a luxury car…If it is not maintained, if is is overused, neglected, abused it will cost you more in the long run. Where is the outrage on how the american public is taking responsibility for their behavior? Smoking, over-eating, stress, not excercising is what is driving the huge costs to the helathcare system. Then when our bodies breakdown, we want the healthcare industry to "fix" us. But many don't want to pay for it. Very hypocritical and pathetic. Those who live healthy now are asked to pay more in taxes to cover those who live medically expensive life-styles. Where is the personal responsibility? The govt want to take care of you…and therefore have control of your lifestyle.
The best time to negotiate with your doctor is at the time of your first visit. It is best to be upfront, easier to negotiate than waiting till after services are rendered, exams costs incurred etc. Once your are dealing with billing depts it is much more difficult, you're more likely to be just a numbered account.
Live With Intention
Dr Bill Toth (retired)
CreateYourFate.com
It hasnt worked for me. I have tried 3 times and always have been threatned with collections from the Mt Carmel Hospital. They got sizable checks for my care and the balance bills was high. I am On a payment plan thats going no where and will probably take me almost 3 yrs to pay off.
Awesome. I love the idea of haggling for health care. Then I can hit the flea market tent in the parking lot and pick myself up some meds. More snarkiness on adavenewworld.blogspot.com
This is such an important topic. We just launched a new website TODAY 10/8 devoted to helping patients become smarter healthcare consumers:
http://www.myhealthandmoney.com
In addition to Donna's great suggestions, you can find more tips and advice on how to lower your out-of-pocket expenses:
http://www.myhealthandmoney.com/learn-about-costs/tips
We also offer comparison pricing on diagnostic tests and hospital procedures, prescription drug discounts, and expert advice & community (eventually) all focused on lowering out-of-pocket healthcare spending.
Billing process, yes the billing department is one thing that hospitals and doctor offices pay way too much. They will be better off if they are able to bill the patient at the time of service not only the copay but also any applicable deductibles as well. Here's an example of an absolute waste of time and money. Personally I put in money into a FSA to pay doc bills, but due to IRS regulation, if I do not pay using the FSA card at time of service I get into this whole nightmare of paperwork that I have submit to have the payment processed.
Another thing that can help save money is, less use of these stupid collection agencies. Give you an example, I visit my doctors office, every time I go there (I go for regular check ups every 3 months) they say my file is missing and get me to sign my HIPPAA forms (required only once a year. Yeah righ!!!), and copy of my insurance card and DLs. I pay my co-pay, but later I get this bill saying that I have a balance for some absurd amount. Calling their billing department I’m told that they do not have my insurance on file. So I end up giving all that information again easily send their unpaid invoices to these agencies and I feel that they do not know what they are doing most of the time. Why don’t I change the doctor right? I like the doctor but its this hospital that he works for and their beaucratic billing department.
Don’t hear from them for a while and then suddenly a call from the collection agency. These agencies, the only thing they know to say is pay the balance and work the rest with the insurance company. There is so much red tape and confusion in the billing area, that by just by putting money into health care overhaul, without any thought into a process that will simplify the payment and collection system will only lead to a healthcare disaster. I would like see congress put more emphasis in the billing process and this will definitely save tons of money and use that to better serve us.
Start with "your" Doctor. When I was unemployed, I was able to pay "just" $75 for an office visit. Once I had coverage again was I surprised to see that my $20 co-pay was matched with Blue Cross Blue Shields $45 payment. WHAT! I was paying him more than he got with I HAD insurance!
Every hospital and physician office will have different policies for negotiating discounts. Larger hospitals in big cities tend to be much more difficult when negotiating. Shop around and if the first place says "no" try another. Doctors, particular those you have seen in the past, are usually more open to discounts. When having a procedure, look to an ambulatory surgery center. Their prices tend to be much less than traditional hospitals.
The problem isn't the doctor or the hospital. The problem is the terrible reimbursements left over frm the insurance companies. First they take $$$ out of my paycheck. Then there's the deductible, the coinsurance, copayments, on and on it goes.
Negotiating the price down is a step in the right direction.
My boyfriend recently took a trip to the ER the night before the insurance from his new job went into effect. When we finally got the bills from both the hospital and doctors, I looked into the "Patient Financial Services" offices with both. We applied with the hospital and got something like 60% taken off and then sent a copy of that letter to the physicians and they ate the entire bill (something like $480, equal to the amount the hospital had taken off). I was amazed! It takes a decent amount of work and some lengthy phone calls (mostly sitting on hold), but completely worth it!
I have heard that money put a way in a Medical Savings account is lost if you do not use it. Is that true?