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How to Negotiate Medical Bills

Aug. 27, 2013
Health, Managing Medical Bills
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One in six Americans struggle with medical bills, and medical bankruptcy accounts for the majority of personal bankruptcies. Many Americans don’t realize they can negotiate their medical bills. As many as 80% of medical bills contain errors, so it makes sense to scrutinize bills and to be prepared to negotiate. Here’s how.

Ask the right questions before and after your care

If you can plan your care ahead of time, always ask both your provider’s billing department and your insurance company how much you should anticipate for your bills. When your bill arrives, you will notice immediate discrepancies when the cost of service is beyond expectations. You can also access NerdWallet’s free Best Hospitals tool to get an estimate of what your procedure should cost at your local hospital. Sometimes you can’t plan ahead, and a trip to the ER cannot be helped. Negotiating your medical bills after treatment is similar to what you would do if your waitress brings you the wrong bill. Take your time to look patiently for discrepancies.

Understand and evaluate your bill 

Start by calling the main line of your doctor and hospital and asking to speak with the billing department. Ask the right questions to learn more about your bill:

1)   Ask for an itemization of all charges

  • This should include equipment, medications, tests, readings and other services provided

2)   Ask what services are covered under your room and facility charges

  • Here you’re looking to see if you’ve been charged twice under separate items for items such as blankets, pillows, etc. that should already be covered by these fees

3)   Ask what treatments were provided

  • You want a detailed explanation of the purpose and necessity of every service

4)   Clarify the date and time of when you were admitted

  • Be specific with dates and times to isolate billing errors based on time

5)   Ask questions about medical terminology that is unclear

  • This helps you avoid duplication of services or exorbitant costs for generic medication (e.g. a tablet of generic Tylenol should not differ from market rates)

As you evaluate your bill, look for times that services were repeated, products that were consumed more than once, and charges that just don’t pass the gut check. Why should you receive two Xrays or pay $5 for a bandaid?

At the negotiating table

Make an in-person appointment to discuss your bill with the billing professional or practice administrator. Ask to eliminate items you believe are erroneous or unnecessary. You might also offer to pay a different price – an amount you deem fair payment for the services received. Try to come to a final figure that you can afford to pay in one lump sum and avoid taking on debt that needs to be repaid monthly.

Get help from professional patient advocates

To lower their expenses, patients are increasingly turning to a growing number of medical bill advocates. These advocates are often experienced medical billing professionals who offer their expertise to interpret your bill, look for errors and overcharges, and ultimately negotiate a lower rate. Many families have saved tens of thousands of dollars through these services, and often there is little or no upfront cost. Instead, these negotiators typically earn a fee as a percentage of the dollars they save you. If you want to learn more about how an advocate can help you, go to NerdWallet’s Ask an Advisor Forum and ask your medical bill question today.

Doctor with calculator photo courtesy of Shutterstock.