Tips for Negotiating Medical Bills

Staring down a mountain of medical debt can be scary, but there are steps you can take to try and reduce those bills!

You know what sounds like a bad way to spend a day? Getting into some sort of medical emergency. No part of that is fun. And to add insult to literal injury, there’s a good chance you could end up with a medical bill that you are not prepared for or capable of paying.

You may feel trapped by your inability to pay and worry that your only options are eternal debt or bankruptcy. And the stress will likely keep you from stepping back and seeing if there might be other ways to get out of your medical debt dilemma.

If you’ve found this page because you’re struggling with medical bills, know someone struggling with medical bills, or are worried you may be struggling with medical bills in the future, we hope this advice may help make the situation more manageable.


Get as much info as you can upfront.

If you’re dealing with a medical emergency, there’s a decent chance you won’t be in the ideal position to get all the necessary information upfront. But the more information you are able to get, the better.

“Ask for cost transparency or a discount upfront,” urged Ted Chan, CEO of CareDash (@caredash). “Many doctors and dentists are understanding and willing to help.”

Assuming you are in a position to make choices about your medical care before undergoing treatment, those choices can make a massive difference in costs.

“When it comes to costly medical bills for less invasive medical procedures or even minor surgeries, one way to negotiate a savings is to have it performed in an outpatient office or ambulatory surgical setting,” advised Beverly Friedmann, content manager for ReviewingThis (@ReviewingThis).

“Surgeons have to pay high costs to rent out spaces in hospitals to perform surgeries, so if there’s ever a way to safely have a procedure performed in-office, you’ll be looking at a much lower bill. You can ask your doctor what your options are, and if this is a safe route to explore. It’s also important to remember the difference between a routine endoscopy and an appendectomy, as there are some procedures best limited to hospital settings.

“If you are given a choice between general anesthesia and a less invasive form of sedation, it’s typically wise to opt for the latter for a few reasons. From a healthcare vantage point, milder forms of sedation are typically just as effective and come with much fewer risks. They also tend to be less costly, and require less downtime spent in the hospital. Less downtime means a faster discharge, which means a lower total bill. You can try and negotiate a milder form of sedation for less invasive procedures and act as your own advocate throughout the process.”

Limit your stay if you can.

In an ideal world, you would feel comfortable taking as long as you need to recover to full health before being discharged. Sadly, the current reality is that the longer you stay in the hospital, the larger your bill will be.

“To save on costly hospital stays that can leave you in debt, being your own advocate is key,” explained Friedmann. “As soon as you enter an emergency room, try to calmly and collectively ensure your symptoms are addressed. If you’re being admitted, try to refer to your rights as a patient and request a bed (politely) as soon as possible. Try to ensure you are discharged as soon as possible within the realm of what is safe and under your physician’s directives. Ultimately, try to stress urgency without being pushy and exercising caution. Getting in and out safely and as quickly as possible will lower your total bill by as much as possible.”

Get the full bill.

There are a lot of mysteries when it comes to medical billing. Well, presumably someone who works for the provider understands the process completely. But you only have to do a little bit of research (or spend enough time in different hospitals) to realize that there is often little transparency or consistency when it comes to medical billing in the United States.

“Ask the billing department for the full, itemized bill—most hospitals/insurance companies send you the summary page,” advised Suzanne Garber, co-founder of the international hospital database Gauze (@GauzeHealth). “Would you buy anything of any value (computer, car, home), without the full itemized statement? Of course not. Healthcare should not be treated any differently. Demand the full bill.”

You should also be keeping track of whatever you can.

“Retain all documentation for your care from beginning to end, including bills, medical records, prescriptions, and receipts,” Chan suggested.

Once you have the bill, you can make sure there weren’t any mistakes working against you. Paying for what you actually owe is tough enough. Why make it harder?

“Check your bill thoroughly,” urged Leslie H. Tayne Esq. (@LeslieHTayneEsq), Founder and Head Attorney at Tayne Law Group (@taynelawgroup). “Ask for an itemized copy of your medical bills and make sure that you received each service you’re being charged for. Additionally, double check with your insurance company that you’re getting as much coverage as possible. Insurance billing codes change frequently, so errors are not uncommon and could be costing you more than you should be paying.”

Do your research.

We’re getting to the part where we tell you that you can attempt to negotiate your medical bills. But first, it’s a good idea to arm yourself with some knowledge.

“Research the fair market cost of each procedure you’ve had done,” offered Garber. “HealthcareBlueBook.com and Bankrate.com offer free estimates on how much healthcare procedures may cost. Castlight Health also offers a subscription based service to compare prices around the country. Know, too, what insurance companies have contracts with the hospitals as each insurance contract nets a discount that can range between 20 to 80 percent.”

Get to negotiations.

Medical bills are often reduced or settled for less. Why not yours?

“Armed with the full bill plus the average cost, you can intelligently speak with the billing manager to negotiate a better price,” explained Garber. “Oftentimes, you will receive 10 to 50 percent of the original bill. You can negotiate for a better discount by paying cash for the remaining balance; lesser discounts will likely have you working out a monthly payment plan.”

Be sure that you have all the details in line so you’ll be negotiating from the strongest position possible.

“Not many people think of trying to negotiate medical debt, but it is certainly possible,” Tayne told us. “First, make sure you’re the responsible party before discussing any payments. When looking to negotiate your debt, be prepared. Medical debt is inherently tied to hardship, so focus on the medical issue that landed you in debt in the first place. If you have a hardship, be prepared to discuss that and also go through your budget before calling so you know what you can and cannot do before having a conversation and feeling pressure to answer and agree to terms that may not make sense.”

Ask for assistance.

Sometimes you just have to ask for help. That might mean getting someone to guide you through the process.

“A medical advocate can help work through and explain the medical billing process,” offered Tayne. “This may be a good option if you’re unsure or overwhelmed by the process. However, be aware that most medical bill advocates will charge a fee.”

If you can prove you’re experiencing financial difficulties, there may be programs you can take advantage of.

“There may be a hardship packet with the hospital that you can fill out, and you can request one if you haven’t seen it,” Tayne advised. “Most hospitals have a financial services department where you can complete a hardship packet, and the department should get back in contact with you relatively soon after you submit your paperwork. The hospital will let you know what costs will be reduced from your bill due to your hardships. You also may be able to negotiate for a payment plan. Many medical bills are interest-free so consider a payment plan in your budget as an offer to resolve the matter.”

Hardship programs like these benefit the hospitals as well.

“Some healthcare systems have a community or charity care center,” explained Garber. “Providing you meet their qualification of needing financial assistance, between 25 to 100 percent of your healthcare may be written off as charity. Ask for their definition and be guided to their portal to fill out the forms. You will likely be asked to show your bank balance as well as tax forms.”

Bankruptcy?

It should be one of the last options you consider, but bankruptcy exists for a reason, and there’s no shame in taking advantage of it if you have to.

“If all else fails and you are unable to pay for your procedure, file bankruptcy,” Garber offered. “Healthcare is the number one reason why Americans file bankruptcy for personal reasons and it’s an embarrassment as no other country on the planet makes its citizens give up everything they own in order to take care of themselves medically.”

The best option is not having a medical issue at all. These are some other options to consider.

Dealing with major life expenses can be difficult. If you’re not prepared to handle them, they can easily deplete your savings, leaving you to rely on short-term bad credit loans and no credit check loans (like payday loanscash advances, and title loans) to make ends meet. So start planning ahead now! To learn more about you can deal with major life expenses, check out these related posts and articles from OppLoans:

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Contributors

Ted Chan is the CEO of CareDash (@caredash), a doctor review website used by more than 1 million patients a month.
Beverly Friedmann works as a Content Manager for the consumer website ReviewingThis (@ReviewingThis)—with a background in Sales and Marketing Management—and is from New York, NY.
Suzanne Garber is the co-founder of Gauze (@GauzeHealth) the world’s most comprehensive database of international hospitals that informs and connects the 1.3 billion international travelers annually with appropriate care anywhere, Suzanne Garber also directed and produced GAUZE: Unraveling Global Healthcare, an award-winning, PBS documentary that highlights her journey to 24 countries, 174 hospitals and interviews with 65 healthcare experts. Her work as COO, International SOS and Managing Director, FedEx South America has taken her to 100+ countries and all 7 continents. Holding degrees with honors from the University of Pennsylvania and Rutgers University, Suzanne has been featured in US News & World Report, The New York Times, Businessweek and hundreds of other media outlets/conferences that focus on globalization, risk mitigation, and international healthcare.
Leslie Tayne HeadshotLeslie H. Tayne, Esq. (@LeslieHTayneEsq) has nearly 20 years’ experience in the practice area of consumer and business financial debt-related services. Leslie is the founder and head attorney at Tayne Law Group (@taynelawgroup), which specializes in debt relief.