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How to negotiate a hospital bill

8 Strategies for Negotiating with the Hospital Billing Department » Medical Debt » 8 Strategies for Negotiating with the Hospital Billing Department



Are you nearing collapse from the weight of a bone-crushing hospital bill? Don’t rush to send payment just yet. First, make sure the amount owed is correct and then try to negotiate a lower bill.

Many hospitals are willing to negotiate a lower bill or a reasonable payment plan. However, you’ll need to come to the table prepared, armed with medical and insurance records and a solution or two of your own to offer.

If you’re struggling with medical debt, don’t rush to charge the balance on your credit card. Try one of these eight negotiating strategies to lower your hospital bill.

1. Verify billing accuracy

Did you know that around 80% of medical bills contain errors or overcharges? Don’t assume that the billing department and hospital staff are immune to billing mistakes. Hopefully, you saved all the Explanation of Benefits (EOB) forms sent by your insurance company. If not, ask your insurer to resend them for your review.

First, request copies of your medical records from the hospital. Then Verify dates of service, along with billing codes for all procedures and services on your hospital bill (or bills). Watch for duplicate billing, incorrect codes and charges for canceled procedures or services.

2. Check your insurance coverage

Even though it’s a tedious task to read the terms of your health insurance coverage, carefully review coverage terms online or in the booklet mailed by the insurer. You may find that a claim was wrongly denied by your insurance company for a diagnosis or procedure that should be covered.

If you’re being billed for something that is covered, ask the hospital billing department to resubmit the claim. If that doesn’t work, appeal the denial with your health insurance company.

How to: Select the best health plan for your situation

3. Be reasonable and polite

You won’t make any headway by going ballistic on the hospital billing department staff. And as heartless as it seems, they don’t want to hear your long, detailed saga of how health problems ruined your life.

When you’re facing health and financial problems, a nasty, inept or uncaring billing department staffer can push you to the brink of your already-shaky patience. As difficult as it may be, stay calm on the phone and in correspondence. Stick to the facts, remove emotion and treat your hospital bill as a business transaction.

4. Research pricing

To get an idea of whether your hospital charged a fair price for a surgery or procedure, look up the average price for the billed medical service on a national database by zip code and procedure. If the hospital charged an unfair price, you can use that information for negotiating leverage.

Search the Healthcare Bluebook or FAIR Health, a health insurance claim database for prices in your region. Look up price by the billing code on the on the Centers for Medicare and Medicaid Services website.

5. Meet with the hospital patient advocate

Most hospitals have a patient advocate on staff who handles complaints and issues before, during or after a hospital stay. The hospital patient advocate is a neutral party who can assist with many issues, including obtaining copies of your medical records and helping you understand and deal with hospital bills and insurance. The patient advocate may also provide information about available hospital financial assistance programs.

6. Hire a medical billing advocate

Unlike an on-staff hospital patient advocate, an independent medical billing advocate is a professional you hire to review your bill for accuracy, dispute or appeal errors with the hospital or insurance company and possibly even negotiate a lower bill.

Medical billing advocates often charge a percentage of the amount their services saved you on the bill. Others charge an hourly rate ranging from $75 to $350.

7. Offer a lump sum payment

Keep in mind that the hospital billing department wants to get rid of your balance as much as you do. Why not offer a lump sum payment for a reasonable percentage of what you owe? For example, if you owe $2,000, you might ask to settle the bill for $1,500 (or even less) in a lump sum paid immediately.

If you can scrounge up the cash, that’s best. However, another option is to transfer the negotiated balance to a credit card with a 0% APR introductory offer for a year or 18 months. Just make sure you pay off the balance before the intro period ends to avoid paying interest.

8. Arrange a payment plan

Even if you’re unable to negotiate a lower bill, you may still be able to arrange a more affordable payment plan with the hospital billing department. Be honest about the monthly amount you can afford and try to arrange a payment plan that is mutually agreeable.

Missing payments could revoke the agreement, so pay on time, and make larger payments when you can to pay off the balance sooner.

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