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How To Negotiate Hospital Bills
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Why Hospitals And Health Insurers Didn’t Want You To See Their Prices
How to spot expensive mistakes on your medical bill and when you should ask for an itemized bill
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You are on the road to healing and finally feeling like yourself again. And then you get an outrageous medical bill in the mail. What are you doing?
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First and foremost: don’t pay now. It may seem counterintuitive, but there are a few steps you should consider before paying, such as asking for an itemized bill, comparing fees, and speaking with an insurance agent.
Note. If you don’t pay your medical bill right away, it won’t hurt your credit score right away. It takes several months to get the debt collection agencies involved.
Hospital billing is like any other bill, people and computers make mistakes, which can result in a bill that charges you more than you actually have to pay.
“We estimate that about half of all medical bills have an error, and we’ve never seen an error that worked out in the patient’s favor,” says Caitlin Donovan, a health policy expert at the National Patient Advocacy Foundation.
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Here are some expert tips on what to do if you’re not sure whether or not you’re being overcharged for medical services.
Knowing what you’re looking for helps to identify the error. Here is a list of common errors on medical bills:
But perhaps the most common mistake of them all is getting a bill that hasn’t gone through your insurance yet.
“The biggest source of error, if you break it down, is billing that goes directly to the patient before the insurer processes it. There are all kinds of reasons why this happens, starting with the purely random,” says Donovan.
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It turns out that billing for medical care isn’t as simple as paying the first bill the hospital bills you for, and that may explain the huge cost. So before you do anything else, first make sure your insurer has received and processed your bill. After the price still seems unreasonably high, start looking for other errors or mistakes.
Let’s say you find a mistake or your bill is more than you can pay. Can you negotiate the hospital bill?
If a bill is hurting you financially, it’s worth arguing, says patient advocate AnnMarie Mcllwain, an experienced medical billing and patient advocate with the Alliance of Professional Health Advocates.
If there are errors, it’s important to point them out, but you may also find that you can negotiate an invoice price even if there are no obvious errors.
Things To Remember As You Negotiate Medical Bills
If you’re worried that not paying right away will affect your credit, don’t worry. “For 180 days, no bill can show up on your credit score. Right off the bat, you have six months,” says Donovan.
Mcllwain suggests calling the hospital’s billing office number to let them know you’re disputing the bill. Make sure and ask them to put a hold on your case so it doesn’t show up as a debt and thus affect your credit score.
It’s also a good rule of thumb to document who you talk to and what they tell you.
It is important to note that you may not receive an itemized bill unless you request one. However, if you request one, the hospital is required by law to issue it to you.
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You can request an itemized bill after receiving the EOB or before planning a major operation such as surgery to get an idea of the expected upfront costs.
“Ask for an itemized bill. It’s full of a lot of detail. You might find yourself being charged for days you weren’t even there. Software and people are fallible,” Mcllwain says.
Compared to an EOB, itemized invoices provide a more detailed description of all services received, including the billing codes on your EOB. A detailed bill may look like and how to read it:
If you have health insurance, contact an insurance agent who can help you review the specific details of your bill and resolve any issues.
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Important: Every medical bill looks different, depending on a number of factors, including where it came from, your health insurance, and the procedure or service you received.
If you don’t have an insurance agent, you can still take steps to negotiate the bill with the billing health care provider. It may just take more work from you.
In either case, you should contact the hospital’s billing department to let them know you are disputing their charge.
Donovan and Mcllwain recommend using Healthcare Blue Book to see the cost of services and procedures at other hospitals near you. Another similar tool is FAIR Health.
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Important. Healthcare Blue Book provides a database of healthcare costs in different areas that you can compare to your bills. Their aim is to reduce the overpayment of treatment procedures. The free version for consumers will be changed by 2021.
It’s similar to comparing car prices, so it’s best to look at the average prices of other nearby hospitals. Once you’ve logged in prices for neighboring medical facilities, you can use your medical facility’s tax manager to compare fees.
“Compare what they charge you to the taxman,” says McIlwain. “Hospitals are increasingly listing a fee guide link on their website where you can look up what their typical fees are for certain procedures. If you see a discrepancy, use that when negotiating.”
If your hospital’s treatment costs were in line with the hospital’s estimated price, you may still be able to negotiate a bill if you are charged much more than you would have paid at a neighboring hospital.
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McCllwain recommends documenting every phone call when negotiating an invoice. Keep track of exactly what mistakes you’re disputing, what you want to negotiate, and what your health insurance should cover.
This means keeping all documents sent to you, highlighting any inaccuracies, and keeping a file on your health insurance policy. Some apps like RexPay also help you track your bills.
Sometimes these issues can take months or even years to resolve, depending on the complexity of the issue.
Be patient and remember to try to stay calm on the phone even though you may be frustrated.
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Mcllwain says the representative you call isn’t responsible for the error, but they’re there to help. Being nice and patient is often a faster and better way to find the truck and solve the problem.
If you find yourself in a difficult situation, it may be time to hire a medical billing or insurance attorney to help you sort through your bills and negotiate your bills.
Medical billing attorneys are professionals who can help resolve billing issues in calls between hospitals and doctors and your insurance.
Depending on the attorney, you may pay an hourly fee or a contingency fee. Since they are independent contractors, their prices can vary widely.
How To Negotiate Hospital Bills
It is important to keep track of your medical expenses and be thorough when paying your hospital bill as you may be overcharged.
If you can’t pay your hospital bill or your appeal is unsuccessful, you have a few options. Some hospitals can help you set up a payment plan so you don’t have to pay everything at once. Some hospitals may also offer in-house financial assistance.
Nonprofit hospitals are required by law to adjust your bill if your income falls below specific guidelines. Payment policies are usually published on each hospital’s website, but be sure to read the fine print.
Additionally, you can apply for Medicaid if you are at or below the poverty line. Additionally, there are many companies and charities that can offer debt relief if all else fails.
The Secret To Negotiating A Lower Medical Bill
Donovan notes that there are some exceptional circumstances that may require more effort. If, for example, a hospital charges ridiculous prices or is particularly aggressive, you can reach out to your local congressman or the press. Sometimes a social media post gets a quick response from the hospital and you
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