Expert Advice on How to Negotiate Medical Bills

Expert Advice on How to Negotiate Medical Bills

By Lizzy Martini

Medical bills are no joke—and if you’re struggling with them, you’re in good company. 26% of US adults say they or someone in their household had problems paying medical bills in the last year, according to the Kaiser Family Foundation/ New York Times Medical Bills Survey.

One common tactic for dealing with overwhelming medical debt is to try to negotiate medical bills. We reached out to six legal, medical and financial experts to get their best advice on how to cut your bills down to a manageable size.

Request an itemized bill and check for errors
To start, make sure you have an itemized bill—not one that shows only the total amount owed—and comb through it for errors.

“The first and most important step is to ask the hospital (or other care provider) for an itemized bill. Once you get the itemized bill, there are a few things you need to review. First, look at the total charges on the itemized bill and make sure they match what’s on the summary hospital bill. Second, go line-by-line and verify, to the best of your ability, that you received the supplies, medicine and/or care the bill says you did.” JR Duren, HighYa

Common errors include duplicate charges, canceled tests or procedures and incorrect quantities. If you find an error, ask your health care provider to correct it ASAP and resubmit a corrected claim to your insurance company, if applicable.

Understand your benefits
Next, dig into your insurance benefits (if you have them) and see if they were properly applied.

“If you have health insurance, make sure you understand your benefits. Then, determine that your insurance has processed and paid the claim to the full extent of your benefits.” R. Ruth Linden, Ph.D., President of Tree of Life Health Advocates

“Time is of the essence, as most health insurers have contractual terms that require bills to be submitted within a certain period of time.” Wesley Pickelsimer, Esq., Pickelsimer LLC

Ask to settle the debt for a lower amount and/or set up a payment plan
Once you’ve determined that the amount you owe is correct—but you aren’t able to pay it in full—you can begin to negotiate. Negotiation typically includes asking to settle the debt for a lower amount and/or setting up a payment plan that is within your monthly means.

 “Call the medical facility and ask for a price to settle the debt immediately. Often, healthcare organizations will take much less than the original amount if you can pay it immediately. If you are unable to shell out that sort of cash, ask if you can set up a payment plan and request a discount in exchange for automatic payments.” Brittney Wilson, BSN, RN, The Nerdy Nurse

“Hospitals are often willing to put you on a payment plan to make sure your bill gets paid. Inquire about these payment plans and don’t be afraid to ask for a low monthly payment.” JR Duran, HighYa

“Should phone call negotiations not reach an agreeable amount, another course of action includes sending a physical check to the provider with your proposed amount. Your check should include the account number, date(s) of service, and “Paid in full” or “For full and final payment of account number [###]” on the face of the check. If the provider deposits the check, then the amount related to that account has been successfully negotiated and there would be no remaining balance.” Wesley Pickelsimer, Esq., Pickelsimer LLC

Understand your options if your bill is sent to a collections agency
Your hospital or health provider may eventually turn over an unpaid debt to a collections agency.

“First, it is important to note that the majority of medical bills that are placed into a collections agency have settlement parameters associated with them. These parameters are the agreed-upon amount of money the agency is allowed to take off the debt, and the parameters often don’t exceed 20%. Also, settlements are at the discretion of the medical facility, so not all will allow for discounts. If you have a 20% settlement parameter, you would be paying around 80% of your total bill. If your medical debt is less than a few years old, it likely falls into this category. Generally, a settlement only occurs if a payment plan is setup. 

When it comes to older medical debt, the patient really has some room for negotiation. Older medical debt is generally sold to a debt buyer for a fraction of what the patient owes. When the collections agency contacts you, you generally have the ability to negotiate anywhere from 35% to 60% off the bill.” Ryan O’Hara, MBA, MSMIT, FrontLine Group

Remember: Keep asking for clarification
Throughout the process, be proactive and don’t pay a bill that you don’t understand.

“If, at any step along the way, you don’t understand the process or the charges, ask for clarification and keep asking until you’re satisfied.” R. Ruth Linden, Ph.D., President of Tree of Life Health Advocates

Bonus tips: How to lower the cost of medical care before getting a bill
Our experts also served up great advice about how to avoid receiving an overwhelming medical bill in the first place.

Shop for reduced medical procedures – “Reach out to physicians ahead of planned treatment to obtain the best price. This can be accomplished by calling the practice ahead of time and asking for their cash rates, indigent patient rates, or what they would charge someone according to your health coverage. Billing departments, however, are often unable to answer with a high degree of certainty. Some facilities even list their prices for certain procedures online—such as Surgery Center of Oklahoma—though this is rare. The online Healthcare Bluebook can also provide guidance on expected medical costs.” Wesley Pickelsimer, Esq., Pickelsimer LLC

Ask for discounts – “If you’re looking for discounts or trying to save money, just ask. I employ this tactic every time I’m opening my wallet for medical care, especially if my insurance doesn’t cover a procedure. Your doctor may have discounts available, like for paying online or over the phone, referring new patients, or sharing his or her practice on social media. Ask about student, military or senior discounts, too. Lastly, some providers offer discounts for committing to a certain number of procedures, like teeth whitening or Botox. If these savings aren’t advertised, you won’t know about them unless you inquire—and there’s no shame in that game when it comes to keeping more of your cash.” Mikey Rox

Max our your health savings account contribution – “Try and avoid racking up medical debt by contributing the maximum amount to your HSA.” Brittney Wilson, BSN, RN, The Nerdy Nurse

What is an HSA? A health savings account (HSA) is a tax-exempt account you can use to pay or reimburse certain medical expenses. Many people choose to direct a certain portion of each paycheck toward their HSA. There are certain eligibility requirements, like being covered under a high deductible health plan.

Help paying medical bills
If you have successfully negotiated down the cost of your medical bills but are still struggling to pay them, you may consider a personal installment loan. With an installment loan, you can borrow a lump sum to wipe out your medical debts. You’ll pay back the borrowed amount and interest with regular payments (or installments) over a fixed period of time.

One notable benefit: making regular payments on an installment loan can boost your credit profile. Personal installment loans are available from banks, credit unions and also online.

 At RISE, we offer personal installment loans from $500 to $5,000, depending on where you live. Applying online makes it fast, and you can usually get the money within a day or two.

We help our customers with the cash they need today, and help them build a better future with financial wellness tools like Credit Score Plus—that’s the RISE difference.

Next Article: Emergency Fund Amount: What Millennials Need to Know