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Cameron Huddleston: How to negotiate hospital bills

McClatchy-Tribune Information Services

January 18, 2016


Medical bills can blow up anyoneís budget. A survey by the Commonwealth Fund found that 64 million people had difficulty paying their medical bills. In fact, medical debt was found to be the single biggest cause of consumer bankruptcy in the U.S., according to several studies.

The cost of medical care can be daunting. A visit to the emergency room can set patients back by up to $700, according to estimates from Blue Cross Blue Shield of Massachusetts. Charges for a single surgical procedure can run thousands of dollars. For pregnant women, labor and delivery at a hospital can cost as much as $10,000 or more.

Those prices, however, arenít set in stone. "Most people donít know that you can negotiate your medical bills," said Jeff Rice, CEO of Healthcare Bluebook, a health care pricing resource for consumers and employers. "And they donít understand the huge difference between the list price and what providers accept as a discounted amount from the insurance company."

He said that providers often accept 50 percent to 80 percent less than the amount billed. Hereís how to talk your way into substantially reducing your hospital bill.

FIND OUT THE FAIR PRICE

Chances are that you comparison shop before making most major purchases. When it comes to your medical care, you should do the same. "Itís much harder to negotiate a bill down than to go to a provider who offers a fair price to begin with," Rice said. Fortunately, there are several resources to help you find the fair price for the procedure or treatment you need.

If youíre insured, you can start by checking with your insurer to see if it offers a cost comparison tool for providers in your network. You also can visit free resources such as HealthcareBluebook.com or NewChoiceHealth.com to find the cost for certain medical procedures in your area. You also can search online for "Medicare fee schedule" along with your state to get an idea of reasonable charges for treatment where you live, said Adria Goldman Gross, owner of MedWise Insurance Advocacy, which helps consumers resolve medical and insurance claims.

This information can help you identify the provider in your network with the best price for the procedure you need. Or you can use this information to negotiate a lower price with the provider of your choice.

NEGOTIATE UPFRONT

Your best bet for getting a provider to lower the fee for medical care is to negotiate before you receive treatment. Always ask upfront what the procedure codes and charges are. Some providers even have an option in their phone menu to get pricing information, Rice said.

If the provider is charging more than the fair price in your area, ask the billing department to come down in price to match the lower rates offered by other providers, Gross said. If the provider wonít budge and the rate is significantly higher than what others charge, you might be better off going to another provider, Rice said. He pointed out that some providers charge less than others even when they work together in the same practice.

OFFER TO PAY CASH

In some cases, patients who are willing to pay cash can get an even better price than what insurance companies get, Rice said. So ask about the rate for a patient paying with cash compared with insurance. Itís especially important for patients without insurance to ask for a self-pay discount. Otherwise, theyíll get charged the full sticker price, Rice said.

Self-pay discounts are more common at independent centers than at hospitals, Rice said. But itís always wise to ask.