The lack of billing transparency in America, has many people facing outrageous prices for even the most basic of medical services. For instance, a CT scan can be charged at a rate of nearly $9,000, and something as little as a band-aid can cost up to $600. Industry experts say that every medical bill is disputable and negotiable though. Below are some tips on how to negotiate medical bills and fight those surprise, or bloated medical bills.
1: Have The Bill Itemized
Surveys show that less than 25% of medical bills are accurate. That is why patients are advised to always review the services rendered. Take the time to verify what treatment and care you actually received as indicated on the invoice. You should also check for duplicate charges. Because so many people are involved in hospital treatments, dual entries are not unlikely. Asking for an explanation of the codes used in diagnosis and medical procedures is also a good idea. One of the reasons many of us overpay for hospital stays and medical care is we simply don’t understand the charges. Take the time to get them clarified and verify their accuracy.
2: Know Market Prices
If you are aware of the market prices, you can find out the average charge for a specific medical service you need. Knowing this will help you understand if charges are inflated and should be negotiated. Look up what Medicare will cover, and what insurance coverage will pay for the services listed on your invoice. You can use online resources such as the Healthcare Bluebook to check pricing information. Some states also have departments and resources that provide such data online for the public. You can use this information, to show the hospital what other health centers are charging for the same procedure or service as part of negotiating your bill.
3: Inform Your Insurance Company
Check the EOB (Explanation of Benefits) in your insurance policy to know the services covered. If you believe that the service you received should be covered according to your explanation of benefits, but the insurance provider is refusing to pay, you should get in touch with the NAIC (National Association of Insurance Commission). You can also utilize the various state government organizations and tools to file an appeal against your insurance companies decision.
4: Contact The Hospital’s Financial Aid Office
Every health care center is required by law to have a financial aid program that offers some reprieve to patients that are unable to pay for their medical expenses. Some hospitals can reduce or cancel bills for people who’s income is below 200% of the federal poverty line. Health centers have payment plans that will provide some assistance; however, beware those that offer a payment plan in lieu of discounting their rates. If you qualify for or deserve a discount, make sure you are getting that too. Note that a payment plan for inflated costs does not provide any relief. Your payment plan should be based on paying on invoice based on fair market rates.
5: Negotiate With The Doctor
Surveys show that many health caregivers and physicians, are unaware when their patients are struggling with medical bills. While you might think the doctors are only out to make money as they offer this essential services, do not shy away from explaining your financial plight to your doctor. Request that the doctor help negotiate a fair price or payment plan, that you can actually afford. Doctors have influence on the billing process and may be willing to discount their services directly as well.
6: Get Help From Organizations
Services offered by organizations like the Patient Advocate Foundation, can help people searching for a way to negotiate medical bills. Many of these services are free. Alternatively, if you can afford it, you can hire groups like Medical Cost Advocate, Systemedic, or Medwise Insurance Advocacy to assist you. Please note that they do charge a minimal fee for their services.
7: Know And Exercise Your Rights
The law stipulates, that hospitals are obligated and required to offer care to every patient with a medical emergency, regardless of their capacity to pay or not. This means you are not required to provide a credit card or any financial information, including your insurance status when seeking emergency medical treatment. The EMTALA law works in your favor, when it comes to such situations.
8: Reach Out To The Hospital’s Top Management
You can contact the hospital’s CFO and/or CEO offices for assistance if you believe you have been unfairly charged for the treatment and medical services received. If your efforts to seek redress from the top offices are unsuccessful, then do what you can to have your matter brought before the hospital’s board of directors. Many of these leaders are quite empathetic and reasonable. They just need to know the situation and how they can help. Some might not be aware of how inflated their billing system is, and could be willing to help if made aware of your situation.
9: Post A Review And Leverage Social Media
A review can be a game-changer; it can be an unstoppable force once it is published on the internet. However, you should give the hospital a chance to see and read it, and give their opinion before posting your issue publicly. When sharing your review, be sure to publish it on various websites like Doctor.com, Yelp, Real Patient Ratings and Rate MDs, to ensure it gets proper traction.
As you do what you can regarding negotiation of medical bills, compliment your efforts with sharing your story. Post your link to your published review on your social media platforms, and then tag the hospital. Doing this could push them to respond to the feedback. If your review is accurate and made public enough, it could provide leverage to get the hospital to take action.
10: Share Your Situation with Media Outlets
Lookup various new outlets that might be willing to tell your story. Research and find news sources that cover the local or national healthcare industry, and share the details of your problem. It will be a great opportunity for your plight to be heard on a larger scale, and may also pressure the hospital or doctor to take action. Many media outlets have special segments just to highlight people who have been treated unfairly or that are in distress.
11: Consider Online Fundraisers
Should you use fundraising sites? The internet not only offers avenues through which your story can be shared, but it also offers a means of raising money. Medical fundraising sites provide resources and fundraising ideas to cover medical expenses. Sites like Medgift.org can provide resources for raising money, as well as emotional support, and resources like this one for making the best of a difficult situation.
12: Contact Your State’s Attorney
Bringing a legal expert on board to help address the situation on your behalf might do the trick. As you email your story to news sources, it is imperative to send another to your lawyer, or the state attorney if you feel you have been treated unfairly. Always remember to “cc” the hospital that treated and billed you when sending emails to the state’s attorney’s office. If the hospital has treated you unfairly and they realize they are about to face consequences, they will most likely act quickly to resolve the dispute.
13: Demand To See The Contract
When faced with the unfair medical bill and the hospital is insisting that you must pay, you should ask to be supplied with the contract that obligates you to pay their bill. If there is no written agreement stating that you agreed to pay the money requested, you may have a stronger argument for not paying. Keep in mind, that any agreements signed when you were incapacitated or under duress may also be invalidated, so circumstances matter. If you are being treated unfairly a contractual argument can you give you a strong standing to fight the hospital.
14: Never Pay For Inappropriate Care
If you received inappropriate health or medical care, or experienced an avoidable complication due to the same, you can request not to be charged for the services rendered. Why should you have to pay for the costs of unnecessary medical care? When paying for the allowable amount under your insurance policy or Medicare, consider paying in cash when possible and settling the entire amount.
15: Inform Your Employer’s HR Department
More than 150 million Americans have their health insurance policies through their employment or employer. If you reach out to the head of Human Resources, they can help you understand more about the negotiation of medical bills, or even advocate for treatment and medical costs on your behalf. If your employer sponsors your benefits, it’s likely that they have resources that can help you, so make sure you have a conversation with them.
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