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The lack of transparency in medical billing 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 like a band-aid can cost up to $600. Industry experts say that every medical bill however, is disputable. Below are some tips on how to negotiate medical bills and fight those surprise, overcharged medical bills.
1: Have The Bill Itemized
Surveys show that less than 25% of medical bills are devoid of errors. That is why patients are advised to review the services rendered, to know what treatment and care they actually received as indicated in the invoice. People should also check for duplicate charges. Asking for an explanation of the codes used in diagnosis and medical procedures, is also a good tip.
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. Look up what Medicare will cover, and what insurance coverage will pay for the same service. You can use online resources such as the Healthcare Bluebook to reference pricing information. Some states also 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.
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-availed tools to file an appeal.
4: Contact The Hospital’s Financial Aid Office
Every health care center is expected, 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 holding financial status below 200% of the federal poverty line. Health centers have payment plans that will provide some assistance; however, you should be aware of those that offer a discount that is too small compared to the total charges. Note that a payment plan for inflated costs does not provide any relief. It should be based on fair market rates.
5: Negotiate With The Doctor
Surveys show that many health caregivers and physicians, are unaware that their patients might be struggling with medical bills. While you might think the doctors are 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 accommodate.
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. Conversely, 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 members. 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 change things.
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 article. When posting your article, 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 made public and becomes a trending topic.
10: Share Your Predicament To Media Outlets
Lookup various new outlets that will 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 injustice. It will be a great opportunity for your plight to be heard on a larger scale!
11: Consider Online Fundraisers
The internet does not only avail avenues through which your story can be heard, but also offer a means of raising money. Some of the top fundraising websites worth considering when seeking financial assistance for your medical bills, include; FundRazer, GoFundMe, GiveForward, Indiegogo, Facebook, and YouCaring.
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. Also, remember to “cc” the hospital that treated and billed you.
13: Demand To See The Contract
When faced with the unfair media bill and the hospital insisting that you must pay, you should ask to be furnished with the contract that obligates you to pay. If there is no written agreement stating the money owed, then you have no legal obligations to settle the unfair bill. Keep in mind, that any agreements coupled with consent for treatment forms signed while the patients under duress, are not legally valid.
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 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 know more about negotiation of medical bills, or even advocate for treatment and medical costs.
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MedGift Advocacy Services, Inc. is a 501c3 non-profit organization, classified as a public charity and is registered in the State of Georgia under EIN 81-4017965.
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