Hospital bill negotiation

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Goblue97
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Hospital bill negotiation

Post by Goblue97 »

Friends,
Any ideas on how to negotiate a hospital bill?
Thanks!
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dm200
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Re: Hospital bill negotiation

Post by dm200 »

Goblue97 wrote:Friends,
Any ideas on how to negotiate a hospital bill?
Thanks!
More details needed. Insured or not insured. Size of the bill. Reason(s) or justification for negotiating. Past due or not? and so on.
BBSpartan
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Re: Hospital bill negotiation

Post by BBSpartan »

Patient Accounts is usually the place to negotiate. Negotiate with department head as that person has the most flexibility, although staff members are sometimes given parameters for limited negotiation. There are always discounts for cash (not covered by insurance) payments. Negotiating co-pays and deductibles are more difficult (even though they are cash), but sometimes possible particularly if large.

I'm sure others will have specific strategies, but these are a start.
Frans
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Re: Hospital bill negotiation

Post by Frans »

You may be in for an uphill battle. When I tried not to negotiate the bill, but for the hospital to explain and justify it (I was insured but thought the insurance company was being ripped off and as a result me as well being on the hook for 10% of the charges), I didn't get anywhere. The only reaction to my specific questions was for them to repeat the cryptic description of the various items on the bill and the amounts for each. The insurance company didn't even bother to question the charges.
MtnTraveler
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Re: Hospital bill negotiation

Post by MtnTraveler »

I think it depends on the circumstances but on charges that the insurance company has refused to pay (and I'm on the hook for the whole thing) I got a 20% discount if I paid that day with a credit card twice. A third time I was able to somehow get the hospital to agree to accept what my co-pay account would of been.
ralph124cf
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Re: Hospital bill negotiation

Post by ralph124cf »

It is frequently worthwhile to negotiate in advance, if you are not in an emergency situation.

Ralph
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Kenkat
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Re: Hospital bill negotiation

Post by Kenkat »

You can call patient billing and ask if they give any discounts if you pay the bill in full immediately. This has worked for me in the past - 10 to 20% is possible in my experience.
mur44
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Re: Hospital bill negotiation

Post by mur44 »

If the amount you owe is large then consider hiring a Paid
Professional Claims Assistance Organization.
Topic Author
Goblue97
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Re: Hospital bill negotiation

Post by Goblue97 »

Insured, bill is not past due date. Insurance Company pays 20% until I hit max out of pocket. The only group I can negotiate with is Hospital. Size of bill is 1300 for one bill and 900 for another (2 separate visits). Keep the good ideas coming!
toofache32
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Re: Hospital bill negotiation

Post by toofache32 »

Goblue97 wrote:Insured, bill is not past due date. Insurance Company pays 20% until I hit max out of pocket. The only group I can negotiate with is Hospital. Size of bill is 1300 for one bill and 900 for another (2 separate visits). Keep the good ideas coming!
What is there to negotiate? Why do you want to negotiate AGAIN? If you have insurance then your share has already been negotiated and you agreed to it with your signature. If you have insurance and went to an in-network hospital, then you're only duty is to make sure all parties held their end of the deal.....but it sounds like you don't want to hold your end of the deal. Lastly, if the hospital charges you fees different from what they charge the insurance company (per the contract), then insurance fraud is committed and you risk losing your coverage.
investor1
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Re: Hospital bill negotiation

Post by investor1 »

toofache32 wrote:Lastly, if the hospital charges you fees different from what they charge the insurance company (per the contract), then insurance fraud is committed and you risk losing your coverage.
Has anyone ever lost their coverage or experienced any other repercussions for "insurance fraud" in such a manner? I'd be surprised if anyone has given the bill is sent to the insurance provider before it is sent to the patient. The patient has no way of knowing what the hospital is charging the insurance provider. Most of the time the patient is not ever given an itemized bill (unless they request it). If they do get an itemitized bill, notice an error, and negoitate with the hospital, it would seem to be the hospital that should contact the insurance provider to inform them they have overpaid. Why would the patient be responsible for this? They did not take anything from the insurance provider.
investor1
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Re: Hospital bill negotiation

Post by investor1 »

1. Get itemized bills, and understand each line. If you see an error, point that out. They will likely take time to review it and try to justify it. Talk to the people that make the decisions, and argue your case.

2. Use something like http://fairhealthconsumer.org/ to see if the hospital is charging you a fair amount relative to the Medicare costs. If it is way out of whack, you might be able to negoitate, but it is an uphill battle.

3. Pay in full to get the lump sum discount.

I have followed this process in the past where the hospital made an error. That combined with the lump sum discount knocked off around 35% off of my bill, IIRC. There is a thread on this forum about it.

Oh, and be nice to people when you talk to them. Nobody is going to help a jerk.
denovo
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Re: Hospital bill negotiation

Post by denovo »

toofache32 wrote:
Goblue97 wrote:Insured, bill is not past due date. Insurance Company pays 20% until I hit max out of pocket. The only group I can negotiate with is Hospital. Size of bill is 1300 for one bill and 900 for another (2 separate visits). Keep the good ideas coming!
What is there to negotiate? Why do you want to negotiate AGAIN? If you have insurance then your share has already been negotiated and you agreed to it with your signature. If you have insurance and went to an in-network hospital, then you're only duty is to make sure all parties held their end of the deal.....but it sounds like you don't want to hold your end of the deal. Lastly, if the hospital charges you fees different from what they charge the insurance company (per the contract), then insurance fraud is committed and you risk losing your coverage.
In the reality-based universe, hospitals are willing to negotiate on bills, even when its insured, on the co-pay and deductible. I had a $4,800 bill, my share was around 1.2k, and they offered to accept 760.
"Don't trust everything you read on the Internet"- Abraham Lincoln
toofache32
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Re: Hospital bill negotiation

Post by toofache32 »

investor1 wrote:
toofache32 wrote:Lastly, if the hospital charges you fees different from what they charge the insurance company (per the contract), then insurance fraud is committed and you risk losing your coverage.
Has anyone ever lost their coverage or experienced any other repercussions for "insurance fraud" in such a manner? I'd be surprised if anyone has given the bill is sent to the insurance provider before it is sent to the patient. The patient has no way of knowing what the hospital is charging the insurance provider. Most of the time the patient is not ever given an itemized bill (unless they request it). If they do get an itemitized bill, notice an error, and negoitate with the hospital, it would seem to be the hospital that should contact the insurance provider to inform them they have overpaid. Why would the patient be responsible for this? They did not take anything from the insurance provider.
The OP was not asking about an error, they were asking about a bill. If a billing error has been made, then the patient should discuss correcting the error with the hospital. This is NOT the same as "negotiating" down a valid bill.
As for repercussions of insurance fraud....doctors offices and hospitals are audited by insurance companies routinely for various reasons. One major reason is to make sure patients are being billed along with the insurance company. They are watching for doctors/hospitals who write off co-insurance or co-pays and only take what the insurance company gives. This is bad because it leads to over-utilization of healthcare resources (and therefore insurance money) since the patients no longer have skin in the game. The most common (I think) way this happens is when doctors don't charge co-pays for office visits to increase patient flow because they are cheaper. And yes, hospitals and doctors can get dropped from insurance plans when they get busted doing this. But more commonly they simply demand money back from the provider/hospital......in other words, if a patient was given a 50% discount on their co-insurance, then the insurance company takes back 50% of what they paid the hospital because the patient and insurance company must receive the same charges (per the insurance company contracts). And they always win because if the provider/hospital refuses to return the money, the insurance company simply deducts it from future payments.
Last edited by toofache32 on Wed Jul 16, 2014 8:49 am, edited 1 time in total.
toofache32
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Re: Hospital bill negotiation

Post by toofache32 »

denovo wrote:
toofache32 wrote:
Goblue97 wrote:Insured, bill is not past due date. Insurance Company pays 20% until I hit max out of pocket. The only group I can negotiate with is Hospital. Size of bill is 1300 for one bill and 900 for another (2 separate visits). Keep the good ideas coming!
What is there to negotiate? Why do you want to negotiate AGAIN? If you have insurance then your share has already been negotiated and you agreed to it with your signature. If you have insurance and went to an in-network hospital, then you're only duty is to make sure all parties held their end of the deal.....but it sounds like you don't want to hold your end of the deal. Lastly, if the hospital charges you fees different from what they charge the insurance company (per the contract), then insurance fraud is committed and you risk losing your coverage.
In the reality-based universe, hospitals are willing to negotiate on bills, even when its insured, on the co-pay and deductible. I had a $4,800 bill, my share was around 1.2k, and they offered to accept 760.
I think the way they get around this is they write off the difference and document it as an uncollectable debt, but they obviously don't actually send you to collections since they agreed to accept less. Technically, they are supposed to turn around and give the insurance company the same discount.

I rarely give discounts in my office because I believe it's unethical to take away a patient's right to complain. But all fees are explained at the beginning.
Swampy
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Re: Hospital bill negotiation

Post by Swampy »

If any of your bill was applied to a deductible, the hospital will not negotiate that price down - even if it is an outrageous overcharge.
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Professor Emeritus
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Re: Hospital bill negotiation

Post by Professor Emeritus »

toofache32 wrote:
Goblue97 wrote:Insured, bill is not past due date. Insurance Company pays 20% until I hit max out of pocket. The only group I can negotiate with is Hospital. Size of bill is 1300 for one bill and 900 for another (2 separate visits). Keep the good ideas coming!
What is there to negotiate? Why do you want to negotiate AGAIN? If you have insurance then your share has already been negotiated and you agreed to it with your signature. If you have insurance and went to an in-network hospital, then you're only duty is to make sure all parties held their end of the deal.....but it sounds like you don't want to hold your end of the deal. Lastly, if the hospital charges you fees different from what they charge the insurance company (per the contract), then insurance fraud is committed and you risk losing your coverage.


We did a case in Georgia where the nominal bill was sent , and then the insurance company but not the patient had a standard 33% reduction. we sued precisely because they fraudulently claimed the share had been negotiated
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bertilak
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Re: Hospital bill negotiation

Post by bertilak »

I negotiated twice, both satisfactorily.
  • When my wife had her first child we got to the hospital at about ten minutes to midnight. She left the hospital the very next day. The hospital charged us for two days stay! They also charged us for the use of the prenatal (or whatever they called it) room but my wife went straight from the emergency entrance to the delivery room and my son was born right away. I told the hospital billing department that she was there less than 24 hours and never even went into into that prenatal room so I did not approve of those charges. They agreed. (Insurance would have covered the whole thing anyway but it was the principle of the thing that got to me.)
  • This one is not is not a hospital bill but a doctor bill. I went in for a hernia operation. The charge included an assistant surgeon. The insurance said no assistant was needed for such a simple, routine, procedure and I was therefore liable for that charge. I talked things out with the doctor. He said that the original agreement was that I was responsible even if insurance didn't pay. I said I had signed no agreement with that second doctor. Turns out that it was a STUDENT doctor who was there to observe. I said he should pay for his own education and I wouldn't pay. The charge was dropped.
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toofache32
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Re: Hospital bill negotiation

Post by toofache32 »

bertilak wrote:I negotiated twice, both satisfactorily.
  • When my wife had her first child we got to the hospital at about ten minutes to midnight. She left the hospital the very next day. The hospital charged us for two days stay! They also charged us for the use of the prenatal (or whatever they called it) room but my wife went straight from the emergency entrance to the delivery room and my son was born right away. I told the hospital billing department that she was there less than 24 hours and never even went into into that prenatal room so I did not approve of those charges. They agreed. (Insurance would have covered the whole thing anyway but it was the principle of the thing that got to me.)
  • This one is not is not a hospital bill but a doctor bill. I went in for a hernia operation. The charge included an assistant surgeon. The insurance said no assistant was needed for such a simple, routine, procedure and I was therefore liable for that charge. I talked things out with the doctor. He said that the original agreement was that I was responsible even if insurance didn't pay. I said I had signed no agreement with that second doctor. Turns out that it was a STUDENT doctor who was there to observe. I said he should pay for his own education and I wouldn't pay. The charge was dropped.
I have seen this 2nd situation before. This was not a student because students are not licensed and cannot bill. This was a surgeon in a non-ACGME funded fellowship. I work with a similarly funded Fellow also, but my patients are advised preoperatively of this. The fellow allows me to give better care by turning a 10-hour surgery into a 6-hour surgery. And this does NOT double the fees. This has to be done with CPT code modifiers such as -62, -80, and -82 and the 2 surgeons each get 62% of the allowed fee (usually) for a total of 124%. In other words, I take a financial hit for doing this. The alternative is to have a minimally-trained surgical tech assisting....who still submits these claims. And your insurance company was correct that only certain procedures/codes qualify for assistant fees, but these can change among different insurance plans.

http://www.priorityhealth.com/provider/ ... /80-and-82
investor1
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Re: Hospital bill negotiation

Post by investor1 »

toofache32 wrote:
investor1 wrote:
toofache32 wrote:Lastly, if the hospital charges you fees different from what they charge the insurance company (per the contract), then insurance fraud is committed and you risk losing your coverage.
Has anyone ever lost their coverage or experienced any other repercussions for "insurance fraud" in such a manner? I'd be surprised if anyone has given the bill is sent to the insurance provider before it is sent to the patient. The patient has no way of knowing what the hospital is charging the insurance provider. Most of the time the patient is not ever given an itemized bill (unless they request it). If they do get an itemitized bill, notice an error, and negoitate with the hospital, it would seem to be the hospital that should contact the insurance provider to inform them they have overpaid. Why would the patient be responsible for this? They did not take anything from the insurance provider.
And yes, hospitals and doctors can get dropped from insurance plans when they get busted doing this. But more commonly they simply demand money back from the provider/hospital.
It sounds like you are agreeing with me. It is typically the responsibility of the hospital rather than the patient to ensure they charge the insurance provider a fair amount relative to what they charge the patient. That makes sense given the typical billing cycle.
ji.isaacs
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Re: Hospital bill negotiation

Post by ji.isaacs »

Goblue97 wrote:Friends,
Any ideas on how to negotiate a hospital bill?
Thanks!
First, I assume you have carefully looked over the EOB???

I had a situation where I was billed for half of a procedure because the 10 day pre-medication routine it was administered half in one state and half in another due to travel to the out of state facility doing the procedure. The insurance claimed it as two different procedures and the facility billed me accordingly.

Conversations with the state, then regional insurance office went nowhere, so I ended up dealing with an RN in Washington, DC. She understood the situation immediately and got everything straightened out, so I didn't have to pay a $2400+ invoice.

Make SURE the insurance portion was billed and paid correctly before negotiating with the hospital.
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bertilak
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Re: Hospital bill negotiation

Post by bertilak »

toofache32 wrote:
bertilak wrote:I negotiated twice, both satisfactorily.
  • When my wife had her first child we got to the hospital at about ten minutes to midnight. She left the hospital the very next day. The hospital charged us for two days stay! They also charged us for the use of the prenatal (or whatever they called it) room but my wife went straight from the emergency entrance to the delivery room and my son was born right away. I told the hospital billing department that she was there less than 24 hours and never even went into into that prenatal room so I did not approve of those charges. They agreed. (Insurance would have covered the whole thing anyway but it was the principle of the thing that got to me.)
  • This one is not is not a hospital bill but a doctor bill. I went in for a hernia operation. The charge included an assistant surgeon. The insurance said no assistant was needed for such a simple, routine, procedure and I was therefore liable for that charge. I talked things out with the doctor. He said that the original agreement was that I was responsible even if insurance didn't pay. I said I had signed no agreement with that second doctor. Turns out that it was a STUDENT doctor who was there to observe. I said he should pay for his own education and I wouldn't pay. The charge was dropped.
toofache -- Thanks much for the clarification!
I have seen this 2nd situation before. This was not a student because students are not licensed and cannot bill. This was a surgeon in a non-ACGME funded fellowship. I work with a similarly funded Fellow also, but my patients are advised preoperatively of this. The fellow allows me to give better care by turning a 10-hour surgery into a 6-hour surgery. And this does NOT double the fees. This has to be done with CPT code modifiers such as -62, -80, and -82 and the 2 surgeons each get 62% of the allowed fee (usually) for a total of 124%. In other words, I take a financial hit for doing this. The alternative is to have a minimally-trained surgical tech assisting....who still submits these claims. And your insurance company was correct that only certain procedures/codes qualify for assistant fees, but these can change among different insurance plans.

http://www.priorityhealth.com/provider/ ... /80-and-82
toofache -- Thanks much for the clarification! I was sure some mention was made of training. Either I misunderstood or the doctor was unclear. The doctor must have been very diplomatic with me!
May neither drought nor rain nor blizzard disturb the joy juice in your gizzard. -- Squire Omar Barker (aka S.O.B.), the Cowboy Poet
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dm200
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Re: Hospital bill negotiation

Post by dm200 »

Conversations with the state, then regional insurance office went nowhere, so I ended up dealing with an RN in Washington, DC. She understood the situation immediately and got everything straightened out, so I didn't have to pay a $2400+ invoice.
In my experience over the years, dealing with a health insurance company [even just to understand the EOB!] is very, very difficult. The folks on the front line of answering questions, etc. for these insurance companies almost always have ZERO knowledge or competence in health/medical issues. . As you point out, if/when you can speak with a medically competent person, many things can be corrected or clarified very quickly.
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Goblue97
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Re: Hospital bill negotiation

Post by Goblue97 »

A special thanks to those who provided helpful tips. One particular individual asked why I would try to negotiate. Simple, it is within my rights as a paying customer and consumer to ask these types of questions. If I believed the bills were realistic and fair for these routine procedures, then I would leave it alone. I am not an expert in the medical field, but like denovo stated, I live in the real world. Thanks again for the help.
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1210sda
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Re: Hospital bill negotiation

Post by 1210sda »

This is a great topic that I will file away for future use.

We (DW and I ) have had one experience in dealing with disagreeing with our doctor's bill. I reviewed the bill (minor female type surgery) and right away I disagreed with some of the charges. (Please don't ask what the disagreement was....it was 20 yrs ago, I don't remember) . My first call was to the insurance company. Their response was "was the bill paid by us (the insurance company)?" I said yes. They said "then what's your problem? I told them I thought the charges were erroneous and didn't want them to pay because it would impact my next years premium. They said there was nothing they could do. Frustrated, I hung up.

1210
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dm200
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Re: Hospital bill negotiation

Post by dm200 »

1210sda wrote:This is a great topic that I will file away for future use.

We (DW and I ) have had one experience in dealing with disagreeing with our doctor's bill. I reviewed the bill (minor female type surgery) and right away I disagreed with some of the charges. (Please don't ask what the disagreement was....it was 20 yrs ago, I don't remember) . My first call was to the insurance company. Their response was "was the bill paid by us (the insurance company)?" I said yes. They said "then what's your problem? I told them I thought the charges were erroneous and didn't want them to pay because it would impact my next years premium. They said there was nothing they could do. Frustrated, I hung up.

1210
I had a similar, frustrating experience several years ago. We are constantly being told that we, as patients, should make sure (even if there is insurance coverage) that we received the services billed. I received an EOB for an Ophthalmology visit/services. There were several billing codes for the various services/procedures and I noticed there were two line items on the same day for the same billing code and one line item for another. So, I called the insurance company to inquire if this might be an error (double billing) - and the terse answer was - "it is OK" - and nothing further. I had to press the guy/gal to learn that, even though I have two eyes and I had two different tests (on each eye) - one of the billing codes was for one test (both eyes) and the other billing code for another test was "per eye". Instead of being happy that I, as a patient, went to the trouble of verifying the correctness of the billing - they seemed to be very annoyed with my call.
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dm200
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Re: Hospital bill negotiation

Post by dm200 »

1210sda wrote:This is a great topic that I will file away for future use.

We (DW and I ) have had one experience in dealing with disagreeing with our doctor's bill. I reviewed the bill (minor female type surgery) and right away I disagreed with some of the charges. (Please don't ask what the disagreement was....it was 20 yrs ago, I don't remember) . My first call was to the insurance company. Their response was "was the bill paid by us (the insurance company)?" I said yes. They said "then what's your problem? I told them I thought the charges were erroneous and didn't want them to pay because it would impact my next years premium. They said there was nothing they could do. Frustrated, I hung up.

1210
I had a similar, frustrating experience several years ago. We are constantly being told that we, as patients, should make sure (even if there is insurance coverage) that we received the services billed. I received an EOB for an Ophthalmology visit/services. There were several billing codes for the various services/procedures and I noticed there were two line items on the same day for the same billing code and one line item for another. So, I called the insurance company to inquire if this might be an error (double billing) - and the terse answer was - "it is OK" - and nothing further. I had to press the guy/gal to learn that, even though I have two eyes and I had two different tests (on each eye) - one of the billing codes was for one test (both eyes) and the other billing code for another test was "per eye". Instead of being happy that I, as a patient, went to the trouble of verifying the correctness of the billing - they seemed to be very annoyed with my call.
island
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Re: Hospital bill negotiation

Post by island »

Goblue97 wrote:A special thanks to those who provided helpful tips. One particular individual asked why I would try to negotiate. Simple, it is within my rights as a paying customer and consumer to ask these types of questions. If I believed the bills were realistic and fair for these routine procedures, then I would leave it alone. I am not an expert in the medical field, but like denovo stated, I live in the real world. Thanks again for the help.
What is it about the bills that makes you think they aren't "realistic and fair"?
denovo
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Re: Hospital bill negotiation

Post by denovo »

island wrote:
Goblue97 wrote:A special thanks to those who provided helpful tips. One particular individual asked why I would try to negotiate. Simple, it is within my rights as a paying customer and consumer to ask these types of questions. If I believed the bills were realistic and fair for these routine procedures, then I would leave it alone. I am not an expert in the medical field, but like denovo stated, I live in the real world. Thanks again for the help.
What is it about the bills that makes you think they aren't "realistic and fair"?
I take it you've never seen a hospital bill?
"Don't trust everything you read on the Internet"- Abraham Lincoln
toofache32
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Re: Hospital bill negotiation

Post by toofache32 »

denovo wrote:
island wrote:
Goblue97 wrote:A special thanks to those who provided helpful tips. One particular individual asked why I would try to negotiate. Simple, it is within my rights as a paying customer and consumer to ask these types of questions. If I believed the bills were realistic and fair for these routine procedures, then I would leave it alone. I am not an expert in the medical field, but like denovo stated, I live in the real world. Thanks again for the help.
What is it about the bills that makes you think they aren't "realistic and fair"?
I take it you've never seen a hospital bill?
I take it you're not familiar with how expensive it is to run a hospital?

I'm not defending the hospital here. But I think most people have no clue of what has to go on behind the scenes. Since I started sitting on multiple hospital committees over recent years I understand why everything is ridiculously expensive. The administrative burden, compliance issues, documentation requirements for government oversight, and liability are enormous. Like any business, the costs get passed on to the consumers. This is what we as a society have chosen.
island
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Re: Hospital bill negotiation

Post by island »

denovo wrote:
island wrote:
Goblue97 wrote:A special thanks to those who provided helpful tips. One particular individual asked why I would try to negotiate. Simple, it is within my rights as a paying customer and consumer to ask these types of questions. If I believed the bills were realistic and fair for these routine procedures, then I would leave it alone. I am not an expert in the medical field, but like denovo stated, I live in the real world. Thanks again for the help.
What is it about the bills that makes you think they aren't "realistic and fair"?
I take it you've never seen a hospital bill?
Whoa I take it your bias is showing. Why don't you let the OP answer my legitimate question?
Is it an error, terms/conditions of coverage open to interpretation, surprise at the bottom line of the shared cost or something else?
I don't have an ax to grind and am not taking sides. Just think having more info would allow us to provide more constructive info rather than serve up disgruntled opinions about the cost of healthcare or how we handled an obvious erroneous bill from decades ago if that's not the issue.
RunningRad
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Re: Hospital bill negotiation

Post by RunningRad »

Goblue97 wrote:A special thanks to those who provided helpful tips. One particular individual asked why I would try to negotiate. Simple, it is within my rights as a paying customer and consumer to ask these types of questions. If I believed the bills were realistic and fair for these routine procedures, then I would leave it alone. I am not an expert in the medical field, but like denovo stated, I live in the real world. Thanks again for the help.
So you are negotiating for the sport of it?
Few decisions in life motivated by greed ever have happy outcomes--Peter Bernstein, The 60/40 Solution
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White Coat Investor
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Re: Hospital bill negotiation

Post by White Coat Investor »

toofache32 wrote:
denovo wrote:
island wrote:
Goblue97 wrote:A special thanks to those who provided helpful tips. One particular individual asked why I would try to negotiate. Simple, it is within my rights as a paying customer and consumer to ask these types of questions. If I believed the bills were realistic and fair for these routine procedures, then I would leave it alone. I am not an expert in the medical field, but like denovo stated, I live in the real world. Thanks again for the help.
What is it about the bills that makes you think they aren't "realistic and fair"?
I take it you've never seen a hospital bill?
I take it you're not familiar with how expensive it is to run a hospital?

I'm not defending the hospital here. But I think most people have no clue of what has to go on behind the scenes. Since I started sitting on multiple hospital committees over recent years I understand why everything is ridiculously expensive. The administrative burden, compliance issues, documentation requirements for government oversight, and liability are enormous. Like any business, the costs get passed on to the consumers. This is what we as a society have chosen.
This is a point a lot of people don't get. Even if we solved "the problems" with medicine, increased transparency and fairness, medical care is simply very expensive. Expensive equipment, highly trained staff, difficult compliance issues, high liability etc. Someone's got to pay for that $1 Million MRI machine.
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EnjoyIt
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Re: Hospital bill negotiation

Post by EnjoyIt »

It is more than just the MRI machine and the trained personnel. A large part of the cost is the behind the scenes personnel: The coding people, the compliance people, the billing people, the charting people, the insurance compliance people, the collections people, the patient liaison people, the language translator people, the IT people, the legal people, the patient satisfaction survey people, the non medical personnel list goes on and on. This is indeed what we have chosen in America and it is expensive.

Interestingly by removing government out of the picture, a huge chunk of those people disappear and costs go down. You remove private insurance and it decreases further.

Sorry to digress from the OP. But, to answer your question you could wait a few months without paying let them harass you and eventually agree to meet with them. Once there let them offer you a discount, then reply back with something less if paid today.
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toofache32
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Re: Hospital bill negotiation

Post by toofache32 »

EnjoyIt wrote:It is more than just the MRI machine and the trained personnel. A large part of the cost is the behind the scenes personnel: The coding people, the compliance people, the billing people, the charting people, the insurance compliance people, the collections people, the patient liaison people, the language translator people, the IT people, the legal people, the patient satisfaction survey people, the non medical personnel list goes on and on. This is indeed what we have chosen in America and it is expensive.

Interestingly by removing government out of the picture, a huge chunk of those people disappear and costs go down. You remove private insurance and it decreases further.

Sorry to digress from the OP. But, to answer your question you could wait a few months without paying let them harass you and eventually agree to meet with them. Once there let them offer you a discount, then reply back with something less if paid today.
But what about all the greedy doctors???
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Re: Hospital bill negotiation

Post by denovo »

"It is difficult to get a man to understand something, when his salary depends upon his not understanding it!"

---
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toofache32
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Re: Hospital bill negotiation

Post by toofache32 »

denovo wrote:"It is difficult to get a man to understand something, when his salary depends upon his not understanding it!"

---
Upton Sinclair

Who is this directed towards? Any hospital administrators here?
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Re: Hospital bill negotiation

Post by denovo »

toofache32 wrote:
denovo wrote:"It is difficult to get a man to understand something, when his salary depends upon his not understanding it!"

---
Upton Sinclair

Who is this directed towards? Any hospital administrators here?
Res ipsa loquitur
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toofache32
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Re: Hospital bill negotiation

Post by toofache32 »

denovo wrote:
toofache32 wrote:
denovo wrote:"It is difficult to get a man to understand something, when his salary depends upon his not understanding it!"

---
Upton Sinclair

Who is this directed towards? Any hospital administrators here?
Res ipsa loquitur
Although I live in Texas, I don't speak Spanish. Can someone translate?
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Re: Hospital bill negotiation

Post by bertilak »

toofache32 wrote:
denovo wrote:
Res ipsa loquitur
Although I live in Texas, I don't speak Spanish. Can someone translate?
I'll bet there's a Google in Texas ...

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Although I don't see the relevance.
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Re: Hospital bill negotiation

Post by in_reality »

bertilak wrote: Although I don't see the relevance.
I think the insinuation is that doctors are greedy and part of the high bill.

I don't know if that is true but in general think the people who have responsibility should be rewarded for taking the risk of taking responsibility. You know cause when things go wrong, it's on you.
toofache32
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Re: Hospital bill negotiation

Post by toofache32 »

in_reality wrote:
bertilak wrote: Although I don't see the relevance.
I think the insinuation is that doctors are greedy and part of the high bill.
Doctors bill separately. Even hospitalists have their own management groups. Another common misconception is that doctors and the hospital are one and the same. I am actually a customer at the hospital like my patients. If I don't like how the hospital treats me then I can take my patients to a different hospital.
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Re: Hospital bill negotiation

Post by Ervin »

toofache32 wrote:Doctors bill separately. Even hospitalists have their own management groups. Another common misconception is that doctors and the hospital are one and the same. I am actually a customer at the hospital like my patients. If I don't like how the hospital treats me then I can take my patients to a different hospital.
Nowadays that is less and less true. More physicians are employees than not, and the numbers are increasing. Obamacare dealt an almost deadly blow to private medicine and doctors as professionals. There are few specialties and few doctors where the above quote still applies.
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Re: Hospital bill negotiation

Post by staythecourse »

[OT comments removed by admin LadyGeek]
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EnjoyIt
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Re: Hospital bill negotiation

Post by EnjoyIt »

toofache32 wrote:
EnjoyIt wrote:
But what about all the greedy doctors???
Ahh yes, the doctors. Although there definitely are greedy and unscrupulous physicians out there, it is not their bill that is so extravagant. Their billing is actually tiny compared to the facility fee you are paying. Not to mention physicians also have to pay for the same personnel. Coders, billers, collectors, IT, insurance compliance, etc. someone has to pay those people.

Today's physicians are also forced to spend more time on computer documentation and compliance than actual patient interactions.

While at the same time their reimbursement is decreasing. Add on top the physician shortage and you find doctors working longer hours for less pay. Stress ensues followed by burnout and mistakes. I honestly fear what our medical system will be 20 years from now.

I know plenty of docs who are just sick of it all and wish they could quite. Sometimes they pop up here on the forum asking for advice.
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TX_TURTLE
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Re: Hospital bill negotiation

Post by TX_TURTLE »

EnjoyIt wrote:
toofache32 wrote:
EnjoyIt wrote:
But what about all the greedy doctors???
Ahh yes, the doctors. Although there definitely are greedy and unscrupulous physicians out there, it is not their bill that is so extravagant. Their billing is actually tiny compared to the facility fee you are paying. Not to mention physicians also have to pay for the same personnel. Coders, billers, collectors, IT, insurance compliance, etc. someone has to pay those people.

Today's physicians are also forced to spend more time on computer documentation and compliance than actual patient interactions.

While at the same time their reimbursement is decreasing. Add on top the physician shortage and you find doctors working longer hours for less pay. Stress ensues followed by burnout and mistakes. I honestly fear what our medical system will be 20 years from now.

I know plenty of docs who are just sick of it all and wish they could quite. Sometimes they pop up here on the forum asking for advice.
What you are describing is happening mostly to everybody, not just doctors. Everywhere you go (Megacorps, school districts, you name it) there is an emphasis in 'compliance' and 'productivity' that translates into increased documentation and assorted non-value added steps, as well as increased workload and lower compensation (in real terms).
We could spend some time analyzing the reasons, but in the real world, if you are a doctor and most of your patients (in business terms, clients) are having a hard time, it is pretty much straightforward that you will be impacted, to a greater or lesser extent.
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Re: Hospital bill negotiation

Post by LadyGeek »

Please stay on-topic, which is negotiating a hospital bill.
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Goblue97
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Re: Hospital bill negotiation

Post by Goblue97 »

To answer some questions before I retire this thread, I have never "stiffed" anyone, never tried to buy a Porsche for $5. I have negotiated my cable/cell phone bill like any prudent consumer would. In addition, I understand my role in paying for our expensive healthcare system.

To all the medical/administration professionals out there, I still have admiration for you. However, I cannot count on you folks to answer Personal Consumer Issues regarding healthcare issues.

Have a great weekend folks. I will be on the lookout for that $5 Porsche!!!
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Re: Hospital bill negotiation

Post by denovo »

Goblue97 wrote:
To all the medical/administration professionals out there, I still have admiration for you. However, I cannot count on you folks to answer Personal Consumer Issues regarding healthcare issues.
Exactly. You said what I wanted to do say in more diplomatic terms.
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toofache32
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Re: Hospital bill negotiation

Post by toofache32 »

investor1 wrote:
toofache32 wrote:Lastly, if the hospital charges you fees different from what they charge the insurance company (per the contract), then insurance fraud is committed and you risk losing your coverage.
Has anyone ever lost their coverage or experienced any other repercussions for "insurance fraud" in such a manner? I'd be surprised if anyone has given the bill is sent to the insurance provider before it is sent to the patient. The patient has no way of knowing what the hospital is charging the insurance provider. Most of the time the patient is not ever given an itemized bill (unless they request it). If they do get an itemitized bill, notice an error, and negoitate with the hospital, it would seem to be the hospital that should contact the insurance provider to inform them they have overpaid. Why would the patient be responsible for this? They did not take anything from the insurance provider.

It's not exactly the same situation, but I just came across this and I thought of this thread....

https://www.kirschenbaumesq.com/article ... lance-bill
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