How to negotiate bills from hospital?

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misterno
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How to negotiate bills from hospital?

Post by misterno » Wed Jul 25, 2018 1:04 pm

Long story short, I had pain in my kidney and I knew it was kidney stone but I wanted to let it go by itself.

This happened several times but they were all like sand and alittle bit of pain and then you drink lots of water and it flushes away

This time, the pain increased and increased so much that it was unbearable so the first that came to mind as urgent care. I totally forgot that my physician had a walk in on Saturdays. But with that pain how can you think accurately?

So the first urgent care I went to was closed on Saturday. I knew that there are doctors there but it was closed. The pain was increasing so I went to the 2nd closest urgent care. Why urgent care? Because I am supposedly smart not to go to an ER and pay much higher prices

So the 2nd urgent care I went to did not have doctor but only nurse practitioner. By that time I started screaming and yelling. The assistant give me a shot on my hip and pain went away. 2 minutes later nurse practitioner came to check on me and I asked for Vicodin which is what I always got to relieve the pain

She says "oh I am not a doctor I am not licensed to prescribe that"

What? So what am I supposed to do? Come here every 2 hours?

No, you should go to ER

So I went to an ER. But instead I should have checked google or yelp to see if there were any walkins open, but with that pain I did not think about that

Paid $40 for urgent care, went home expecting that pain will go away. No it started again

So went to the closest ER. They put me on IV then gave me strong pills, then doctor gave me strong pills and other pills I forgot for what.

I have blue cross so I was not expecting a huge bill. The first bill was for $11K of which I owed $900

Second bill $1,900 of which I owe $380

I know that these bills are based on negotiated terms. But just thinking, what if I call the hospital and offer cash? Am I too late?

If it was Sunday, there would be no walk in clinic then what should I do?

Now, I know what to do on a regular day, just call my physician and get an appt same day. But what if it is Sunday or 9PM when all urgent cares are closed and even though some are open most do not have doctors only nurse practitioners who can not prescribe strong medicine?

What is the smart way to approach? What would you do?

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Pajamas
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Re: How to negotiate bills from hospital?

Post by Pajamas » Wed Jul 25, 2018 1:13 pm

Not enough information. Seems like your issue may lie with your insurance company and the terms of your coverage, not the providers.

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BolderBoy
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Re: How to negotiate bills from hospital?

Post by BolderBoy » Wed Jul 25, 2018 1:13 pm

misterno wrote:
Wed Jul 25, 2018 1:04 pm
The assistant give me a shot on my hip and pain went away. 2 minutes later nurse practitioner came to check on me and I asked for Vicodin which is what I always got to relieve the pain
So you asked for narcotic pain medicine when you weren't in pain? Careful doing this as it can be interpreted as "drug seeking behavior".
I have blue cross so I was not expecting a huge bill. The first bill was for $11K of which I owed $900

Second bill $1,900 of which I owe $380

I know that these bills are based on negotiated terms.

What is the smart way to approach? What would you do?
The "deal" has been prenegotiated for you by Blue Cross. Pay what the EOB says is your share.

That's what I would do.
"Never underestimate one's capacity to overestimate one's abilities" - The Dunning-Kruger Effect

ResearchMed
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Re: How to negotiate bills from hospital?

Post by ResearchMed » Wed Jul 25, 2018 1:14 pm

What is you offer to pay cash to the hospital?

How much... are you planning to offer them *more* than what they are receiving from the insurance!?

Or offering to pay the full non-negotiated rate that is billed to those who are self-pay/without insurance?

:confused

RM
This signature is a placebo. You are in the control group.

misterno
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Re: How to negotiate bills from hospital?

Post by misterno » Wed Jul 25, 2018 1:18 pm

ResearchMed wrote:
Wed Jul 25, 2018 1:14 pm
What is you offer to pay cash to the hospital?

How much... are you planning to offer them *more* than what they are receiving from the insurance!?

Or offering to pay the full non-negotiated rate that is billed to those who are self-pay/without insurance?

:confused

RM
I understand what you are saying. It is already been negotiated and discounted from 11K to 900

I guess there is not much I can do

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FlyAF
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Re: How to negotiate bills from hospital?

Post by FlyAF » Wed Jul 25, 2018 1:20 pm

OP is asking if he calls the hospital, can he talk them down from the $1280 that he owes.

I guess it's worth a try and I share your frustration with HC costs, but it is what you owe. I doubt they do much but offer to put you on a payment plan.

11k sure seems like a lot for an IV and a prescription. Sounds like a lot has been left out. I also don't really understand what the day of the week has to do with anything. You either needed medical treatment or you didn't.
Last edited by FlyAF on Wed Jul 25, 2018 1:22 pm, edited 1 time in total.

misterno
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Re: How to negotiate bills from hospital?

Post by misterno » Wed Jul 25, 2018 1:21 pm

BolderBoy wrote:
Wed Jul 25, 2018 1:13 pm
misterno wrote:
Wed Jul 25, 2018 1:04 pm
The assistant give me a shot on my hip and pain went away. 2 minutes later nurse practitioner came to check on me and I asked for Vicodin which is what I always got to relieve the pain
So you asked for narcotic pain medicine when you weren't in pain? Careful doing this as it can be interpreted as "drug seeking behavior".
I have blue cross so I was not expecting a huge bill. The first bill was for $11K of which I owed $900

Second bill $1,900 of which I owe $380

I know that these bills are based on negotiated terms.

What is the smart way to approach? What would you do?
The "deal" has been prenegotiated for you by Blue Cross. Pay what the EOB says is your share.

That's what I would do.
When it comes to kidney stone, doctors know pain will come back

So when I was in ER, doctor prescribed very heavy pain killer and he gave it. But he was expecting anyway

Thegame14
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Re: How to negotiate bills from hospital?

Post by Thegame14 » Wed Jul 25, 2018 1:22 pm

usually if you wait like 6 months and don't pay they will send it to collections and collections will normally take like 50-75% of the balance and called it closed. It may hurt your credit, but maybe that isn't an issue.

njdealguy
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Re: How to negotiate bills from hospital?

Post by njdealguy » Wed Jul 25, 2018 1:28 pm

I've had some success negotiating down the 'patient's responsibility' amounts in a bill based on the insurance negotiated rate with smaller doctors clinics but not sure if a big hospital will be willing to do so. Doesnt hurt to try or else I guess are on the hook for these amounts anyway.

Katietsu
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Re: How to negotiate bills from hospital?

Post by Katietsu » Wed Jul 25, 2018 1:31 pm

I have paid bills from two hospitals in the last year. One gives 10% and the other a 20% off if you call and ask for a discount in return for paying in full on the phone with a ACH pull or a credit card.

As to what you should have done.. if you need an ER, then you go to the ER. In return for their help, you pay the negotiated rate. The rate seemed reasonable to me and so did your use of the ER.

I will try to avoid medical advice, but have you determined whether there are any actions you can take to reduce the likelihood of future kidney stones? I would look into this if you have not already done so.
Last edited by Katietsu on Wed Jul 25, 2018 1:35 pm, edited 1 time in total.

mouses
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Re: How to negotiate bills from hospital?

Post by mouses » Wed Jul 25, 2018 1:33 pm

I think the OP is lucky that's all he or she owes.

I think everyone should know what urgent care places are open when and think in advance about that vs. calling the doctor's answering service vs. the ER. In fact this is a good discussion to have with your primary care doctor.

The local hospital has set up several urgent care places. Unfortunately they aren't 24 hour on the weekends. If I were running things, I'd have them located at the hospital itself, so that patients can be sent to the ER if necessary, the labs and xray are accessible. One stop shopping.

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BolderBoy
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Re: How to negotiate bills from hospital?

Post by BolderBoy » Wed Jul 25, 2018 2:02 pm

misterno wrote:
Wed Jul 25, 2018 1:21 pm
When it comes to kidney stone, doctors know pain will come back

So when I was in ER, doctor prescribed very heavy pain killer and he gave it. But he was expecting anyway
The difference, as you said, is the doctor offered you the pain meds. Any reasonable caregiver will assess the situation and do likewise.

What I'm suggesting that you do not do in the future is to request pain meds BY NAME, lest you be labeled and get squat.
"Never underestimate one's capacity to overestimate one's abilities" - The Dunning-Kruger Effect

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Pajamas
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Re: How to negotiate bills from hospital?

Post by Pajamas » Wed Jul 25, 2018 2:08 pm

mouses wrote:
Wed Jul 25, 2018 1:33 pm
If I were running things, I'd have them located at the hospital itself, so that patients can be sent to the ER if necessary, the labs and xray are accessible. One stop shopping.
A lot of hospitals have set up urgent care centers near the emergency room but for the opposite reason, so the great numbers of patients who show up at the emergency center in the absence of a real emergency can be diverted to urgent care.

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Artful Dodger
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Re: How to negotiate bills from hospital?

Post by Artful Dodger » Wed Jul 25, 2018 2:22 pm

As Katietsu noted above, call them and ask for a prompt pay discount. They know that there is a good chance, you won't pay anything, and if you do, you can spread it out and pay over the next 6 to 12 months. I've never seen a hospital charge late interest, if someone is making regular payments. However, most would rather dispense with lower regular payments, and prefer you settle it upfront. They can clear the bill off their system now by offering a small discount. Not all will do this. You'll only find out if you ask. If you are lower income, they may offer a discount if you apply for and qualify for a financial aid.

misterno
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Re: How to negotiate bills from hospital?

Post by misterno » Wed Jul 25, 2018 2:50 pm

I am an idiot

I paid the first bill from the hospital $900

Then after reading this thread, I called for the 2nd bill from the physician for $380

Customer care rep did not even think for 1 second to offer me a discount of 50%.

Oh man, I could have called the hospital and got the same from the hospital but I could not figure that out

Stupid of me

theplayer11
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Re: How to negotiate bills from hospital?

Post by theplayer11 » Wed Jul 25, 2018 4:15 pm

you are lucky to get such a discount..I had a $3,900 Lifespan bill for a kidney stone procedure and they wouldn't discount, just a 0% interest payment plan.

toofache32
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Re: How to negotiate bills from hospital?

Post by toofache32 » Thu Jul 26, 2018 9:46 pm

Thegame14 wrote:
Wed Jul 25, 2018 1:22 pm
usually if you wait like 6 months and don't pay they will send it to collections and collections will normally take like 50-75% of the balance and called it closed. It may hurt your credit, but maybe that isn't an issue.
It's getting more difficult for "medical debt" to hurt one's credit. Increasingly, patients know this and ignore the collections agencies. So in my office I just send patients a 1099-c for cancelled debt because the government considers this income. They can hide from me but not from the IRS.

btenny
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Re: How to negotiate bills from hospital?

Post by btenny » Thu Jul 26, 2018 11:29 pm

Both of the Urgent Care places I have visited had nothing to do with the hospitals near them. The services offered were OK but DEFINITELY not a complete ER. They are fine for colds and ear aches and similar stuff, NOT kidney stones or bad falls and broken bones. And my urologist has a 2-4 week wait period for an appointment and will tell any patient to go to the ER if they have bad pain.

Be thankful your stone did not require surgery or other more intensive procedures. Pay the bill to cover the high end equipment.

Good Luck.

MnD
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Re: How to negotiate bills from hospital?

Post by MnD » Thu Jul 26, 2018 11:50 pm

misterno wrote:
Wed Jul 25, 2018 2:50 pm
I am an idiot

I paid the first bill from the hospital $900

Then after reading this thread, I called for the 2nd bill from the physician for $380

Customer care rep did not even think for 1 second to offer me a discount of 50%.

Oh man, I could have called the hospital and got the same from the hospital but I could not figure that out

Stupid of me
Pay the $380 or 50% off offer or whatever and move on with your life. Quit calling yourself stupid and an idiot.
Be thankful it wasn't kidney cancer that has spread or something horrible like that.
You got the negotiated rate plus an additional discount and despite what you read here, further price improvement was unlikely.

Erwin007
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Re: How to negotiate bills from hospital?

Post by Erwin007 » Fri Jul 27, 2018 7:41 am

toofache32 wrote:
Thu Jul 26, 2018 9:46 pm
Thegame14 wrote:
Wed Jul 25, 2018 1:22 pm
usually if you wait like 6 months and don't pay they will send it to collections and collections will normally take like 50-75% of the balance and called it closed. It may hurt your credit, but maybe that isn't an issue.
It's getting more difficult for "medical debt" to hurt one's credit. Increasingly, patients know this and ignore the collections agencies. So in my office I just send patients a 1099-c for cancelled debt because the government considers this income. They can hide from me but not from the IRS.
This is a great idea. It really is like income since it’s money they don’t have to spend paying their responsibility.

tibbitts
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Re: How to negotiate bills from hospital?

Post by tibbitts » Fri Jul 27, 2018 7:51 am

toofache32 wrote:
Thu Jul 26, 2018 9:46 pm
Thegame14 wrote:
Wed Jul 25, 2018 1:22 pm
usually if you wait like 6 months and don't pay they will send it to collections and collections will normally take like 50-75% of the balance and called it closed. It may hurt your credit, but maybe that isn't an issue.
It's getting more difficult for "medical debt" to hurt one's credit. Increasingly, patients know this and ignore the collections agencies. So in my office I just send patients a 1099-c for cancelled debt because the government considers this income. They can hide from me but not from the IRS.
That's very interesting - I'd never thought of that.

MnD
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Re: How to negotiate bills from hospital?

Post by MnD » Fri Jul 27, 2018 9:55 am

Erwin007 wrote:
Fri Jul 27, 2018 7:41 am
toofache32 wrote:
Thu Jul 26, 2018 9:46 pm
Thegame14 wrote:
Wed Jul 25, 2018 1:22 pm
usually if you wait like 6 months and don't pay they will send it to collections and collections will normally take like 50-75% of the balance and called it closed. It may hurt your credit, but maybe that isn't an issue.
It's getting more difficult for "medical debt" to hurt one's credit. Increasingly, patients know this and ignore the collections agencies. So in my office I just send patients a 1099-c for cancelled debt because the government considers this income. They can hide from me but not from the IRS.
This is a great idea. It really is like income since it’s money they don’t have to spend paying their responsibility.
This is routine in the in-house credit and collections department of a major retailer my sons girlfriend works in.
The funny thing is, the deadbeats will often call the credit/collections office, sometimes repeatably, with angry tirades along with empty threats of lawsuits immediately upon receiving the 1099-C. This after months of taking every step possible to avoiding communicating with that same department. Love it! :mrgreen:

toofache32
Posts: 1380
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Re: How to negotiate bills from hospital?

Post by toofache32 » Fri Jul 27, 2018 10:08 am

MnD wrote:
Fri Jul 27, 2018 9:55 am
Erwin007 wrote:
Fri Jul 27, 2018 7:41 am
toofache32 wrote:
Thu Jul 26, 2018 9:46 pm
Thegame14 wrote:
Wed Jul 25, 2018 1:22 pm
usually if you wait like 6 months and don't pay they will send it to collections and collections will normally take like 50-75% of the balance and called it closed. It may hurt your credit, but maybe that isn't an issue.
It's getting more difficult for "medical debt" to hurt one's credit. Increasingly, patients know this and ignore the collections agencies. So in my office I just send patients a 1099-c for cancelled debt because the government considers this income. They can hide from me but not from the IRS.
This is a great idea. It really is like income since it’s money they don’t have to spend paying their responsibility.
This is routine in the in-house credit and collections department of a major retailer my sons girlfriend works in.
The funny thing is, the deadbeats will often call the credit/collections office, sometimes repeatably, with angry tirades along with empty threats of lawsuits immediately upon receiving the 1099-C. This after months of taking every step possible to avoiding communicating with that same department. Love it! :mrgreen:
Yes it definitely gives a warm fuzzy feeling to those of us who have been cheated. Like a warm blanket by the fireplace.
Just this week I had a patient whose insurance denied payment for a multi-step treatment which was pre-authorized and approved. She signed our standard written treatment plan showing the total cost, the portion the insurance company "says" they will pay, and the patient's portion. The form also has bold red print that this is only an estimate and the patient is responsible for anything the insurance company doesn't pay.
So after insurance didn't pay, the bill went to the patient for about $700. Then she got mad and said I "talked her into the treatment" and she didn't want that portion of treatment we are billing her for (conveniently). She didn't pay so we sent her to collections. Then she threatened the collection agency with legal action so they gave up and gave her account back to us. She was incredibly rude and nasty, yelling and hanging up on my staff, etc. So I told my staff to send her the dismissal letter and a 1099-c. Can't wait to hear what she says when she gets the IRS notice. I know I'll hear from her.

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