Big Hospital Bill - Any way to negotiate ?

Non-investing personal finance issues including insurance, credit, real estate, taxes, employment and legal issues such as trusts and wills
Topic Author
confusedinvestor
Posts: 606
Joined: Thu Mar 15, 2012 11:04 am

Big Hospital Bill - Any way to negotiate ?

Post by confusedinvestor » Tue Jul 02, 2019 12:17 am

Folks, Recently went to emergency room and now got a 6K hospital bill (after insurance adjustments) meet the deductible

Is there any recommendations to negotiate this with the hospital billing dept ?

Is it better to not pay and let it go to collections and then negotiate with them ?

I could use some help and tips on this issue, thanks all.

DesertDiva
Posts: 462
Joined: Thu Mar 01, 2018 12:49 pm
Location: In the desert

Re: Big Hospital Bill - Anyway to negociate ?

Post by DesertDiva » Tue Jul 02, 2019 12:26 am

First, ask for an itemized bill. Ensure you aren’t being charged for services you didn’t receive.

User avatar
southerndoc
Posts: 1022
Joined: Wed Apr 22, 2009 7:07 pm
Location: Atlanta

Re: Big Hospital Bill - Anyway to negociate ?

Post by southerndoc » Tue Jul 02, 2019 12:29 am

You can always call and ask. The worst they can say is no adjustment.

Sorry the bill was so high. Hope everything is ok.

aude
Posts: 251
Joined: Sat Feb 11, 2012 11:06 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by aude » Tue Jul 02, 2019 1:12 am

hospitals routinely permit payment plans without interest if that helps.

livesoft
Posts: 67352
Joined: Thu Mar 01, 2007 8:00 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by livesoft » Tue Jul 02, 2019 3:34 am

aude wrote:
Tue Jul 02, 2019 1:12 am
hospitals routinely permit payment plans without interest if that helps.
Very true. I am on one such plan.
Wiki This signature message sponsored by sscritic: Learn to fish.

User avatar
Nate79
Posts: 4777
Joined: Thu Aug 11, 2016 6:24 pm
Location: Delaware

Re: Big Hospital Bill - Anyway to negociate ?

Post by Nate79 » Tue Jul 02, 2019 5:10 am

I was under the impression that their contract with the insurance company usually forbids them to negotiate on the reduced insurance rate.

Housedoc
Posts: 396
Joined: Thu May 24, 2018 4:25 pm
Location: Alabama

Re: Big Hospital Bill - Anyway to negociate ?

Post by Housedoc » Tue Jul 02, 2019 5:32 am

A few times I got a 20pct discount for paying bill in full. Ask for that option also.

Spirit Rider
Posts: 10983
Joined: Fri Mar 02, 2007 2:39 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by Spirit Rider » Tue Jul 02, 2019 6:41 am

Nate79 wrote:
Tue Jul 02, 2019 5:10 am
I was under the impression that their contract with the insurance company usually forbids them to negotiate on the reduced insurance rate.
I don't know where you got that impression. As pointed out by @Housedoc, hospitals routinely offer discounts for prompt full payment of the patient's co-pays/co-insurance and other discounts based on ability to pay.

Local hospitals offer a 20% discount for payments in full within 60 days. One offers a 25% discount on pre-payment of out-patient procedures.

I have helped moderate income individuals negotiate no interest payment plans with as much as a 50% discount. I have even helped lower income individuals apply for and receive a charitable waiving of the full bill.

Bb073084
Posts: 38
Joined: Sun Feb 03, 2019 10:24 am

Re: Big Hospital Bill - Anyway to negociate ?

Post by Bb073084 » Tue Jul 02, 2019 6:48 am

Let them know that you will be paying out of pocket for the remainder and this is a hardship. Ask if they can give you a “self-pay” discount or if you may qualify for a charity care program.

Typically hospitals give a self pay discount that is quite substantial.

User avatar
bengal22
Posts: 1747
Joined: Sat Dec 03, 2011 6:20 pm
Location: Ohio

Re: Big Hospital Bill - Anyway to negociate ?

Post by bengal22 » Tue Jul 02, 2019 7:07 am

One night my wife went to the ER because she was having some dizzy issues. We paid the copay and I thought everything was cool. However because they thought it was possibly life threatening they ran some test. 4 hours later she was discharged and was OK.

Later I got a 5K bill. After a lot of fussing and phonecalls the hospital billing Dept turned me over to a patient advocate. We had a nice talk and woila a few days later they forgave our bill.

So ask for the customer advocate.
Last edited by bengal22 on Wed Jul 03, 2019 1:51 pm, edited 1 time in total.
"Earn All You Can; Give All You Can; Save All You Can." .... John Wesley

jacksonm
Posts: 171
Joined: Tue Oct 16, 2018 11:48 am

Re: Big Hospital Bill - Anyway to negociate ?

Post by jacksonm » Tue Jul 02, 2019 7:18 am

On my last job before I retired our benefit package included a service with a company that was in the business of negotiating medical bills. The service was free - they made their money by taking a percentage of the savings.

I don't remember the name of the company but I believe it was available to the general public. Might be worth googling to see if you can find something similar.

User avatar
Nate79
Posts: 4777
Joined: Thu Aug 11, 2016 6:24 pm
Location: Delaware

Re: Big Hospital Bill - Anyway to negociate ?

Post by Nate79 » Tue Jul 02, 2019 7:36 am

Spirit Rider wrote:
Tue Jul 02, 2019 6:41 am
Nate79 wrote:
Tue Jul 02, 2019 5:10 am
I was under the impression that their contract with the insurance company usually forbids them to negotiate on the reduced insurance rate.
I don't know where you got that impression. As pointed out by @Housedoc, hospitals routinely offer discounts for prompt full payment of the patient's co-pays/co-insurance and other discounts based on ability to pay.

Local hospitals offer a 20% discount for payments in full within 60 days. One offers a 25% discount on pre-payment of out-patient procedures.

I have helped moderate income individuals negotiate no interest payment plans with as much as a 50% discount. I have even helped lower income individuals apply for and receive a charitable waiving of the full bill.
I have seen it posted multiple times on BH. True or not I don't know.

Example was in this thread:
viewtopic.php?t=247372.
and this one
viewtopic.php?t=73477

But they may break the rules of the contract if they are not enforced.

In network rate is already a negotiated rate by the insurance company and is contractual rate.

I'm curious in the cases that you mention were these costs before the deductible or after hitting deductible?
What amount counted towards the deductible, the insurance agreed amount or the new discounted amount that the patient actually paid?

NativeTxn
Posts: 72
Joined: Mon May 20, 2019 9:32 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by NativeTxn » Tue Jul 02, 2019 7:44 am

As someone stated, ask for an itemized bill to double check it.

Then call and ask them what type of discount they offer if you pay in full. Many, if not most, hospitals will have a 15-20% discount with no negotiation required if you pay in full. I tried to get more than that a few years ago on a surgery bill, but they said 20% is the highest they go and that is standard (at least for this hospital - YMMV with others).

If you can't/don't want to pay it in full, you can ask for a payment plan, though you will likely not be able to negotiate any, or much of, a discount if you pay it out in a payment plan. They will probably want to start you at $100 or more a month, but if you tell them it's a hardship and you need, say $50 a month, they should work with you to get it down to that (though it may take escalating to their manager because, in my experience, the ones answering the phone for billing only have so much leeway on reducing the monthly payment amount).

I had a bill several years ago for an ER visit that after insurance, etc. was about $2,200 out of pocket. I called for a payment plan (not necessarily because I needed it, but my philosophy is if they don't charge interest, why not). The first person said that I could do $100 a month. I told them I'd prefer $50. She said that should be fine but I'd need to talk to the manager for him to approve that because the lowest she could go is $100 a month. I talked to the manager the next day and set up $50 a month to be debit from my checking account each month with no push back or issue getting that in place.

Not sure you'd want to go that low on a $5,000 bill, but they tend to be pretty flexible when it comes to payment plans. I assume they're happy they're getting paid consistently and will get paid in full, since I would guess there are a fair amount of payment/collection issues they have to deal with frequently.

All of that being said, I don't know that I would let it go to collections, because then you run the risk of it affecting your credit score (which I suppose for some isn't a big deal, but I wouldn't want to take that risk personally).

Best of luck with whatever approach you take.

researcher
Posts: 996
Joined: Thu Mar 12, 2015 7:05 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by researcher » Tue Jul 02, 2019 8:25 am

Bb073084 wrote:
Tue Jul 02, 2019 6:48 am
Let them know that you will be paying out of pocket for the remainder and this is a hardship. Ask if they can give you a “self-pay” discount.
Typically hospitals give a self pay discount that is quite substantial.
Do exactly this and you are very likely to get an immediate 20%-50% discount.
I've gotten this type of discount every time.

Just make sure to stress that you are paying out-of-pocket, and are willing to pay the bill in full now with a credit card if they are able to give you a 'self pay' discount.

Spirit Rider
Posts: 10983
Joined: Fri Mar 02, 2007 2:39 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by Spirit Rider » Tue Jul 02, 2019 8:43 am

Nate79 wrote:
Tue Jul 02, 2019 7:36 am
I have seen it posted multiple times on BH. True or not I don't know.

Example was in this thread:
viewtopic.php?t=247372.
and this one
viewtopic.php?t=73477

But they may break the rules of the contract if they are not enforced.

In network rate is already a negotiated rate by the insurance company and is contractual rate.

I'm curious in the cases that you mention were these costs before the deductible or after hitting deductible?
What amount counted towards the deductible, the insurance agreed amount or the new discounted amount that the patient actually paid?
I can't comment on what other's experiences are. I think it unlikely that it breaks the rules as I have done it with several insurance companies over decades. They prompt payment discount is printed right on the providers bills, so it is not like it is a secret or anything.

It has been a variety of different circumstances, before deductible, after deductible, co-insurance and co-pays. The insurance company pays their obligation of the negotiated rate, leaving your responsibility which in my experience is always fully applied to the deductible.

The insurance company never knows or seems care to ask if you pay the full amount of your responsibility. That is one purpose of negotiated rates. Otherwise the provider can not inflate the charge to get paid more by the insurance company and then offer a bigger discount. The negotiated rate is the negotiated rate and it is no skin off the back of the insurance company if the provider doesn't get paid the full amount of your responsibility.

chessknt
Posts: 174
Joined: Wed Jul 13, 2016 3:15 am

Re: Big Hospital Bill - Anyway to negociate ?

Post by chessknt » Tue Jul 02, 2019 9:01 am

Do you have a coinsurance requirement/is this a high deductible plan? Is it actual insurance or health cost sharing plan? Are you actually unable to pay or just don't want to?

carolinaman
Posts: 3731
Joined: Wed Dec 28, 2011 9:56 am
Location: North Carolina

Re: Big Hospital Bill - Anyway to negociate ?

Post by carolinaman » Tue Jul 02, 2019 9:46 am

I recommend that you try to negotiate. It sounds like the charges are your insurer's rates which means they are reduced from the hospital's retail rates. In negotiating, I would not jump too quickly to a payment plan. I would lament on your ability to pay this very high bill. Ideally, they will agree to reduce the rate for you. If it were me, I would be much more interested in reducing the charges than a payment plan.

quantAndHold
Posts: 3438
Joined: Thu Sep 17, 2015 10:39 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by quantAndHold » Tue Jul 02, 2019 10:07 am

Let me guess. You’re on a HDHP, and $6k is your out of pocket max for the year.

Can you not afford to pay, or do you just not want to? Huge copays are part of the deal with HDHP’s, so you need to be ready for that.

It seems like a really bad idea to ruin your credit over this. I would call and ask for a payment plan.

If you just reached your out of pocket max, then you aren’t going to have any more medical bills this year. If you didn’t, you might start adding medical copays into your budget.

JGoneRiding
Posts: 1740
Joined: Tue Jul 15, 2014 3:26 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by JGoneRiding » Tue Jul 02, 2019 10:55 am

Not the OP. I am not in a hdhp I would actually like to be. And our oopm is over 6k. And the combined family is 11.5k. This has become a hardship as I had thought it was 4k. I will be calling the hospital as soon as I finally get the bill. Ty for tips! But I will definitely pay promptly.

I think it is tagged at the top op on how not to run up a large er bill, written by one of our md s on here. But basically er docs have yo assume you could be dying and run tests to prove you aren't these cost more than if done in regular hours. We ALL end up paying for this in the form of taxes and higher insurance.

TaxingAccount
Posts: 115
Joined: Sun Mar 17, 2019 8:34 am

Re: Big Hospital Bill - Anyway to negociate ?

Post by TaxingAccount » Tue Jul 02, 2019 2:20 pm

i would rather pay the ultimate price than go to the emergency room

JackoC
Posts: 872
Joined: Sun Aug 12, 2018 11:14 am

Re: Big Hospital Bill - Anyway to negociate ?

Post by JackoC » Tue Jul 02, 2019 2:43 pm

carolinaman wrote:
Tue Jul 02, 2019 9:46 am
I recommend that you try to negotiate. It sounds like the charges are your insurer's rates which means they are reduced from the hospital's retail rates. In negotiating, I would not jump too quickly to a payment plan. I would lament on your ability to pay this very high bill. Ideally, they will agree to reduce the rate for you. If it were me, I would be much more interested in reducing the charges than a payment plan.
Agree, no downside to negotiating. No downside to negotiating aggressively but some people don't like to. I'm not saying it's natural for me either. But even for 'insurance adjusted' medical prices it is really not like filling your shopping cart at the supermarket then trying to negotiate with the cashier (if there even still is a human cashier :D ). You didn't agree to the charges before getting the treatment, you couldn't. They are still, even with the 'insurance adjustment' pulled out of...the air, to some degree. And loads of people are being allowed not to pay. Which I'm not putting forward as some kind of moral or ethical let alone political argument, just a practical one. They do cut people deals besides just paying over time. It's like if a car's MSRP is $20,000 but you walk in and the dealer says 'for you, $19k', there's nothing set in stone about $19k just because it's not list price, nor for hospital 'insurance adjusted' prices either.

Which isn't to say you can force them to give you a big discount. Try your best and see. But definitely don't just ignore their bills and wait for it to go to a collection agency. That reduces your leverage. Right when you get the bill it's a long way from the hospital putting the squeeze on you via your credit report, it doesn't go on now until 180 days after being declared past due. More on medical bills and credit scores under recent changes:
https://www.creditkarma.com/advice/i/ho ... t-reports/

SoonerD
Posts: 241
Joined: Tue Jul 21, 2015 8:28 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by SoonerD » Wed Jul 03, 2019 10:03 am

Nate79 wrote:
Tue Jul 02, 2019 5:10 am
I was under the impression that their contract with the insurance company usually forbids them to negotiate on the reduced insurance rate.
I was told same thing by an executive at our hospital.

I commented that I negotiated a discount on my prior stay. She confirmed that it was a newer policy/ regulation/rule/law (I don’t recall which) but negotiating discounts on top of insurance’s discounts isa thing of the past.

People without insurance can negotiate discounts.

Bills sent to collections, whether the collection department is an arm the the hospital or a separate entity, i.e. , a 3rd party collection company, can be negotiated to a lower amount.

cashisking500
Posts: 61
Joined: Fri Dec 02, 2016 1:08 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by cashisking500 » Wed Jul 03, 2019 10:20 am

I recently went through the same situation, with a $4,000 bill for the birth of our daughter. Right off the bat, the hospital offered us a 10% discount if we paid in full. After discussion and pushing on them a bit, they knocked off another $500 on top of the 10%. We accepted this and paid in full with the discounts offered.

User avatar
willthrill81
Posts: 11856
Joined: Thu Jan 26, 2017 3:17 pm
Location: USA

Re: Big Hospital Bill - Anyway to negociate ?

Post by willthrill81 » Wed Jul 03, 2019 10:23 am

confusedinvestor wrote:
Tue Jul 02, 2019 12:17 am
Folks, Recently went to emergency room and now got a 6K hospital bill (after insurance adjustments) meet the deductible

Is there any recommendations to negotiate this with the hospital billing dept ?

Is it better to not pay and let it go to collections and then negotiate with them ?
Just call their billing department and ask them if there's anything you can do to get the bill reduced, such as paying it in full right now. If you need to, speak with a supervisor.

I would not wait for it to go collections as your credit will probably get dinged significantly by doing so.

Are you on an HDHP?
“It's a dangerous business, Frodo, going out your door. You step onto the road, and if you don't keep your feet, there's no knowing where you might be swept off to.” J.R.R. Tolkien,The Lord of the Rings

User avatar
SlowMovingInvestor
Posts: 1275
Joined: Sun Sep 11, 2016 11:27 am

Re: Big Hospital Bill - Anyway to negociate ?

Post by SlowMovingInvestor » Wed Jul 03, 2019 12:43 pm

SoonerD wrote:
Wed Jul 03, 2019 10:03 am
Nate79 wrote:
Tue Jul 02, 2019 5:10 am
I was under the impression that their contract with the insurance company usually forbids them to negotiate on the reduced insurance rate.
I was told same thing by an executive at our hospital.

I commented that I negotiated a discount on my prior stay. She confirmed that it was a newer policy/ regulation/rule/law (I don’t recall which) but negotiating discounts on top of insurance’s discounts isa thing of the past.

People without insurance can negotiate discounts.

Bills sent to collections, whether the collection department is an arm the the hospital or a separate entity, i.e. , a 3rd party collection company, can be negotiated to a lower amount.
What happens to the deductible/OOP max for a patient if the hospital were to offer a discount to the patient ? If it's not actually adjusted down by the insurance company to the actual amount the patient pays (after discount), it would seem to give patients a chance to game the system by reaching their deductible or OOP max without actually paying that much.

For example, if a HDHP has a deductible of $2000, and a provider bills $2000, but later offers a discount to the patient so that he/she only pays $1000, is the insurance company informed by the provider that the patient has actually paid only $1000 ?

That might be the reason why insurance companies don't allow further discounts unless the bill actually does go to collections. And that reason does strike me as valid.

Presintense
Posts: 214
Joined: Thu Nov 06, 2014 1:58 pm
Location: "Somewhere in the middle of America"

Re: Big Hospital Bill - Anyway to negociate ?

Post by Presintense » Wed Jul 03, 2019 12:51 pm

DesertDiva wrote:
Tue Jul 02, 2019 12:26 am
First, ask for an itemized bill. Ensure you aren’t being charged for services you didn’t receive.
This sounds like a good first step. If there’s the possibility of an inaccuracy I would think you would want to address it first and negotiate what’s left.
Performance = Potential - Distraction

User avatar
dm200
Posts: 21275
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Big Hospital Bill - Anyway to negociate ?

Post by dm200 » Wed Jul 03, 2019 1:12 pm

For reason(s) too complex to go into, several years ago my wife was in the hospital for a few days and had surgery, etc. We were unable to just write a check for the several thousand dollars that her insurance did not pay. All the charges were both reasonable and fully due - according to her insurance.

The bills for this hospitalization and surgery came from three different folks/places. One from the hospital, one from the surgeon and one other (cannot recall). The hospital was very willing to work out a monthly payment plan. She/we had to "push" a bit for the others, but they eventually agreed as well.

Since, it seems, the OP charges were all according to her insurance plan AND were for all actual services received - I suggest asking for a fair and reasonable payment plan.

User avatar
dm200
Posts: 21275
Joined: Mon Feb 26, 2007 2:21 pm
Location: Washington DC area

Re: Big Hospital Bill - Anyway to negociate ?

Post by dm200 » Wed Jul 03, 2019 1:21 pm

JGoneRiding wrote:
Tue Jul 02, 2019 10:55 am
Not the OP. I am not in a hdhp I would actually like to be. And our oopm is over 6k. And the combined family is 11.5k. This has become a hardship as I had thought it was 4k. I will be calling the hospital as soon as I finally get the bill. Ty for tips! But I will definitely pay promptly.
I think it is tagged at the top op on how not to run up a large er bill, written by one of our md s on here. But basically er docs have yo assume you could be dying and run tests to prove you aren't these cost more than if done in regular hours. We ALL end up paying for this in the form of taxes and higher insurance.
Yes - I agree.

In our cases (DW and I), we can go to our Kaiser Urgent care Center (24x7) for almost anything (probably 95% or more) that we might go to a Hospital ED for. They can keep folks for up to 24 hours. It is much less costly to us than the Hospital ED. If, for some reason, hospitalization is required - they make those arrangements - as was the case a few years ago with my wife. With this Urgent Care center - we have never had a large or incorrect billing.

Topic Author
confusedinvestor
Posts: 606
Joined: Thu Mar 15, 2012 11:04 am

Re: Big Hospital Bill - Anyway to negociate ?

Post by confusedinvestor » Wed Jul 03, 2019 8:34 pm

Update:

I've called the Hospital and the Billing Dept said they will not lower my bill (as it is already insurance contracted rates) but will be happy to set up a payment plan for 12 months interest free. It can be even extended to 18 months.

If I don't pay in 4 months, then my bill will be forwarded to the 'internal' collections dept and the bill rep is unsure if they will reduce my bill before going to external collection agencies

I am waiting for a billing manager callback and will update everyone, thanks again for all the feedback

FI4LIFE
Posts: 150
Joined: Sun Apr 28, 2019 9:27 am

Re: Big Hospital Bill - Anyway to negociate ?

Post by FI4LIFE » Wed Jul 03, 2019 8:55 pm

I have no personal experience with this, but a good friends wife had a baby and he was left with a $9k bill after insurance. He decided just to not pay it and see what happened. He eventually got a call from the hospital asking what he was able to afford and he was able to knock several thousand off the bill. I would certainly try to negotiate up front but this is an option if you don't mind rolling the dice.

Spirit Rider
Posts: 10983
Joined: Fri Mar 02, 2007 2:39 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by Spirit Rider » Wed Jul 03, 2019 9:32 pm

SoonerD wrote:
Wed Jul 03, 2019 10:03 am
Nate79 wrote:
Tue Jul 02, 2019 5:10 am
I was under the impression that their contract with the insurance company usually forbids them to negotiate on the reduced insurance rate
I was told same thing by an executive at our hospital.

I commented that I negotiated a discount on my prior stay. She confirmed that it was a newer policy/ regulation/rule/law (I don’t recall which) but negotiating discounts on top of insurance’s discounts isa thing of the past.

People without insurance can negotiate discounts.
I don't care who this person is and maybe they are talking about their hospital policy, but they are categorically wrong about any regulation, rule, law, etc.... I just prepaid my 25% co-insurance for a procedure yesterday and received a 20% discount on the patient's responsibility. So it most definitely is NOT a thing of the past.

toofache32
Posts: 1712
Joined: Sun Mar 04, 2012 6:30 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by toofache32 » Wed Jul 03, 2019 10:13 pm

You already got a negotiated discount based on the contract you signed with your insurance. You agreed in advance to this. Now why do you want to re-negotiate??

toofache32
Posts: 1712
Joined: Sun Mar 04, 2012 6:30 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by toofache32 » Wed Jul 03, 2019 10:15 pm

FI4LIFE wrote:
Wed Jul 03, 2019 8:55 pm
I have no personal experience with this, but a good friends wife had a baby and he was left with a $9k bill after insurance. He decided just to not pay it and see what happened. He eventually got a call from the hospital asking what he was able to afford and he was able to knock several thousand off the bill. I would certainly try to negotiate up front but this is an option if you don't mind rolling the dice.
This is exactly why I (surgeon) no longer participate with insurance plans. People pay their mortgage, cell phone bill, and Netflix first....the doctor gets paid last if at all. Now I get paid up front prior to surgery. <removed non-actionable comment - mighty72>

Tlmlb
Posts: 14
Joined: Mon Jan 30, 2017 8:13 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by Tlmlb » Wed Jul 03, 2019 10:28 pm

If the bill is accurate, why should the rest of us subsidize your medical expenses via higher premiums and other costs? You chose your insurance and rolled the dice. Get a payment plan. Bluntly, you owe the dough.

toofache32
Posts: 1712
Joined: Sun Mar 04, 2012 6:30 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by toofache32 » Wed Jul 03, 2019 10:33 pm

SoonerD wrote:
Wed Jul 03, 2019 10:03 am
Nate79 wrote:
Tue Jul 02, 2019 5:10 am
I was under the impression that their contract with the insurance company usually forbids them to negotiate on the reduced insurance rate.
I was told same thing by an executive at our hospital.

I commented that I negotiated a discount on my prior stay. She confirmed that it was a newer policy/ regulation/rule/law (I don’t recall which) but negotiating discounts on top of insurance’s discounts isa thing of the past.

People without insurance can negotiate discounts.

Bills sent to collections, whether the collection department is an arm the the hospital or a separate entity, i.e. , a 3rd party collection company, can be negotiated to a lower amount.
The executive is technically correct. Insurance contracts require everyone to be "charged" the same rate, but the contracts stipulate write-offs for insurance companies. Giving discounts is supposed to require documentation of hardship. But many hospitals don't bother with this because it's rare that insurance companies audit hospitals from this angle. I guess it similar to how you are NOT supposed to drive over 65mph on the interstate, but most people do since it's not enforced unless you get to 75.

scorcher31
Posts: 159
Joined: Sun Mar 06, 2016 11:13 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by scorcher31 » Wed Jul 03, 2019 10:55 pm

toofache32 wrote:
Wed Jul 03, 2019 10:33 pm
SoonerD wrote:
Wed Jul 03, 2019 10:03 am
Nate79 wrote:
Tue Jul 02, 2019 5:10 am
I was under the impression that their contract with the insurance company usually forbids them to negotiate on the reduced insurance rate.
I was told same thing by an executive at our hospital.

I commented that I negotiated a discount on my prior stay. She confirmed that it was a newer policy/ regulation/rule/law (I don’t recall which) but negotiating discounts on top of insurance’s discounts isa thing of the past.

People without insurance can negotiate discounts.

Bills sent to collections, whether the collection department is an arm the the hospital or a separate entity, i.e. , a 3rd party collection company, can be negotiated to a lower amount.
The executive is technically correct. Insurance contracts require everyone to be "charged" the same rate, but the contracts stipulate write-offs for insurance companies. Giving discounts is supposed to require documentation of hardship. But many hospitals don't bother with this because it's rare that insurance companies audit hospitals from this angle. I guess it similar to how you are NOT supposed to drive over 65mph on the interstate, but most people do since it's not enforced unless you get to 75.
This is correct, insurance rates are not supposed to be further discounted as a generalization. Now I do believe some hospitals are more strict with this than others. They will also sometimes make exceptions to this in hardship situations and when people fail to pay. Obviously you run the risk of it hurting your credit. Hospitals will commonly drastically discount self pay to get it in line with insurance rates. If a charge is wrong that could be a way to get it dropped/changed as well. I am unsure what happens if it is an out of network charge, but if the insurance company doesn't pay it and you don't get the discounted rate I presume that can be discounted as well.

4nwestsaylng
Posts: 509
Joined: Thu Jun 15, 2017 2:03 am

Re: Big Hospital Bill - Anyway to negociate ?

Post by 4nwestsaylng » Wed Jul 03, 2019 11:08 pm

confusedinvestor wrote:
Wed Jul 03, 2019 8:34 pm
Update:

I've called the Hospital and the Billing Dept said they will not lower my bill (as it is already insurance contracted rates) but will be happy to set up a payment plan for 12 months interest free. It can be even extended to 18 months.

If I don't pay in 4 months, then my bill will be forwarded to the 'internal' collections dept and the bill rep is unsure if they will reduce my bill before going to external collection agencies

I am waiting for a billing manager callback and will update everyone, thanks again for all the feedback
That is good news. Assuming that the charges are correct and accepted rates by your insurance company, is the reason you owe the $6k because you have a high deductible health plan? If so, and if you have had the insurance for a while, you have likely saved thousands of dollars in premiums that you would have had to pay for a low or no-deductible plan.

The best thing if you have a HDHP is to put those savings in either an HSA or your own special fund just for such emergencies. I know, hindsight is 20/20, but if this is all owed deductible, just do the payment plan with the hospital and then put away a nest egg for future deductibles.

<deleted non-actionable comment -mighty72>

OnTrack
Posts: 474
Joined: Wed Jan 20, 2016 11:16 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by OnTrack » Wed Jul 03, 2019 11:29 pm

I would not let it go to collections. In the article below, a woman had a bill of $12,019 in 2007 (after insurance paid their share). She is now 63 and owes about $33,000. The increase is due to interest, attorney fees and court costs. The court has ordered her to pay $100 per month (her income is $1150 per month); if she pays as ordered and there are no additional interest charges or fees, it will be paid off when she is 90. In many cases, the hospital gets the court to order that employers garnish the debtor's pay checks.

https://www.propublica.org/article/meth ... dical-debt

SoonerD
Posts: 241
Joined: Tue Jul 21, 2015 8:28 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by SoonerD » Thu Jul 04, 2019 12:00 am

Spirit Rider wrote:
Wed Jul 03, 2019 9:32 pm
SoonerD wrote:
Wed Jul 03, 2019 10:03 am
Nate79 wrote:
Tue Jul 02, 2019 5:10 am
I was under the impression that their contract with the insurance company usually forbids them to negotiate on the reduced insurance rate
I was told same thing by an executive at our hospital.

I commented that I negotiated a discount on my prior stay. She confirmed that it was a newer policy/ regulation/rule/law (I don’t recall which) but negotiating discounts on top of insurance’s discounts isa thing of the past.

People without insurance can negotiate discounts.
I don't care who this person is and maybe they are talking about their hospital policy, but they are categorically wrong about any regulation, rule, law, etc.... I just prepaid my 25% co-insurance for a procedure yesterday and received a 20% discount on the patient's responsibility. So it most definitely is NOT a thing of the past.
I commented regarding MY experience at MY hospital and of MY conversation to which you were not privy.

“newer policy/ regulation/rule/law (I don’t recall which)”. In my hospital it’s a thing of the past.

you might admit to yourself you don’t know the rules at my hospital.

Happy 4th to all the great Bogleheads!

User avatar
alpenglow
Posts: 824
Joined: Tue May 31, 2011 12:02 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by alpenglow » Thu Jul 04, 2019 11:47 am

researcher wrote:
Tue Jul 02, 2019 8:25 am
Bb073084 wrote:
Tue Jul 02, 2019 6:48 am
Let them know that you will be paying out of pocket for the remainder and this is a hardship. Ask if they can give you a “self-pay” discount.
Typically hospitals give a self pay discount that is quite substantial.
Do exactly this and you are very likely to get an immediate 20%-50% discount.
I've gotten this type of discount every time.

Just make sure to stress that you are paying out-of-pocket, and are willing to pay the bill in full now with a credit card if they are able to give you a 'self pay' discount.
I have received a 50% discount doing this.

User avatar
White Coat Investor
Posts: 14087
Joined: Fri Mar 02, 2007 9:11 pm
Location: Greatest Snow On Earth

Re: Big Hospital Bill - Anyway to negociate ?

Post by White Coat Investor » Thu Jul 04, 2019 12:28 pm

confusedinvestor wrote:
Tue Jul 02, 2019 12:17 am
Folks, Recently went to emergency room and now got a 6K hospital bill (after insurance adjustments) meet the deductible

Is there any recommendations to negotiate this with the hospital billing dept ?

Is it better to not pay and let it go to collections and then negotiate with them ?

I could use some help and tips on this issue, thanks all.
Oh, are we doing this again? I thought we just did this "how to get out of paying doctors" thing yesterday.

I had an A/C guy over yesterday. He gave me a $6K bill. Any recommendations to negotiate this with the company?

Is it better to not pay and let it go to collections and then negotiate with them?

I could use some help and tips on this issue, thanks all.

Feel any different? I bet it would if you were an A/C guy or an emergency doctor.

If you don't want a $6K bill, don't go to the ED. That's what it costs to go there. If you don't meet your max out of pocket with one ED visit, you certainly will with two. Too many people think the cost is more similar to a clinic visit than a hospitalization. It isn't because the service you receive is more similar to a hospital stay than 8 minutes with a family doc and her medical assistant.
1) Invest you must 2) Time is your friend 3) Impulse is your enemy | 4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course

User avatar
White Coat Investor
Posts: 14087
Joined: Fri Mar 02, 2007 9:11 pm
Location: Greatest Snow On Earth

Re: Big Hospital Bill - Anyway to negociate ?

Post by White Coat Investor » Thu Jul 04, 2019 12:32 pm

TaxingAccount wrote:
Tue Jul 02, 2019 2:20 pm
i would rather pay the ultimate price than go to the emergency room
Even with the day old turkey sammich and some graham crackers thrown in?
1) Invest you must 2) Time is your friend 3) Impulse is your enemy | 4) Basic arithmetic works 5) Stick to simplicity 6) Stay the course

JPM
Posts: 62
Joined: Sun Aug 19, 2018 2:29 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by JPM » Thu Jul 04, 2019 1:12 pm

From 1985 to 1996 years ago I had a HDHP with a $5000 deductible. Had to pay it twice for surgeries on DW and DS one year and twice for employees over those years, but overall the HD plan saved me money over the eleven year period. When you choose the HD plan, this is the deal you make. Taking the HDHP deal seems to me a Bogleheaded way of approaching health insurance for an individual or small shop but like poker hands you expect to lose once in awhile as being in the nature of the deal. For most people a deal is a deal, but some seem to feel a deal is only a deal for the other guy and I have a right to hold him to it if it works out for me, but a deal is not a deal for me and I can Welsh on it when it works against me.

mighty72
Moderator
Posts: 478
Joined: Fri May 04, 2018 11:22 pm
Location: Somewhere in the West

Re: Big Hospital Bill - Anyway to negociate ?

Post by mighty72 » Thu Jul 04, 2019 2:24 pm

Please stay on-topic and refrain from commenting on politics and personal comments.

JackoC
Posts: 872
Joined: Sun Aug 12, 2018 11:14 am

Re: Big Hospital Bill - Anyway to negociate ?

Post by JackoC » Thu Jul 04, 2019 2:59 pm

White Coat Investor wrote:
Thu Jul 04, 2019 12:28 pm

I had an A/C guy over yesterday. He gave me a $6K bill. Any recommendations to negotiate this with the company?
I see your point. I walked into a car dealership the other day and the MSRP for the car was $30k, so I just paid it. :D That's the price, right?

quantAndHold
Posts: 3438
Joined: Thu Sep 17, 2015 10:39 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by quantAndHold » Thu Jul 04, 2019 3:07 pm

If it goes to collections, the collection agency will add a bunch of fees, and you’ll owe more than $6k. At that point, you will probably be able to negotiate it back down to $6k. It’s doubtful, though, that the in-house collection agency will reduce it below the insurance negotiated price, for the same reason that the hospital billing department won’t. If you skip out on the hospital’s collection people, they will eventually sell the bill to an external collection agency, which will have more room to negotiate. But by that time, you will have ruined your credit, and the total you’re negotiating from will be a *lot* higher.

This is how high deductible plans work. You save on the insurance premiums. But you have...a high deductible. My recommendation would be to take the 12 month payment plan, and also recognize that this can happen every year. So you need to have an emergency fund that’s capable of paying the deductible.

quantAndHold
Posts: 3438
Joined: Thu Sep 17, 2015 10:39 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by quantAndHold » Thu Jul 04, 2019 3:09 pm

JackoC wrote:
Thu Jul 04, 2019 2:59 pm
White Coat Investor wrote:
Thu Jul 04, 2019 12:28 pm

I had an A/C guy over yesterday. He gave me a $6K bill. Any recommendations to negotiate this with the company?
I see your point. I walked into a car dealership the other day and the MSRP for the car was $30k, so I just paid it. :D That's the price, right?
In this case, OP is using a buying service (the insurance company), that already did the negotiating.

JackoC
Posts: 872
Joined: Sun Aug 12, 2018 11:14 am

Re: Big Hospital Bill - Anyway to negociate ?

Post by JackoC » Thu Jul 04, 2019 3:20 pm

quantAndHold wrote:
Thu Jul 04, 2019 3:09 pm
JackoC wrote:
Thu Jul 04, 2019 2:59 pm
White Coat Investor wrote:
Thu Jul 04, 2019 12:28 pm

I had an A/C guy over yesterday. He gave me a $6K bill. Any recommendations to negotiate this with the company?
I see your point. I walked into a car dealership the other day and the MSRP for the car was $30k, so I just paid it. :D That's the price, right?
In this case, OP is using a buying service (the insurance company), that already did the negotiating.
OK, so if I go to a car dealer with a TrueCar certificate I have to pay that price? They already did the negotiating, didn't they? Actually on my last purchase a car dealer told me exactly that, 'we're contractually obligated not to further negotiation the TrueCar price'. I said 'yeah, right', and the negotiation continued to a lower price. :happy

User avatar
ram
Posts: 1244
Joined: Tue Jan 01, 2008 10:47 pm
Location: Midwest

Re: Big Hospital Bill - Anyway to negociate ?

Post by ram » Thu Jul 04, 2019 3:23 pm

Have you looked at how much you saved on insurance premium by taking the HDHP. If it is more than 6000 you are already ahead.
HDHP plans are not for everybody. For those that prefer a more uniform monthly payment the traditional low deductible plans are more appropriate.
Ram

quantAndHold
Posts: 3438
Joined: Thu Sep 17, 2015 10:39 pm

Re: Big Hospital Bill - Anyway to negociate ?

Post by quantAndHold » Thu Jul 04, 2019 3:42 pm

JackoC wrote:
Thu Jul 04, 2019 3:20 pm
quantAndHold wrote:
Thu Jul 04, 2019 3:09 pm
JackoC wrote:
Thu Jul 04, 2019 2:59 pm
White Coat Investor wrote:
Thu Jul 04, 2019 12:28 pm

I had an A/C guy over yesterday. He gave me a $6K bill. Any recommendations to negotiate this with the company?
I see your point. I walked into a car dealership the other day and the MSRP for the car was $30k, so I just paid it. :D That's the price, right?
In this case, OP is using a buying service (the insurance company), that already did the negotiating.
OK, so if I go to a car dealer with a TrueCar certificate I have to pay that price? They already did the negotiating, didn't they? Actually on my last purchase a car dealer told me exactly that, 'we're contractually obligated not to further negotiation the TrueCar price'. I said 'yeah, right', and the negotiation continued to a lower price. :happy
In this case, yes. You take the price. The hospital has a contract with the insurance company for that price. You have a contract with the insurance company. You don't have a contract with TrueCar, so you can walk out of that deal. You already did the deal with the insurance company when you signed up for coverage. So you pay the bill.

Locked