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How to Best Prepare Yourself for Negotiating Medical Bills

Negotiating medical bills isn't difficult, as long as you've done the preparation to make it successful.

November 28, 2017 - By Hal Levy - read

Even the luckiest among us will have to rush to a hospital at some point. Hospitals are required to treat you in an emergency, regardless of your insurer – and even if you’re not insured at all. Once you’re on the mend, your next step will be to negotiate medical bills.

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When a medical emergency strikes, what matters is getting care as soon as possible. However, that doesn’t mean your care will be free.

Fortunately, there are some go-to tips that will give you the best possible chance to lower your healthcare costs. Getting a fair shake on your medical bills takes the same basic advice, no matter the circumstances of your bill.

To guide you in making it easier prepping your negotiation, we break down the necessary steps you should take during and after receiving medical treatment below.

As You’re Receiving Treatment:

1. Focus on Medically Necessary Services  

Think about ways to minimize your bill before your care is over.

Understandably, medical debt is a big concern. That being said, it’s hard to avoid costs, so you shouldn’t over-obsess about cutting back. Manage costs to the best of your ability and prioritize on getting the immediate care you need. Focus on your medical care first and work out payment once you’re in a healthier state (you can’t save money by making your health issue worse).

2. Write Down Everything That Happens

Set the record straight by writing down basic information about the care you receive and the doctors that you see. Taking notes makes it easier to remember at a later date what kinds of treatment you received; more importantly, keeping this record makes it easier to negotiate medical bills later.

You can take notes during your hospital stay or doctor’s appointment. If you’re in a hospital for a long period of time, you can ask for a pen and paper. If you’re discharged after a short time, you can write down what happened after you leave. You could even use your phone.

Create a Timeline of Actions & Names: If you have a timeline of actions and names, you’ll be able to explain your bill to others instead of having costs explained to you. This allows you to direct the discussion, giving you a significant advantage when contesting your medical costs.

After Getting Care:

1. Don’t Pay Right Away; Analyze Your Bill for Errors

If costs matter to you, you’ll need to closely examine your bill. This can’t really be done at the moment you’re being discharged from the doctor’s office or hospital.

Request an Itemized Copy of Your Hospital Bill: Once you’re discharged, you should request an itemized copy of your bill, along with any other financial info your doctors can provide. You don’t have to pay right away, but you will need to take action.

Compare Your Bill with Your Policy’s Explanation of Benefits: If you’re insured, you can compare this bill against the statement your insurance provider will mail to you (also called an explanation of benefits).

There are a number of coding errors made in the heat of the moment that typically go unchallenged by hospitals and insurance companies. Maybe you’re paying separately for a service that should be part of a less expensive package. Maybe the bill you received is simply incorrect. You won’t know until you see the document.

2. Keep All Your Documents

You’ll never know where the fine print will lead, when it will contradict your bill, or who will offer to help pay. Having information handy will keep you grounded and get any of your advocates (including friends, family, or outside support) up to speed.

Even if your hospital wants to help, it’s not easy to request information from multiple doctors and departments. Keeping your own records will keep you and the hospital on the same page. In the end, you’ll need to rely on your own documentation.

Make Sure You Leave a Paper Trail: If you’re verbally given a payment offer or other important information, make sure to get it in writing (if it’s not in writing, it doesn’t exist). You can email summaries of conversations back and forth to create a paper trail.

Take Note of Your Bill & Debt Collectors: When you’re contesting your medical costs, it helps to take notes about your bill, and to note the people you’ve spoken with about what you owe. Debt collectors can be penalized for using unfair tactics if you catch them making threats or calling at odd hours.

3. When Negotiating Medical Bills, Stay Calm and Polite

You may have great reason to be upset at the cost of your care. Health professionals can be flexible with costs and payment arrangements, but they will react defensively if you are angry.

Leave a Good Impression: People will be more willing to help if you’re respectful. Medical offices are very communicative places, and word about your demeanor will get around. Even if you’ve just talked to someone who was rude and unhelpful, you don’t want to make a poor impression on someone else.

Return Documents on Time: Return any documents promptly, so that you can be seen as a reliable person to discuss medical costs with.

4. Carefully Consider Your Responses

You don’t have to exhaustively explain your situation to every person at the hospital you contact. Although it’s important to discuss why you need financial assistance and why your care warrants it, some people will be ready to speak to you without you doing so.

Don’t Get Political: You’ll generally want to avoid distracting people from your billing needs by associating those needs with political issues of importance to you – like the high cost of care nationwide. While bills may be an emotional issue for you, your charges aren’t unusual to someone working in the billing department.

5. Ask Questions

You’ll probably need some health and insurance issues explained to you, particularly if you want to make a case for lowering the cost of your care.

If you’re maintaining a good relationship with the hospital, it will be easy for them to answer your questions. You don’t have to accept an answer that you don’t like. (You can also ask us any health insurance-related questions you may have).

Look for Help Elsewhere:

1. Ask a Patient Advocate or Someone You Trust

It’s valuable to have someone else visit the doctor with you, especially if you’re in the hospital. They can help get you something to eat when you’re immobile, or remind you of the things that you need to ask when you’re distracted.

Once you leave, it’s also much easier for someone else to check your mistakes. The sooner you have an ally, the fewer problems you’ll have.

Trust a friend or family member to watch for hospital mistakes while you’re distracted, to help you put things into perspective, and to show the hospital that you’re taking your bills seriously.

2. Believe in a Higher Power – Your State or Hospital Ombudsman

Many hospitals and medical groups will have a semi-independent position known as an ombudsman. Their job is to review the quality and necessity of your care.

They may be listed on your bill, and may be able to influence your bill. Your state department of health may also have specific resources for challenging exaggerated costs of care, and the institutional knowledge of who to contact at your specific hospital.

If your income prevents you from getting charity care, an ombudsman could be a good option. They may just help you find a sympathetic ear.

Taking the Next Steps

Medical debt is a leading cause of bankruptcy filings in the United States. Before seeking care for a medical condition, look at all the options available to you and make sure you’re following the least-costing path.

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