Rules For Negotiating Your Medical Bills

Bills.com Team
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Highlights


  • Remember that cash-flow is king for medical offices.
  • Be tactful and polite in your negotiations.
  • Research will help you achieve a successful result
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How to Negotiate Medical Debt

Less than 15% of consumers have asked their physician to negotiate their medical bills. Approximately 40% of people who ask for a discount get one. Many medical providers and hospitals offer programs where patients who can prove they have a financial hardship are offered discounts, some of which are significant. The medical provider will either deny the discount, grant a steep discount, or write-off the balance completely. For wealthier cash-paying customers who can pay immediately, discounts range from 20% and 50% off of the normal charge. Discounts may still apply for people who pay off their medical bills over a short period of time.

Here are three helpful rules to keep in mind when negotiating medical debt:

1) Cash-Flow is King

Medical providers care about their cash flow and want to receive payments quickly. You can negotiate with your medical provider by stating you will pay immediately if you are offered a discount now. This is usually effective. Medical providers know there is risk in receiving full payment on a patient balance because many people and insurance companies take too long to pay or do not pay at all. They will work with people who are willing to pay something.

2) Negotiate Carefully

You probably do not want to negatively impact your relationship with a provider you see frequently. If requests to the billing office do not give you your intended result, tactfully ask your physician directly. This may be more effective. But weigh the cost of losing the relationship if you insist on a discount. See Six Steps To Successful Negotiation below to learn how to negotiate tactfully.

3) Do Your Research

Sometimes the most effective method of receiving a discount from your medical bill is to do a little bit of research. If you can prove that your physician bills higher than other similar providers in the area or that you are being asked to pay more than what a health plan would pay for the same service, then this could help you reduce your bill. This information would be helpful in your negotiations because you would claim that you would like to pay the going rate for the medical procedure based on what other physicians bill in the area, and/or that you do not wish to pay more than what a normal health plan would pay.

These three rules apply to medical providers. You need to know the six general rules for successful negotiations that work in all situations.

Quick Tip

Consult with a Bills.com debt settlement partner to learn if debt settlement is the right strategy for you.

Six Steps To Successful Negotiation

Follow these six steps whenever you need to negotiate almost anything with anyone.

1) Be Polite

Politeness gets you further than anything else when negotiating with a creditor, or anyone else for that matter. After all, creditors are humans too. Some in the service business spend most of their time dealing with angry and difficult customers, so you may find that by being courteous the person you speak to will be more likely to give you what you want.

Want proof politeness matters? Think of the last time you gave a big tip to a rude waiter or waitress.

2) Be Specific

Let the creditor know that your goal is to resolve the bill. The medical provider is under no obligation to give you a steep discount or a payment plan. However, if you do not ask, the answer is always no.

3) Be Flexible

Let the creditor know you are willing to accept a reasonable compromise. Medical offices need to pay their bills, too. If you present a “win-win” situation, then the medial provider can feel good about the negotiation.

4) Be Realistic

Some creditors refuse to negotiate initially. Don’t take it personally and try again at a later date.

5) Be Persistent and Methodical

Negotiation takes time and effort. As with many things in life, hard work and persistence will help improve your chances of success. Record the names and phone numbers of the people you speak to. Document the date, time, and results of each phone call.

6) Get It In Writing

If the discount you negotiate is significant, get the agreement in writing before submitting your payment. This is the proof you’ll need in cases where a creditor fails to properly note the agreement in your file, and later tries to make additional claims on your account. You can ask them to send the agreement letter by mail or fax. Or, if the billing office is local, stop by and pick up the agreement in person and make an immediate payment. Make sure the offer letter is on the provider’s letterhead and is signed.

Other Options For Medical Debt

If you are unable to negotiate the medical bill by yourself, you have other options available. The most common are debt consolidation loans, consumer credit counseling, and debt settlement. The Bills.com Debt Coach offers non-nonsense information about your debt relief options, and will give you the pluses, minuses, and costs for each of your options.

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36 Comments

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  • 35x35
    Jan, 2013
    Jan
    I have surgery (shoulder replacement) scheduled in the next couple of weeks. I have insurance through the school where I am employed but I need to negotiate my portion of the expenses with the physician and the hospital. My insurance will pay 15% of both expenses but that could be extremely costly and I'm told that payment for my portion will be expected at pre-op appointments. I am a single mother, work in education and simply don't have that kind of disposable cash available. What is the best route to take in trying to negotiate reduced payments?
    0 Votes

    • 35x35
      Jan, 2013
      Bill
      I am surprised a person's health insurance will pay only 15% of the total cost of the bill. Perhaps you have a high deductible, or are electing for surgery in a facility not in your plan, or your doctor in not in your health insurance network. If you can't cut your costs by changing doctors or where the surgery is taking place, then you have two options I see:
      1. Do not have the surgery. This is likely a painful option, and I mean that literally.
      2. Talk to the doctor and the surgery center about payment plans in advance, well before the day of the surgery. Explain the insurance issue, and see what, if any, payment plans they offer.

      Readers, I welcome your constructive suggestions for Jan.

      0 Votes

  • 35x35
    Jul, 2012
    Ryan
    Thank you for the great information here. I am starting to feel a little bit better about my situation.

    Recent my wife had to visit a local ER due to severe abdominal pains which were found to be a miscarriage from a 3 month pregnancy. We then had to travel to another hospital where her ob/gyn could perform a D&C. I am a young high school teacher with very bad high deductible insurance and my wife is unemployed due to the recession. We have about $1,500 in a HSA, and a little cash in our savings, but fear our medical bills are going to be outrageous due to going to two different hospitals and with all of the tests, anesthesia, surgery, etc. We would like to negotiate a lower bill, but we are new to this. Should we wait until we get the bill after its been applied towards our deductible or be proactive and call the hospitals ASAP? Should we argue what should be or is a fair price of these procedures in other markets? Aside from always being courteous and polite, what are a few things we should really do regarding these in coming bills from the hospitals? Any and all help would be great.
    0 Votes

    • 35x35
      Jul, 2012
      Bill
      I do not see an advantage for you to call the billing departments at both hospitals before the "final" statements arrive. Who knows, a miracle may have occurred and all of the service providers at both hospitals may be in your plan. You may have liability for your deductible and nothing more.

      I love your idea of comparing the prices for services with market prices. It would be great if hospitals would publish the prices for common procedures so that people could compare. Alas, I know of no reliable source for that information.
      0 Votes

  • 35x35
    Mar, 2012
    Bill
    I had a heart attack and was hospitalized early this year in N. Michigan. My "Limited Benefit Plan" max'd-out and now I owe over $45k to the Hospital. I applied for some assistance but they told me that because I had ANY insurance (even garbage insurance), I did not qualify. After my heart attack I applied to BCBS and was accepted with a 6-month pre-exist exclusion. I told the Hospital 'BCBS would pay you 52% of the bill, why can't I set up an arrangement similar to this?' They told me 'we don't do things that way...' I want to pay my expenses but I am now buried in debt. I was healthy, so I thought and never gave a heart attack much of a thought, but it happened. The Hospital told me that the minimum they would consider is $400/month but I can't afford this level of payment. My script coverage is already max'd-out and this will cost me another $200/month on top of my new BCBS premium. I don't want to lose my house, I don't want to claim Bankruptcy and I do not know how to handle this. I have to get out from much of this and I need avenues to look into for options. If I mess this up I will kill my credit, whatever is left of it. I am just getting some work after 5-months of extremely limited income.
    0 Votes

    • 35x35
      Mar, 2012
      Bill
      Every debt resolution strategy has pros and cons. Look at all of your options, including bankruptcy objectively and unemotionally. Consider:
      • Credit counseling if you can afford to repay about 3% or more of your balance due each month. This repays the entire balance over 5 years if the credit counseling agency can convince your creditors to sign onto a debt management plan.
      • Debt settlement is an aggressive strategy that will resolve most debts in three to four years. You mentioned your credit score was harmed due to your recent setbacks, so the main disadvantage to debt settlement — a lowered credit score — is not an issue for you. Look at this option closely.
      • Bankruptcy will resolve the debt quickly if you qualify for a chapter 7 discharge. If you do not qualify for a chapter 7, chapter 13 will create a payment plan you can afford for five years.
      Look at your options objectively and follow the links I mentioned to learn more about the pluses and minuses of each. No solution is pain-free, and every person's priorities are different. Do not be stunned into inaction because you make perfect the enemy of the good.
      0 Votes

  • 35x35
    Jan, 2012
    DeLonda
    I was informed that Tennessee has a law giving self pay patients a 51% discounts on their medical bill. I've gotten them before. One place I'm dealing with is refusing to give me the discount but I know it exists. Could you tell me where to look to find this? Please answer soon. Thanks
    0 Votes

    • 35x35
      Jan, 2012
      Bill
      I could not find any information about the program you mention, when I did a online search. If any readers have information, I invite them to share it.

      Perhaps you can check with your elected state representative, to see if his or her office can guide you.
      0 Votes

  • 35x35
    Jan, 2012
    Polly
    Hello bill. I have been searching this site for some information. I recently received a bill for medical back in 2006. actually the letter stated the bill date as nov 2011. I called and asked what this was and they apologized and said the real date was jan 19 2006 just days before the statue of limitations in Nevada 6 years. i had some other bills with the company that were paid off in July of last year. I am mad that first this is the first bill i have ever seen of this and second i had them look and make sure that we had everything in July. I am planning on doing a validation letter. but i have no intention of paying what rights do I have?
    1 Votes

    • 35x35
      Jan, 2012
      Bill
      If you had the procedures and you actually do owe the debt, then the best thing you can hope for is that the debt's statute of limitations has expired or that they cannot validate the debt... or that they concede and agree to waive the bills. Make sure that you communicate with them that you know your rights and the facts of the situation, and then you may want to make a low ball offer to settle the debt for less than the full value so that you can get the debt resolved and also get it off of your credit report.
      0 Votes

  • 35x35
    Dec, 2011
    Steven
    Both my parents passed away this year. My dad in June & mom in November. There are outstanding medical bills for both of them that insurance did not cover. Is the estate obligated to pay these bills? If so, what is the best way to negotiate medical bills?
    0 Votes

    • 35x35
      Dec, 2011
      Bill
      You must probate the estate. Consult with a lawyer in your state who has probate experience. He or she will help you start the process, and answer your questions according to the estate's circumstances and state law.
      1 Votes

  • 35x35
    Nov, 2011
    Amy
    My dentist wants me to pay a bill for a service that was done back in 06-2009. Her accountant told me that she was going to adjust it but didn't offer a written receipt with the adjustment. This accountant left her job and the new one is saying no adjustment and I have to pay or the bill will go for collection. Is there a time limitation for a medical bill? Can she ask me to pay after 2 years and a half of service?
    0 Votes

  • 35x35
    Nov, 2011
    Virginia
    My older sister just died after 5 days in a medical center in the Chicago area. She was 62 years old, had chronic and acute medical conditions for which she had not sought treatment because of her distrust of the medical community. She had no health insurance. She wanted no extraordinary measures implemented, and within 48 hrs of being taken to the ER, she was put on hospice with a morphine drip, and died 4 days later. As her only surviving relative, I am going to be handling her affairs. Her hospital bill is $40,000. She was an alcoholic and had not worked in 30 years.....our father supported her all these years, and left her a sum of money when he died. It was not a huge sum, but I am certain her estate is worth more than the $40,000 bill she incurred. I do not believe she had a will.....so handling her affairs will be a mess. Will I have any room to negotiate a reduced bill? Once I determine that her estate does indeed have funds, I thought I would offer the hospital a reduced amount (I thought 50%) in cash, which I would pay from my own resources. The bill seems extraordinary to me for less than a week of hospice services.
    0 Votes

    • 35x35
      Nov, 2011
      Bill
      Consult with a probate attorney to settle her estate in accordance with state law. Before funds can be released to heirs the debts of the estate will need to be paid off. You can approach the hospital and explain to them that it will take time for the estate to go through probate and you are willing to settle for less, through a cash payment. I would speculate that if the hospital feels that there will be sufficient funds in the estate to cover their bill then they will not negotiate.

      You should also ask the hospital to send an itemized bill and discuss with the probate lawyer if the bill is reasonable, and how to go about contesting it, if not.
      0 Votes

  • 35x35
    Oct, 2011
    Sam
    Can we legally offer our patients a discount on their patient balance once the insurance has processed the medical claim? This discount would only be offered after we have attempted to collect the patient balance by statements and/or phone calls.
    0 Votes

    • 35x35
      Oct, 2011
      Bill
      There is no state or federal law I am aware of that prohibits medical service providers from negotiating an accord and satisfaction on delinquent debt with patients. However, medical service providers contract with insurance companies in which there are many terms and conditions. One of these may be to discourage or ban giving patients a discount after the insurance benefit is paid, but my statement is purely speculation.
      0 Votes

  • 35x35
    Jun, 2011
    dennis
    I was in the hospital via 911 for eplispsy. I had two doctors. Whats the purpose? I saw them both twice. 4 minutes total. What is going on in the medical world??
    0 Votes

  • 35x35
    Jun, 2010
    Bob
    I have twenty years experience negotiating any medical related bill as well as formal training and experience auditing bills for errors.
    0 Votes

    • 35x35
      May, 2011
      Casey
      I have nearly $40,000 in medical debt from a visit to the hospital from a DUI crash in 2007. I haven't received any summons or anything but am scared that it will happen. I am contemplating bankruptcy and already have the packet. I would like to settle the debt but don't think that they will be able to lower it enough that I could even wrap my head around the ammount even at 50% off there is absolutley no way that I would be able to pay it off. Any advice? Also, do you think that just paying the $350 to file my bankruptcy would be worth it at this point?
      0 Votes

    • 35x35
      May, 2011
      Bill
      The facts you shared raise a lot of questions about your exact circumstances, and whether the $40,000 debt qualifies for bankruptcy. Consult with a lawyer who has bankruptcy experience. I realize a lawyer's time is not cheap, but if you do not qualify for Chapter 7, then your spending the money to file for bankruptcy will be a complete waste of money.

      If you were injured by a drunk driver, you may have a cause of action against the driver. Again, consult with a lawyer who can advise you accordingly.
      0 Votes

    • 35x35
      Jun, 2011
      dennis
      Hello, I was resently in the hospital for the three days after a seizure the cost 35,572.00. i have had epilepsy all my life but have been free of seizures for 6 years. This hospital knew I had a history and I was not taking meds. Normally your there until your dilantin levels are stablized but they conducted tests i've never heard of and some I didn't let them preform. The average stay is 1800.00 a day posted from the epilepsy foundation. What's going on with this hospital? I want to reduce my bill. How do I start?
      0 Votes

    • 35x35
      Jun, 2011
      Bill
      Consult with a lawyer in your area who specializes in medical malpractice. If the doctors ordered unnecessary tests and procedures for the purpose of generating large fees for themselves and the hospital, then that is a terrible breach of trust, and is certainly unethical. You may have a cause of action against the doctors and hospital if either or both performed procedures you did not authorize.
      0 Votes

  • 35x35
    Jun, 2010
    Bob
    Medical bills, like other debts, can be negotiated in the majority of cases. As comments have suggested, it's very helpful, if not essential, to have the ability to understand and audit these bill. You must understand the billing methods, coding and how to abstract from the medical record. At that point, negotiating professionally and armed with knowledge of your bills, most providers would prefer to lower your balance then to see it wiped out by bankruptcy.
    0 Votes

  • 35x35
    Mar, 2010
    Bob
    This is why we need universal healthcare people! In no other modern country would this be an issue. No one in any other modern country worries about medical bills. No one goes bankrupt because they got sick.
    7 Votes

  • 35x35
    May, 2009
    William
    Linda, I have a few bills id like to care of. Ill give you a percentage of money saved.
    1 Votes

  • 35x35
    Apr, 2009
    Bill
    I am sorry but my expertise is limited only to personal finance issues. I am guessing that you could advertise for your services and charge a fee based on the percentage of reduction that you get for your clients.
    0 Votes

  • 35x35
    Apr, 2009
    Linda
    I have been neg. medical bills for family and friends for quite sometime now - I would like to know how I can turn this into a business - where I can make some money PLEASE HELP.
    0 Votes

  • 35x35
    Apr, 2009
    Stew
    Dennis--if you have not done so already, you need to first call the company making this claim and ask them to submit a claim to your late wife's insurance company and Medicare. I know that many insurance companies will not honor claims that are older than one year (some allow less time; this is usually dictated by state law), so you may be fighting an uphill battle in trying to get your wife's insurance company to pay this debt. In theory, you are responsible for making sure that all claims are submitted to your insurance company in a timely manner and are responsible for paying any claims not submitted--I know that sounds crazy, especially considering that many providers do not even tell you what they are planning to submit, but that's the way most policies are structured. If you are the "responsible party" for this medical care, you may end up being legally liable to pay it. However, if you never signed a document stating that you would be responsible for the charges, then you may not be legally liable for your wife's medical expenses. Your liability really depends on your state's laws regarding marital debts and assets. Even if you are liable, you may be able to settle the debt for much less than is being claimed; settlement may be a less expensive alternative to hiring an attorney to dispute the claim legally. I wish you the best of luck in resolving this claim.
    0 Votes

  • 35x35
    Apr, 2009
    dennis
    question is my wife was taken to hospital emergency on 02/15/07 was admitted same.died on 02/22/07.all bills paid thru med car & bcbs & copay,now over two years later,i received a bill from not the hospital, but emergency med assoc.for 1005.00,all payments made thru all was about 37,000+.have all paper work. supposed to be paid off.now on 04/08/09,this bill was summited on- theres two claims on 1 bill.first on 03/06/07&05/29/07.now i get a bill saying they denied because no policy infect.what do i do next?
    0 Votes

  • 35x35
    Mar, 2009
    Bill
    Did the insurance company tell you that a Doctor from an outside company was being called in? If you had known then maybe you could have asked for another surgeon, but in case of emergency, time is also a great factor. if your insurance company is not willing to help you, then there is little you can do. Persistence is key, so keep writing to them to see what best they can offer.
    0 Votes

  • 35x35
    Mar, 2009
    susan
    I went to the emergency room in a true emergency, my husband gave our BCBS insurance card, the hospital told us we were all covered in the BCBS network, and then we receive a HUGE bill from the Orthopaedic surgeon that the hospital had called in, as he was not in the BCBS network. We filed all our appeals to BCBS, filed with the department of insurance to no avail. We contacted the surgeon to try to negotiate the bill ($18,000) and he was nasty and beligerant to us. He is way above customary and reasonable for our geographic area. Any suggestions???
    0 Votes

  • 35x35
    Oct, 2008
    Sam
    Since I do not know what state you live in, I cannot tell you specifically what your rights are in this situation, as laws regarding insurance and billing requirements vary significantly from state to state. Depending on your state law, If you notified the hospital that you had valid insurance at the time, and the hospital failed to bill your insurance company in a timely manner, you may not be required to pay this debt. The question would probably be whether or not you notified the hospital that you had insurance that would cover the claim. Also, your insurance company may not be able to get out of paying so easily either; simply because more than a year has passed does not necessarily forgive them of their obligation to pay a valid claim. I would strongly encourage you to consult with an attorney in your area about this situation so you can discuss your state’s laws regarding medical billing and insurance payments, and what rights you have to rectify the situation.
    0 Votes

  • 35x35
    Oct, 2008
    vicki
    i have a hospital that toke 2 1/2 years to bill me and i n neerd to know what are my rights. to me this is negliance on thier part. the insurance company that would have paid was my car insurance since this was relatred to a car accident and whwn this insurance company informed them they were not paying and this account was in ligation they still NEVER billed me. what are my rights? they were negliant and that isn't my fault. if it was to be billed to sn insurance company they couldn't do it after a year.why should they make me responsilble since they didn't do thier job. had my lawyer had this information it would have been paid.
    0 Votes

    • 35x35
      Jan, 2011
      Ashley
      I know you put this on here a long time ago but I still wanted to answer. Normally they would have at least 6-7 years to bill you. In a lot of instances if you have 2 or more insurances it can take a couple of years. Or if your insurance pays but then realizes they shouldnt have paid they can take it back years later and then you would be responsible for it.
      0 Votes