Three Rules to Negotiating Your Medical Bills

How can I negotiate a medical bill with a hospital?

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Bill's Answer: Bills.com Resident Expert

Less than 15% of consumers have asked their physician to negotiate their medical bill. Approximately 40% of people who ask for a discount receive one. Many medical providers and facilities, such as hospitals, have a system in place where patients who can prove that they are financially unable to pay, will be offered discounts. The medical provider will either deny the discount, or grant a significant discount or complete balance write off. Discounts for cash pay patients without health insurance often range between 20 and 50% off of the normal charge. For those people with additional financial resources and who would not qualify for assistance, could still be offered smaller discounts and a payment plan to pay off the doctor’s bill over a specified period of time.

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

  1. Be Tactful and Courteous
    If you are negotiating with a medical provider who you see frequently, you do not want to negatively impact your relationship with this physician. If requests to the billing office do not give you your intended result, tactfully ask your physician directly. This may be more effective.
  2. Remember: Cash-Flow is King
    Medical providers care about their cash flow and would like to receive their payment quickly. You can negotiate with your medical provider by stating that you would pay immediately if you are offered a certain percentage discount now. This is usually effective. Medical providers know that there is risk in receiving full payment on a patient balance because many people take too long to pay or do not pay at all. They want to work with people who are willing to pay something.
  3. Do Your Research
    Sometimes the most effective method of receiving a discount off of 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.

If you are unable to negotiate the medical bill by yourself, there are other options available to assist consumers struggling with unsecured debts such as medical bills. The most common are debt consolidation, consumer credit counseling, and debt settlement. Bills.com offers a wealth of information about various debt relief options.

Consider a debt settlement program. Rather than making monthly payments to your creditors, these programs negotiate lump sum settlements with your creditors, frequently reducing your debts by 50% to 60% of your principal balances. These programs usually take only 2-3 years to complete, so this is a good option for many people to rid themselves of debt in a relatively speedy manner. In many cases they can also reduce your monthly payment toward your debt. There is one major drawback to debt settlement programs, though — they will significantly damage your credit while in the program and for at least a year or two afterward. However, if you are currently unable to afford to pay your creditors, the hit to your credit may be worth the benefit of ridding yourself of credit card debt. If you enter your contact information in this form, a pre-screened debt settlement firm will contact you to discuss your debt relief options.

I wish you the best of luck in resolving your medical bills, and hope that the information I have provided helps you Find. Learn. Save.

Best,

Bill

Bills.com

Comments (32)


Bill S.
Suttons Bay, MI  |  March 24, 2012
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.
Bills.com
March 26, 2012
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.
DeLonda C.
Cleveland, TN  |  January 26, 2012
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
Bills.com
January 26, 2012
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.
Polly W.
Ely, NV  |  January 19, 2012
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?
Bills.com
January 21, 2012
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.
Steven G.
Eureka, MO  |  December 14, 2011
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?
Bills.com
December 15, 2011
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.
Amy M.
San Mateo, CA  |  November 07, 2011
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?
Bills.com
November 07, 2011
See the Bills.com resource Collection Laws & Exemptions and Statute of Limitations on Debt to learn which rules may apply to you in your state.

You indicated you reside in California. See the Bills.com resource California Medical Bills and Statute of Limitations for a discussion of California's rules.
Virginia I.
Ventura, CA  |  November 06, 2011
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.
Bills.com
November 07, 2011
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.
Sam S.
Brandon, MS  |  October 12, 2011
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.
Bills.com
October 12, 2011
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.
Dennis V.
June 24, 2011
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??
Bob .
June 18, 2010
I have twenty years experience negotiating any medical related bill as well as formal training and experience auditing bills for errors.
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Casey W.
Santee, CA  |  May 18, 2011
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?
Bills.com
May 18, 2011
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.
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Dennis V.
June 20, 2011
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?
Bills.com
June 21, 2011
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.
Bob L.
June 18, 2010
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.
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