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7 Tips for Negotiating Medical Bills

It’s estimated that almost one in 10 Americans owes a medical debt of at least $250. Even more startling is the fact that 3 million Americans have medical debt amounting to more than $10,000.

If you’re among those statistics, we have good news. You may be able to negotiate your medical bill to make it more affordable. Learn more about negotiation statistics and the best medical bill negotiation techniques below.

What Are My Chances of Successfully Negotiating a Medical Bill?

In one study that looked at U.S. adults with medical debt, 92% were at least partially successful in negotiating their medical debts. This means you have a pretty good chance of at least knocking some dollars off your bill.

Just how much you can negotiate depends on several factors. Some experts say you may be able to get 30% to 50% off your bill, but your situation might vary. We know one thing for sure: You cannot get a discount on your bill if you do not ask.

Best Tips for Successfully Negotiating Your Medical Bills

You have the power to significantly reduce your medical costs through negotiation. Use these tips to get medical providers to lower your bill.

1. Ask for an Itemized Bill

Request a detailed, line-by-line breakdown of your charges. This itemized bill is your weapon against hidden fees and inflated costs, as hospitals are known to overcharge for their services.

The Hospital Price Transparency rule is meant to prevent this. It went into effect in 2021 and requires all hospitals to provide you with a clear and accurate cost of services before you receive them. And thanks to the No Surprises Act, you can dispute charges that are at least $400 higher than your initial estimate.

Sometimes, even just asking for an itemized bill can cause the hospital to realize they miscalculated the total amount. You may find your bill shrinks when it’s not tabulated as a lump sum.

2. Look for Errors or Overcharges

Look for duplicate billing, incorrect codes, or procedures you never received. Research shows that up to 80% of medical bills contain errors. Even if this is a small error, such as the wrong billing code being one number off, it could cost you hundreds of dollars in extra fees.

Many medical bills use Current Procedural Terminology (CPT) codes. You can look up your CPT code to make sure it reflects the procedure you had done. If you have questions about whether or not your CPT code is correct, contact your doctor’s office to verify what service you received and how it should be coded.

3. Research Average Costs

Hospitals do not have to follow guidelines for what they charge. This means that they can charge wildly varying amounts for the same procedure. One study found that the same procedure across different hospitals could be as much as 8 times more expensive.

Research average costs for similar procedures in your area to identify potential overcharges. There’s no guarantee your medical provider cares they’re charging you more, but it certainly strengthens your case.

4. Ask for an Upfront Payment Discount

Offer to pay with cash or check for a further discount. In many cases, providers offer a discount if you can pay for an entire procedure upfront. At the end of the day, getting paid is a primary motivation for medical providers. If they know you cannot pay a bill as is, they may be willing to accept a reduction to get a quick return for their services.

5. See if You Can Get a Payment Plan

If the provider understands you do not have the resources to pay the entire bill at once, they may agree to a payment plan. A payment plan can be a good solution for both parties. The provider gets paid, and you can chip away at your debt with a manageable monthly payment.

Approach the billing department with respect and professionalism. Explain your financial hardship and willingness to pay a reasonable amount. If you can provide proof of your hardship, they may knock your bill down further.

6. Leverage Resources and Advocacy

The Affordable Care Act requires nonprofit hospitals to offer some form of financial assistance to patients who cannot afford care. Requirements vary at the state level, so you should contact your hospital’s financial assistance department to see if you’re eligible.

Outside of hospital financial assistance, you can seek guidance from patient advocacy groups or nonprofit organizations. You might also consider using a medical bill negotiation service for assistance.

7. Do Not Be Afraid to Appeal

If you do not agree with what your health insurance company has decided regarding a bill, you can submit an internal appeal and an external review. You have 180 days to submit the internal appeal to your insurance company. You may have to fill out forms or submit documentation from your doctor. If necessary, you can ask your state’s consumer assistance program to help you.

If the internal appeal fails, you can file an external review. You must do this within four months of receiving your insurance company’s final decision. When you do so, a third party will take an unbiased look at your case to decide whether your treatment should be covered.

Negotiating Your Medical Bills Can Save You Big

Negotiating medical bills takes some tact. You may have to channel your persuasive powers to get providers, hospitals, and insurance companies to bargain with you. But the process should be a lot easier if you follow the above tips. Do not be discouraged if your first attempt is unsuccessful. Keep trying, gather information, and seek help when needed. You have the power to conquer your medical bills.

You’re just a few steps away from a personalized health insurance quote.

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You’re just a few steps away from a personalized health insurance quote.

Learn More