This blog entry is the first in a series of posts that will detail strategies you can use to deal with unfair or unaffordable medical bills.  These posts will follow a question/answer format.  This first post presents some misconceptions that people have about medical providers and hospital bills, and gives advice about what you can do to deal with them.

What are some misconceptions about medical institutions and hospital bills?

1) You can ignore medical bills because they are a low priority.

No!  The longer you wait to deal with them, the more difficult they will be to clear up.  Ask for a discount on your bill, and get on an affordable payment plan right away.  In most cases, medical bills should be paid before non-essentials but after essentials like food, utilities, house, and car payments, especially if these assets could be repossessed due to non-payment.

2) Medical bills are non-negotiable.

No, they ARE negotiable!  There’s an old saying that “everything in life is negotiable.”  This is certainly true of medical bills.  The fact is that different people who receive the exact same medical services are expected to pay different prices depending on whether or not they have insurance, or which insurance company or public program they have.  Because of the free-market principles behind America’s private health insurance system, every insurance company negotiates “discounts” at the hospitals where their subscribers are authorized to receive medical care (“in-network” providers).  The same insurance company will pay a lower percentage of the patient’s cost for the same care received at “out-of-network” providers.  Other insurance companies negotiate a flat discount no matter where you go for care.  Even with steep “discounts,” medical providers almost always make a good profit on the payments they receive.

Uninsured people don’t have an insurance company negotiating on their behalf, so they’re expected to pay much higher rates (sometimes called the “sticker price”) for the same care that insurance companies get at “discounted” prices.  Uninsured people are usually those who can least afford healthcare, yet they face the highest prices.  One consequence of this twisted system is that there’s almost always room to negotiate medical bills.

3) You have to accept what the billing officers say if they tell you they can’t offer a discount or a more affordable payment plan.

No!  The front-line staff in medical billing offices may not know about the full extent of their hospital’s charity care programs, financial assistance policies, and financial counseling services.  Sometimes they are only authorized to discount prices to a certain level or to offer particular payment plans under limited time frames.  Billing managers, on the other hand, may have more leeway to help you negotiate an affordable price and payment arrangement.  Don’t be afraid to speak with supervisors and other higher-ups about these issues.  Calling on the telephone and requesting to speak with a supervisor or “manager of patient accounts,” can be an effective way to find someone who can help you.  Otherwise, you can arrange face-to-face meetings with the Manager of Credit and Collections, the Manager of Patient Accounts, or even the Chief Financial Officer, if necessary.

4) Hospital billing offices always follow the written policies of their institutions.

Absolutely not!  I know of many cases where billing and collections staff were unaware of policies that their institutions had adopted.  In other words, medical providers may have “paper policies,” written rules and procedures, that aren’t being implemented by the people who work directly with patients.  When you speak with a manager of patient accounts, ask him or her for written copies of the financial assistance and charity care policies.

5) You are not important enough to speak with a powerful hospital administrator.

No!  You have the right to ask for more information and negotiate your medical bills.  The hospital billing clerks should work with patients to find affordable payment options.  They should also inform people about charity care and other financial assistance options.  If they are not following the proper procedures, the higher-up administrators need to know about it.  Informing the Manager of Patient Accounts or Chief Financial Officer about a faulty customer service system is one way to promote meaningful change so that “paper policies” begin to help people in practice.

Have you attempted to negotiate medical bills?  What was your experience in doing so?  Please share your stories!

My next entry will help you figure out if your bill contains any errors and provide advice about what to do if you find something on your bill that doesn’t seem right.