When an unexpected medical emergency, such as a heart attack or an incident requiring an airlift, results in a bill you can’t afford, don’t worry.
There are tried and tested tactics for reducing the bill amount, as well as other ways to get help paying what you owe.
Here are rules of thumb to follow when a medical bill gives you sticker shock according to experts.
Appeal
If your insurer is unwilling to pay for the treatment you received and declined coverage for a procedure, find out why.
“It’s important to understand the reason for refusal,” Braden Pan, founder and CEO of Resolve, a company that helps patients save money on medical bills, told CBS MoneyWatch. “We see claims being rejected all the time for stupid things, like a patient’s middle initial was wrong, or their date of birth was wrong, so the insurance company denied coverage,” he said. In such cases, Resolve can always successfully resolve the claim, he added.
Other times, an insurance company will not cover the cost of a service they do not deem medically necessary. All insurers have an objection procedure. Find out what their process is and appeal to make your case.
“Very often you can appeal and get things covered, but the success rate is a little lower,” Pan said. It helps to have a doctor or medical provider support your case by documenting why you are being billed for used to be medically necessary.
“You want your doctor to weigh in on your side,” he said.
Don’t pay a sticker price
Consider the total amount of the bill as a starting point for negotiations.
“Oftentimes, medical provider prices are crazy,” Howard Dvorkin, a certified public accountant and president of Debt.com, told CBS MoneyWatch.
Dvorkin recalls receiving a bill for a medical incident that required his daughter to be airlifted for treatment. The initial total? $18,000.
He asked the practitioner what rate they would have charged his insurance company and said, “That’s the rate I’ll pay.”
He ended up paying about $5,000, he recalled. “Each provider has the flexibility to lower rates,” he said.
Ask for an itemized bill so you can see exactly what you’re being charged for. Go through it line by line to identify any errors, such as charges for services you never received.
“Make sure there’s no mistake. Mistakes are made, people bill for the wrong thing and sometimes bill the wrong patients. Don’t assume the bill is right,” Patricia Kelmar, senior director of Health Care Campaigns for US PIRG EducationFund reports this to CBS MoneyWatch.
You may also be inadvertently billed for a medical test that was requested but never received, for example. “Those are the kinds of things you could mark and delete,” Kelmar added.
It’s also worth asking the hospital if paying a lump sum, as opposed to paying a bill in small chunks over time, will get you a discount.
“Talk to the hospital and ask if they would accept a lower amount in exchange for a lump sum settlement,” said Pan of Resolve. “If you owe $5,000, say, ‘I’ll give you $2,500 now if we can consider this settled and paid in full.'”
Make consistent payments, avoid credit cards
Especially large medical providers, such as hospitals, will often take what you give them, according to Dvorkin. Pay what you can afford each month and it will be applied to your balance.
“As long as you keep paying something, they usually won’t reverse it,” he said. “If you owe $1,000 and you can only afford $25 a month, guess what, they’re going to take it.”
Don’t use a credit card to pay off medical debts unless you plan to pay the bill in full at the end of the month, because carrying a credit card balance is expensive, while unpaid medical bills are not charge interest.
“Most medical bills, even if they’re overdue, don’t charge interest. So it’s not a good idea to put medical bills on credit cards,” Dvorkin said.
Hardship programs
According to Kelmar, all nonprofit hospitals in the US should offer financial assistance programs to help patients who cannot afford their care.
Ask your provider if you qualify for a discounted health care program, Dvorkin advised.
Eligibility criteria vary and they can be difficult to identify, so it pays to do your research on your provider’s program.
They can be cumbersome to navigate and require a lot of paperwork, but they can save patients thousands of dollars.
