How to Negotiate Medical or Hospital Bills and Win

As if the stress of a medical procedure or a visit to ER wasn’t bad enough, you then get a sucker punch—a whopping great medical bill. Looking at the amount to pay, you know you’ve not got the funds to cover that. I mean, where did all those numbers come from? Your heart starts racing, you break out in a cold sweat, and the last thing you need is another visit to the hospital. But don’t panic. You can negotiate medical bills just the same way as you negotiate any other kind of bill. Negotiating hospital and medical bills can bring the cost down to a reasonable level you can manage. 

So, where do you start? You know that picking up the phone to rant at a customer service representative isn’t going to help—certainly not your blood pressure anyway. In this article, you will learn how to negotiate down medical bills and knock money off the amount. 

Spiraling Costs of Healthcare

Let’s face it; healthcare is expensive. Even if you have insurance, paying deductibles, billing errors, or getting bills for procedures you thought were covered, can send medical bills skyrocketing. 

Hospital bills are even more eye watering if you don’t have enough or any insurance. If you’re struggling to make ends meet, getting a medical bill for thousands of dollars risks sinking you deeper financially.

Data provided by the U.S. government shows that many low-income families can’t get the medical care they need due to deductibles and copayments. Figures released show that yearly, Americans pay a whopping $365 billion on out-of-pocket costs for healthcare. 

It is also shocking to find out that hospitals list prices for up to 3 times the actual cost of providing care. In many cases, they do this to give them room to negotiate with insurers. So, if insurers can negotiate lower prices (and hospitals are willing to back down), why can’t you negotiate, too? The good news is, you can negotiate medical bills. If you are on low-income, you should see if you qualify for Medicaid

How to Negotiate Medical or Hospital Bills

What can you do to negotiate hospital bills and pay less for medical treatments and procedures?

1. Get an itemized medical bill to check for billing mistakes

The first step to negotiate your medical bills is this: ask for an itemized hospital bill. Did you know that the outrageous balance on your medical bill could be due to errors? 

You see, hospital bills contain a couple of general categories. But the Kaiser Health News reports that up to 80% of medical bills contain errors. The only way to find expansive blunders on your bill is to get an itemized bill. So, first step? Find out every item that makes up that enormous balance on your medical bill. After all, you would never accept paying for your groceries if they were all grouped together in a couple of categories—so, why should you pay for your medical treatment that way? 

What are some of the most common medical billing errors? Sometimes, procedures are listed that were never performed. You could be charged inflated prices for simple medication. Or, there could be a typo that put a decimal point in the wrong place or added an extra zero. The possible list of errors on a medical bill goes on and on. 

Another billing trick is to overcharge you for a simple procedure. If you think the hospital billed you for an excessive amount, you can visit fairhealthconsumer.org. This website lists the average costs of medical procedures in your area. This information can give you leverage to negotiate a bill.

You should make sure that every item on your itemized bill lines up with the treatment you received. Even if it means learning medical mumbo jumbo or treatment codes, it is worth doing so to save some money.

What if you get slapped with a huge hospital bill, and there are no mistakes? You should still negotiate anyway if you are strapped for cash. Consumer Reports say that 57 percent of people were successful in lowering their medical bills when they told the hospital that they would struggle to pay.

2. Negotiate a better rate

As long as you are not getting rushed to the ER, you should always ask upfront about the costs involved. Did you know that hospitals have a dozen rates for the same procedure? You should never be shy about negotiating with a medical practitioner for a discount. 

When discussing rates with doctors, remember to include all the fees associated with medical treatment. For example, surgery involves several medical professionals as well as lab tests and other procedures. 

Always double-check that you see medical personnel who are in-network and accept your insurance. It is not uncommon to get referred to out-network specialists. This may lead to a shocking medical bill when you’re charged top dollar for fees that your insurance doesn’t cover. 

Ask for generic drugs rather than the brand-name medication. Remember that hospitals usually quote their top rates to give them room to negotiate. So, always ask for a better price. What’s the worst that can happen? They can say no. If you’re unhappy with the cost, it can be worthwhile shopping around in your area.

3. Make sure your health plan pays up

Another reason to thoroughly check your hospital bill is to make sure your health plan paid what it should. Once again, it can be confusing getting your head around medical jargon. Each insurance company must provide an “Explanation of Benefits” (EOB). Check that you’re not getting stuck with a bill for treatment that is supposed to be covered in your plan. If you find errors, then dispute the claim and appeal the decision if necessary. 

4. Ask for prompt-pay discount to lower medical bills

If everything looks legit on your medical bill, then you can try to negotiate a lower payment if you can settle your bill immediately. 

Sometimes, you may need to be persistent in asking for discounts to bring the price down. But from the hospital’s point of view, getting a smaller payment is easier than chasing down a bill that may never get paid.

If you can’t afford to pay the full amount, negotiate a payment plan with the hospital to get a discount. This can allow you time to pay a reduced medical bill and not take a hit on your credit report for an unpaid debt. 

A word of warning: avoid putting the medical debt on a credit card. This will leave you paying high-interest rates, and your debt may end up spiraling out of control. Also, don’t let the debt go to a collection agency as it will be almost impossible to negotiate. 

5. Find a patient advocate

What if negotiating a hospital bill down doesn’t work? Who can you turn to? Many medical billing advocates are available and ready and willing to help. These professionals know the ins and outs of the medical industry. They also know the law and how insurance plans work

Some healthcare advocates charge a fee per hour, some work on a “no-win-no-fee” basis, and others provide services free of charge. These advocates can help you find benefits you’re entitled to and negotiate down healthcare bills. 

Negotiating Medical Bills and Winning: A Takeaway

The last thing you need is the stress of trying to pay an extortionate medical bill that you can’t afford. But don’t panic. Check your bills for errors, always negotiate down medical bills—even if you can afford them, and plan your costs as much as possible in advance.