Unfair Medical Bills: Unveiling the Secrets to Successful Negotiation
Medical bills can be a daunting issue for many, especially when they seem inflated and unjust. From one-dropped local anesthesia costing an exorbitant amount to emergency room charges that seem astronomical, there are numerous cases where patients face outrageous charges. In this article, we will explore the strategies and techniques that can help shrink these bills without just accepting them.
Understanding the Burden of Unfair Medical Charges
Healthcare in many countries, including Australia and the United States, has a complex system that can lead to unexpected and unreasonable charges. The experiences of patients like Sue Null, Patricia Rowan, and Jason Zanders highlight the necessity of understanding and challenging these charges. Cases like Sam Metcalf's show that it is possible to negotiate and get significant reductions, but these efforts require time, patience, and sometimes additional support.
Strategies for Negotiating Medical Bills
Challenge the Coded Items and Services
Sue Null, a professional patient advocate, advises looking for documentation and verifying the coded services on your medical bill. Misclassification can lead to higher charges, as seen in Sam Metcalf's case where he was initially coded as a level 5 visit for bronchitis. After a prompt and thorough negotiation, the charge was reduced to a more appropriate level 1.
Key Steps:1. Obtain an itemized bill.2. Check if the charges align with actual services provided.3. Use databases like Fair Health or Healthcare Bluebook to compare prices in your area.
Ask for a Prompt-Pay Discount
If the bill seems fair, prompting a prompt-pay discount is often the next step. Hospitals are usually willing to offer a discount when the patient agrees to pay in full and immediately. For instance, Patricia Rowan negotiated a discount of 20 to 40 percent across multiple bills. Persistence and timing are crucial—starting right after the billing department opens can save time on hold.
Key Steps:1. Call the billing department.2. Ask for a discount if the bill seems reasonable.3. Be persistent and ask for a supervisor if the first person isn't helpful.
Persistent Follow-Up
Negotiating medical bills often requires multiple attempts and time on the phone. As Martha Shea found out, patience and persistence can yield results, even if it means waiting six months to reduce the bill to a manageable amount. Jackson also emphasizes the importance of preparation: having all documents and records at hand and setting up a workspace dedicated to bill negotiation.
Key Steps:1. Develop a negotiation plan and persistence strategy.2. Be prepared to spend significant time on the phone.3. Record the calls and keep notes for follow-ups.
Consider Professional Help
For more complex bills, hiring a professional patient advocate or a lawyer can be beneficial. Professional patient advocates like Sue Null specialize in complex medical billing issues and can offer valuable insights and support. Melissa Jackson, who had a $12,966 bill for emergency surgery, found it necessary to call repeatedly and eventually hired a lawyer, reducing the bill to zero.
Key Steps:1. Look for employee benefits that offer patient advocacy.2. Consider hiring an advocate or a lawyer for assistance.3. Understand the process and be willing to invest time and resources.
Going Public
If all else fails, making your story public can sometimes yield better results. Media outreach and social media can draw attention to your case and pressure hospitals to negotiate. Greg Sargent, a patient advocate, found that public pressure often leads to bill reductions, as seen in cases across various states.
Key Steps:1. Share your story with local news outlets.2. Use social media to spread the word.3. Provide necessary documentation and be transparent in your interactions.
Be Prepared for Repercussions
It's important to be aware that negotiation attempts can sometimes backfire. Timothy Boudreaux's experience highlights how giving incorrect information or expecting automated processes to handle your case might not always yield the desired outcome. Always verify your information and be cautious about the steps you take.
Key Steps:1. Double-check your insurance information before any interactions.2. Understand the hospital's policies and procedures.3. Be prepared for unexpected outcomes and have a backup plan.
Conclusion
Dealing with unfair medical bills can be overwhelming, but with the right strategies and persistence, significant reductions are possible. By understanding the coding process, leveraging prompt-pay discounts, engaging in persistent follow-ups, and sometimes seeking professional help, patients can significantly reduce their medical bills. Remember, public pressure can also be a powerful tool, so don't hesitate to bring your story to light.
Resources
For more information, consider contacting a professional patient advocate firm like Systematic or looking into hospitals' patient assistance programs. For legal help, consider retaining a professional healthcare attorney.