Negotiating Your Way to a Lower Medical Billing

Relief from pain and illness often comes at a steep price. One visit to a doctor’s office or the emergency room can produce a bill for hundreds or even thousands of dollars. The good news? That “total due” isn’t set in stone. It’s often possible to negotiate a lower balance and a manageable payment plan.

A 2014 NerdWallet study found that 63 percent of Americans have received medical bills that were higher than expected, but too few patients know they might be able to mitigate a crushing medical bill. Here’s how to make sure you have a say in the matter.

1. Check for Errors

Your first task when you receive a new medical bill is to look it over carefully for mistakes. Check for things such as incorrect dates of service, charges for things you didn’t receive or duplicate charges. Compare the bill with the explanation of benefits you receive from your insurance company to see that the numbers jibe.

 2. Do Your Homework

Health insurance can be confusing. But here’s where it’s important to understand what you’re looking at on your bill and EOB, and why you owe the balance due. Are the medical charges going toward your annual deductible? Did you see an out-of-network medical provider and receive less coverage for it?

Call your insurance company if anything is hazy. Don’t be afraid to ask questions, and when the reply is confusing, ask for it in simpler language. You pay for your benefits and have a right to understand how they’re being applied.

Also, research your charges. Claire Freeman, president of Compass Co-Pay, a patient advocacycompany, suggests using online pricing tools such as Healthcare Bluebook or OkCopay to see if the charges are reasonable for your geographic area.

Reminder: Be polite. You might be on hold for a while, and you may be greeted less than courteously by the billing office. Still, maintain your cool. Stay professional.

“It’s very easy to be swept away with the tide of emotions that comes with discussing a potential financial obligation.” says Freeman, who often makes these calls on behalf of clients. But no matter the emotions of the situation, “the person you speak to at the provider’s office needs to become your greatest ally.”

3. Call (or Visit) the Billing Office

Medical providers’ billing representatives are accustomed to helping patients and negotiating – they have similar conversations all day – so don’t be nervous that you’re asking them to step outside what’s considered normal.

Explain your situation and your willingness to ultimately pay the bill. Then, ask what can be done to lower the balance due. If you can afford to make a single lump-sum payment, the rep might be willing to cut the balance significantly. If you also need to negotiate payment arrangements, a discount on the final amount due is still a reasonable request.

Use affirmative phrases such as “I’m willing to” and “I can afford” rather than “I can’t” or “I won’t.”

Remember to keep your cool, even if the billing representative is less than cordial. If you think you’d have better success with someone else, call back later or ask for a supervisor.

Reminder: Be realistic. “It is unrealistic to expect for the whole amount to be written off, or to make payments of $1 a month,” Freeman says. “Target a realistic outcome.”

Questions such as “How can you help me?” and “Can we compromise?” can be helpful.

“Negotiating the final amount and monthly payments should be a win-win situation,” Freeman says, so set your expectations accordingly – and be firm but flexible.

4. Get Arrangements in Writing

Whatever the final outcome of your negotiations, get the terms in writing. Also, make a note of who you talk to and when the discussion happened. It’s important to have the details in hand in case the representative doesn’t fully document the conversation on his or her end.

Medical providers negotiate lower rates with insurers all the time. Whether you’re uninsured and pay cash for your medical care, or if you just have high out-of-pocket costs with your health care plan, it’s often possible to negotiate with your medical provider and come out with more manageable expenses on the other side.


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