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Message
re: Negotiating a medical bill
Posted on 6/9/15 at 8:06 am to Teauxler
Posted on 6/9/15 at 8:06 am to Teauxler
By mistake I failed to pay a medical bill. Hospital tuned it over to a contracted law firm/collection firm.
I get a call from them and they offer a 50% discount if I pay now. I ask if this was reported to credit bureau and was told no, it wont for another 90-120 days if not paid(checked and it wasn't). Gladly paid and now this will be my moving forward practice.
I get a call from them and they offer a 50% discount if I pay now. I ask if this was reported to credit bureau and was told no, it wont for another 90-120 days if not paid(checked and it wasn't). Gladly paid and now this will be my moving forward practice.
1
Posted on 6/9/15 at 8:19 am to cuyahoga tiger
quote:
I ask if this was reported to credit bureau and was told no, it wont for another 90-120 days if not paid(checked and it wasn't). Gladly paid and now this will be my moving forward practice.
That's unfortunate. I wish they would've hit your credit. Hopefully it shows up and they just told you that to get you to pay.
Posted on 6/9/15 at 8:36 am to LSUAfro
quote:
That's unfortunate. I wish they would've hit your credit.
Why is that, because medical billing is so straight forward.
Posted on 6/9/15 at 8:47 am to LSUAfro
quote:
That's unfortunate. I wish they would've hit your credit.
Speaks volumes about you.
Oh and negotiating what you pay before a procedure is not a shake down but i won't type anything further its pointless as is the tone of your posts.
Posted on 6/9/15 at 8:52 am to cuyahoga tiger
quote:
Why is that, because medical billing is so straight forward.
This is an honest mistake.
quote:
By mistake I failed to pay a medical bill. Hospital tuned it over to a contracted law firm/collection firm.
I get a call from them and they offer a 50% discount if I pay now.
This is my problem.
quote:
Gladly paid and now this will be my moving forward practice.
Imagine if everybody did this. You were provided a service that you now don't want to pay for.
Posted on 6/9/15 at 8:57 am to MoreOrLes
quote:
Speaks volumes about you.
Absolutely does. If I'm provided a service that I requested, I'm going to pay for it in full to the best of my ability.
quote:I agree and I said as much earlier when discussing cash payments, but that's not what has been discussed here. Many in this thread are talking about not paying after a bill it's received and service has been rendered.
Oh and negotiating what you pay before a procedure is not a shake down but i won't type anything further its pointless as is the tone of your posts.
Of course the hospital will negotiate with you if you tell them you can't afford the bill after the fact. They'd rather get 50 cents on the dollar rather than 25 cents on the dollar when they turn you over to collections.
Posted on 6/9/15 at 8:58 am to LSUAfro
Medical billing would have free reign to do whatever they please if billing was not negotiable. Insurance companies have a responsibility to cover your costs according to the terms of your coverage. Medical billing knows this and would charge whatever they wanted, because they know insurance has to cover it. Insurance uses their leverage to negotiate costs down. It happens on nearly every bill that insurance covers. As a private payer, you are on a playing field with insurance companies. Why should you not have the ability to negotiate if you are facing the same pricing scheme as insurance. Doctors sure as hell aren't lowering prices just because you aren't utilizing insurance. You have just as much a right to negotiate as the insurance company although you won't have as much swing with them since you only represent one patient, but you have the right.
It's not like a restaurant or a dry cleaner as their pricing is dictated by supply and demand. The contractual obligation of insurance to pay no matter what (to a certain extent this is true) has allowed the medical field to price their services outside of what an average person is willing to pay. That's easy to see.
It's not like a restaurant or a dry cleaner as their pricing is dictated by supply and demand. The contractual obligation of insurance to pay no matter what (to a certain extent this is true) has allowed the medical field to price their services outside of what an average person is willing to pay. That's easy to see.
Posted on 6/9/15 at 9:01 am to LSUAfro
quote:
You were provided a service that you now don't want to pay for
That's the rub in my eyes. Who ever knows what a procedure cost is beforehand. I inquired on a "follow up blood test" that was suggested by doc. I asked if this procedure was being coded as "preventative" so i would not be charged. Was told, no it would be biiled as diagnostic. Asked what it would cost. Was told, " don't know. You will have to contact your insurance company to determine how much we are going to bill you."
However, it was honest bill pay oversight on my part and I don't care what everyone else does.
Posted on 6/9/15 at 9:04 am to Teauxler
I'm assuming you've already checked with your insurance company and they have already did their stuff with it.
Something many people don't realize is this: assuming the procedure would be covered by insurance, but you are still meeting the deductible, you are only supposed to pay what the insurance company's rate is. So let's say it's a $1,000 procedure, the insurance company's rate is $300, and you have not yet met your deductible, then you should pay $300.
Hospitals and insurance companies are tough to deal with. Back in December, my doctor suggested I have a diagnostic test done at East Jeff. It was not mandatory but would be helpful. I called the hospital and was told they needed to call BCBS to pre-authorize and to check how the insurance coverage would work. About a week later I get a call from East Jeff saying that BCBS told them the test is considered preventative and they would pay for it 100 percent. We did the test.
Last week I get a call from East Jeff demanding $213. I ask them ok, what for? They tell me for that test. I ask why they have not sent a bill. They say we sent one two days ago!! I say ok, let me get the bill and I will see what's happening. Bill arrives on Saturday. No itemization at all, just says balance due and the date of service, no description of service. I call East Jeff yesterday and tell them to please send me an itemized bill, which they say they will.
I also call BCBS yesterday and they have in their notes that the rep told East Jeff that the test was covered under insurance but subject to deductible.
Quite honestly I feel like East Jeff lied to me. The test ended up being completely useless. I'm sure I need to pay the bill, but I'm very annoyed. If they would have told me up front that the test was subject to deductible, I probably would have passed. I'm also stunned that it's taken them 6 months to bill me.
Something many people don't realize is this: assuming the procedure would be covered by insurance, but you are still meeting the deductible, you are only supposed to pay what the insurance company's rate is. So let's say it's a $1,000 procedure, the insurance company's rate is $300, and you have not yet met your deductible, then you should pay $300.
Hospitals and insurance companies are tough to deal with. Back in December, my doctor suggested I have a diagnostic test done at East Jeff. It was not mandatory but would be helpful. I called the hospital and was told they needed to call BCBS to pre-authorize and to check how the insurance coverage would work. About a week later I get a call from East Jeff saying that BCBS told them the test is considered preventative and they would pay for it 100 percent. We did the test.
Last week I get a call from East Jeff demanding $213. I ask them ok, what for? They tell me for that test. I ask why they have not sent a bill. They say we sent one two days ago!! I say ok, let me get the bill and I will see what's happening. Bill arrives on Saturday. No itemization at all, just says balance due and the date of service, no description of service. I call East Jeff yesterday and tell them to please send me an itemized bill, which they say they will.
I also call BCBS yesterday and they have in their notes that the rep told East Jeff that the test was covered under insurance but subject to deductible.
Quite honestly I feel like East Jeff lied to me. The test ended up being completely useless. I'm sure I need to pay the bill, but I'm very annoyed. If they would have told me up front that the test was subject to deductible, I probably would have passed. I'm also stunned that it's taken them 6 months to bill me.
Posted on 6/9/15 at 9:05 am to KG6
quote:
It happens on nearly every bill that insurance covers. As a private payer, you are on a playing field with insurance companies.
Maybe you know something I don't know, but when I receive a medical bill it states that my insurance covers 90% of said procedure, and I see that 90% deducted from the amount I owe. If they don't actually pay that 90%, that's news to me.
quote:You don't think the medical profession is based on supply and demand?
It's not like a restaurant or a dry cleaner as their pricing is dictated by supply and demand
I'll definitely admit I'm not privy to understanding the inside workings of insurance/medical billing, so I can't really speak to that.
Posted on 6/9/15 at 9:18 am to Teauxler
I'm self employed and my BCBS has a large deductible and limited coverage. When one of my children had outpatient surgery that wasn't covered, I asked them if they would reduce the cost to what they would have accepted from BCBS if covered. They were happy to do so and it saved me at least 2/3 of the bill.
Posted on 6/9/15 at 9:19 am to LSUAfro
quote:
Maybe you know something I don't know, but when I receive a medical bill it states that my insurance covers 90% of said procedure, and I see that 90% deducted from the amount I owe. If they don't actually pay that 90%, that's news to me.
It's a two step procedure.
Step 1: Doctor bills $2,000. Insurance company has negotiated rate of $600.
Step 2: Insurance pays 90% of $600, or %540. You pay 10% of $600, or $60.
The other $1400 is BS and just disappears
quote:.
You don't think the medical profession is based on supply and demand?
It is and it isn't. When you need medical care, you really don't have many choices. Plus, medical care, outside of the most basic shots and visits, is completely non-transparent with costs and billing.
When your car breaks down, the mechanic can give you an estimate of the cost to fix it. It's just an estimate, something could happen that is unforeseen that causes cost to increase.
Go ask your doctor for an estimate and see what happens!
Posted on 6/9/15 at 9:22 am to LSUAfro
I've been involved in a lawsuit from a car accident and saw a little more about insurance coverage than some probably know (It's a shady business when lawyers get involved I fully admit). The insurance company will work with the provider to lower the cost for the portion that they owe. That's why they have "in network" doctors and such.
And it's not the same as supply and demand. If there was a way that you had "coverage" that said as long as you pay a $20 dollar deductible, we will pay the rest of you dry cleaning, then dry cleaning could charge $500 dollars. You wouldn't care since you only pay $20. So the insurance has to step in and negotiate. In the real world, you shop for a cheaper dry cleaner. That's not the way the medical field works. And it's even more difficult since your costs are not shown up front.
And it's not the same as supply and demand. If there was a way that you had "coverage" that said as long as you pay a $20 dollar deductible, we will pay the rest of you dry cleaning, then dry cleaning could charge $500 dollars. You wouldn't care since you only pay $20. So the insurance has to step in and negotiate. In the real world, you shop for a cheaper dry cleaner. That's not the way the medical field works. And it's even more difficult since your costs are not shown up front.
Posted on 6/9/15 at 9:44 am to LSUFanHouston
quote:
It's a two step procedure.
Step 1: Doctor bills $2,000. Insurance company has negotiated rate of $600.
Step 2: Insurance pays 90% of $600, or %540. You pay 10% of $600, or $60.
The other $1400 is BS and just disappears
Got it.
I can definitely see where the uninsured have some wiggle room in there.
Maybe I'm speaking out of place due to ignorance and I obviously don't understand how revenue management factors all of these things in to their pricing models, but the thought of negotiating after you're "fixed" just seems off to me.
Posted on 6/9/15 at 10:09 am to LSUAfro
quote:
Maybe I'm speaking out of place due to ignorance and I obviously don't understand how revenue management factors all of these things in to their pricing models, but the thought of negotiating after you're "fixed" just seems off to me.
It's just not cut and dry. Really depends on the circumstances.
You have to understand that the "charge" from the doctor - the rack rate - is complete and utter BS that bears no relevance to reality. It's simply a negotiation number that is reduced down to the insurance level.
If you have insurance, and insurance correctly processes and pays, and there is a co-pay left over for you to pay, and you have the ability to pay it - I fully believe you should pay that in full and not negotiate it. Granted, many people may need a payment plan to pay it off, and I've found that docs and hospitals are generally willing to do this.
If you don't have insurance, you should absolutely negotiate it down after the fact to a level that insurance would pay.
If you don't have the money, then, you don't have the money, and you should try to pay it down to what you can.
We would be so much better off if we went back to fee for service like it was 30-40 years ago. Everyone charges a rate, the same rate to every customer they have, if you have insurance, then after a certain level insurance kicks in to assist you with the payment.
I mean, isn't this how it works with auto insurance, if the situation is your fault? Does Joe's mechanic charge $250 for a new bumper to Geico Customers, $280 to State Farm Customers, $210 to Liberty Mutual customers, and $800 to cash customers?
Posted on 6/9/15 at 10:11 am to Teauxler
quote:I agree with this.
I'm convinced 100% we as the consumer are being taken to the woodshed by these hospitals.
quote:Write them a nicely worded letter. I did and got a 25% reduction. I'll say this in a general sense - all you have to do is ask.
Would appreciate any success stories.
Posted on 6/9/15 at 10:24 am to CE Tiger
quote:
wife just had a baby and the bill was $1600. are yall saying i should negotiate this down?
When my wife has our baby in a few weeks, I will be attempting to negotiate our portion of the bill down. I feel like medical billing is a sham, and tons of people are taken advantage of all the time.
This post was edited on 6/9/15 at 10:28 am
Posted on 6/9/15 at 12:37 pm to Teauxler
I was recently asked by a patient's husband how much an epidural costs for his wife. I didn't know what to tell him because I honestly have no idea. I know that an epidural is billed as 5 "units.' Each pts insurance company has negotiated and agreed what the reimbursements to mds for what 1 "unit" will be. So that's how they pay us. However, as a provider and not knowing a patient's insurance setup (insured vs noninsured, which insurance company, copay and deductible setups, etc), I have no idea how much they will pay out of pocket for that epidural. So asking me up front what a procedure is going to cost is pretty useless.
As a provider, I think it's pretty frustrating that people think they don't have to pay their bills. I can't think of any other industry where someone can request services and then think they don't have any obligation to pay for these services after they are performed. Try calling out an attorney at 3 am for 3-4 hrs of service and see if they agree to do it for free. My group does not work for a hospital, so our bill is separate. Some people are shocked that they get a bill from us too.
ETA: Feel like I came across as an arse regarding paying one's medical bills. Diid not mean to. Unfortunately, we have overhead expenses and bills as a business that we have to pay as well, and we have invested a significant amount of time and money in our education and development of skills. I wish I didn't have to care about the business side of medicine.
As a provider, I think it's pretty frustrating that people think they don't have to pay their bills. I can't think of any other industry where someone can request services and then think they don't have any obligation to pay for these services after they are performed. Try calling out an attorney at 3 am for 3-4 hrs of service and see if they agree to do it for free. My group does not work for a hospital, so our bill is separate. Some people are shocked that they get a bill from us too.
ETA: Feel like I came across as an arse regarding paying one's medical bills. Diid not mean to. Unfortunately, we have overhead expenses and bills as a business that we have to pay as well, and we have invested a significant amount of time and money in our education and development of skills. I wish I didn't have to care about the business side of medicine.
This post was edited on 6/9/15 at 1:14 pm
Posted on 6/9/15 at 1:07 pm to LSUAfro
quote:
That's unfortunate. I wish they would've hit your credit. Hopefully it shows up and they just told you that to get you to pay.
You seem butt hurt.
Posted on 6/9/15 at 1:15 pm to BayouNation
quote:
You seem butt hurt.
Why? Because I believe in compensating professionals for their services? You seem stupid
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