I am a healthcare management consultant. Here are some tips for handling hospital medical bills. Everything is negotiable, including any balance due on a medical bill from a hospital. This holds true whether the amount due is after insurance has paid - or if you do not have insurance. The key to getting the bill DISCOUNTED is to immediately communicate w/ the patient rep/business office at the hospital - as soon as you get the final statement. Time is on your side in the sense of - "the quicker the better." The quicker you work on negotiating, the more amenable the hospitable will be. The hospital has to pay between 18-24% of the bill to a collector . . . so they want to avoid this, and will lower your bill to do it. Plus, once a bill has aged 90 days, they know the chances of collecting the full amount starts diminishing. To keep their cash flow, they often give you a quick 25% discount if you ASK FOR IT. They will be especially open to this if you tell them you can put it on your credit card. I had a $4500 bill cut by 25% even close to 90 days out. However, I had to agree to let them immediately charge my credit card for the adjusted balance. Don't assume the only way they will cut the bill is by telling them you can put it on a credit card. Just ask for the discount. Be frank - tell them you are going to have a very difficult time paying this off. Be humble - tell them you want to meet your obligations, but you are struggling and you need their help and any suggestions they have will be appreciated. But don't hesitate to ask if they can discount it. If they agree to discount it, make sure you have the date, time and person's name that you talked to. Ask them to send you an updated statement, reflecting the new balance. If you have NO INSURANCE, it is EXTREMELY IMPORTANT that you ask for the discount, as many hospitals have negotiated deals w/ the feds to adjust their rates for those w/ NO INSURANCE to reflect the same types of discounts that would be recognized if you did have insurance (contract rates). You will most likely get at least a 25% discount on the spot if you say - I have no insurance - I would appreciate your reviewing this and advising how much you can discount my final bill. JUST ASK. Do not DEMAND. If you have no insurance, and get the discount, do not let them bully you into agreeing to put the balance immediately on a credit card or set up a payment plan (unless you wish to). Tell them that once you get the new invoice showing the new balance, you will figure out if you can put it on a credit card or set up a payment plan at that time. Stall however you need to stall. Tel them you have to discuss options w/ your spouse, parents, whatever. Once you get the corrected, final bill, decide if you need to set up a payment plan. Do not agree to a payment plan unless you can truly meet the payments. Tell them you have to have different terms b/c otherwise, you are going to go into bankruptcy b/c you cannot handle the payments. Ask to speak to a supervisor. Hopefully, you can agree to a payment that you can truly make. If you cannot negotiate a payment rate that you can meet, do not agree to a payment plan. Instead, get the name of the CEO of the hospital, write him a letter briefly outlining your situation, tell him the date you called, who you spoke with, and ask if they can further discount the balance or set up a payment plan that has a lower monthly payment (or both). If you have a dire circumstance, such as a critically ill child, ask the CEO if the hospital's foundation has provisions for Charity Care. You may be surprised at the assistance that is available to you. Under no circumstances should you simply ignore the bill. Rather, negotiate for discounts, lower payment or charity care provisions. Keep good records, stay humble, and emphasize your desire to meet your obligations. Write letters as necessary. And once you have gotten help, consider writing a thank you to the person/s who assisted you. The goodwill goes a long way and you never know when you may need some goodwill again for a hospital bill.
Particularly for those without or with inadequate health insurance, it is important to recognize that hospital bills are significantly inflated. They charge what the market will bear. Do some research on the hospital and compare their costs to their billings. There are a number of sites out there that provide this data. The data is compiled by the Federal Government on a semi-annual basis. Costs are as low as 30% of what is charged and can range as high as 65-70% of what is charged. Keep in mind that Medicaid, Medicare and medical insurance companies negotiate payments based on a standard set of hospital costs plus a reasonable profit (usually 10-15%). The collected data is the starting point of the negotiations. Courts have also held that the general public is entitled to similar consideration. Ani is right. Don't ignore the bill. But just make sure that your bill is fair and reasonable in the pantheon of the marketplace.
What if you have a medical bill that has gone to collections? Do they sell the debt as a general rule or will they pull it back from collections? Or is this just something that varies from one hospital to another?
Medical collections is in its own ballpark, primarily because it gets entwined in the provisions of the HIPAA. I would think each medical biller approaches collections and HIPAA in ways that suit their own operations, so a variation would be expected. I don't think that a standard approach has evolved. As medical debt gets sold, the equation is more difficult for holder in due course to solve as the debt passes down the line.
This varies a lot It varies a lot. Also, it varies as to the size of the hospital, what their ratio of medicaid to insured patients is, what their overall financial status is . . . and who owns the hospital (county, national corporation, etc). You would think some of the hospitals w/ a religious affiliation might be less predatory, but this is not always the case!!! My advice on medical collections would be to never deal w/ a collections agency w/o first contacting the hospital. I don't think most people realize that everything that happens in a hospital is subject to review by the CEO/Administrator. That is the area I deal with - and I assure you - the CEO really does read the letters that come in from patients - and he/she truly can make debts GO AWAY, or change the terms of payment, discount the amount, get help from the hospital Foundation . . . A letter will get you further than a call. Just briefly write a letter to the CEO or hospital administrator, explain when the expenses occurred and what your situation was at the time (or currently) and say you want to work something out - but you just can't handle xx amount - is there any way someone can work with you to reduce the balance due, set up a payment program that is realistic, etc. Even if the bill is in collections. . . go ahead and write and see what happens. It is worth a try. This advice only applies, of course, if you do intend to pay!!! I have found, from personal experience over a lifetime, as well as horror stories from others - that medical collections agents can be the most hateful, relentless and sneaky of all collectors. Maybe they get a higher percentage for recovery!!!
Just FYI Too bad that most people who come to these boards are like me - seeking some guidance *after* getting into a debt situation . . . but I would just like to mention . . . that despite anyone's financial situation - please do not deny medical care to yourself or your loved ones. There are so many people who are already trying to pay off medical debt - and they then feel they cannot seek out treatment later - b/c they already owe so much money, have no insurance, are strapped financially - whatever the situation. You should know that by federal mandate, no hospital Emergency Department can turn away anyone seeking medical assistance. That is why there is such a controversy over "illegal aliens" (I prefer to say - non-citizens) receiving "free" treatment in EDs across this country. Yes, it has put a tremendous burden on the medical system, but my point is - federal law mandates that anyone who needs help will be treated in an ED, whether they have means to pay OR NOT. I hope someone will read this, and that it will make a difference to them - to know that if they need medical assistance - it is your right to receive treatment at an ED, even if you cannot pay a penny. Most people do not know they can demand this right and further, you can ask to speak w/ the hospital's medical social worker, and find out what assistance may be available (i.e., medicaid, Foundation monies, special federal, state or county funds for a particular disorder, i.e. diabetes, renal disorder, etc) If you get turned away from an ED, you have rights under the law, regardless of your ability to pay. An institution can lose their non-profit status,or have sanctions placed on them, if they are not properly dispensing "charity care." This is a huge issue right now and is currently being investigated by IRS and Congress - as I write.
