A Guide to Reach the Goal of Negotiating Medical Bills
There may be no more difficult field to navigate as a consumer than in the health insurance industry. Dealing with medical bills can be particularly stressful. You may already feel vulnerable after surrendering your health and safety to your doctor.
Trying to resolve medical bills that appear to be written in a foreign language only exacerbates the situation. Negotiating medical bills is not for the faint of heart. It can be frustrating, stressful, and cause anxiety, but if you know how to approach it, then you will make your load lighter.
National Representation
In a national representation, a reputable research center surveyed 2,537 US adults, 83% of them were respondents. For them, high treatment costs that made high-quality health care unaffordable were "a big problem." This can delay seeking treatment because you fear the financial repercussions. However, sometimes you need to be in an emergency situation and unable to pay the insurmountable medical bills. This can lead to frustration.
Expert Advice
Before looking at expert advice on navigating large medical bills, it's important to recognize that even doing so is a privilege. This usually takes a lot of time and energy (often during normal business hours) and is generally easier if you have health insurance. If you are a woman, a person of color, a disability, or some other (or many) fringe groups, it can be even more difficult to get people to listen to you. While many of the tips here are comprehensive, some of them specifically address these concerns. In this regard, check out the recommendations on how to steer clear of incorrect medical bills or, those that are too large and unaffordable. There are ways that you can commit to them later.
Research the Cost
First, you should inquire from the health provider, whether a family doctor or hospital are part of your network of doctors. Find out if they will accept your particular insurance, which means that you would have a lower medical bill if that is the case. Call your insurance company to inquire if they have all your information on file including the medical providers that will be able to provide you with the health care you need.
At times, you may need a specific referral from a surgeon, OB/GYN, ophthalmologist, etc. Therefore, you should be aware of which one will accept your referral in the network and the cost for the procedure. Every insurance company has different policies and the way they handle the process. So, it is best to know in advance. You would then contact the doctor or hospital in your network, find out the cost of the procedure, how much you have to pay, and how much the insurance will pay. You can also negotiate costs with your doctor or hospital.
Having Health Insurance
If you don’t have health insurance, it is best to find out how you can get one. This means you would be prepared beforehand to go through with the procedure and not have to worry about the cost that most uninsured have to pay. If you can't afford insurance, find out if you qualify for Medicaid which insures many low-income individuals and families. You could be eligible and not even know you are
The rating is based on your income and the size of your family. Then you will see if you are eligible. If you do qualify, it would help you to reduce the cost of your procedure. If you are not eligible to receive Medicaid and you are going through a situation such as giving birth to a child, getting a divorce, getting married or losing a job, you could try contacting your state health insurance to register. Typically, you can only sign up for the healthcare marketplace during open enrollment period (usually in November and December, although it takes longer depending on the state you live in), but these situations will give you an exception. If this is not possible, there are no options available. You can contact a free or low-cost health center to get the care you need. Federal health centers serve underserved populations, often on a sliding scale.
Call the Insurer
If you are still enrolled in a plan, health insurance companies will send you a Statement of Performance (EOB or Explanation of Benefits) after visiting a doctor or hospital. This shows the types of services that will be covered by your insurance.
Going through your bill and your EOB can be quite consuming. Get help with figuring out your bill. This will ensure that everything that you need to do is covered and that the bill for the service provided was accurate. If you are on Medicaid, you must be protected from the impact of the stickers by the federal safeguards. So if all the costs seem exorbitant, contact your Medicaid office to see if your bill is correct.
Ask for a Discount
If a medical bill seems correct but is still too expensive for you, you can ask the medical provider, whether a doctor or hospital to give you a discount on the original cost. If you pay it, this will reduce your rate if you pay the fees immediately. Not every medical provider will give you a discount, but most of them will.
If you cannot pay the full bill, then you could ask to get on their payment program for a specific amount of time. If you can only afford a small amount per month, then you should let them know. Most hospitals prefer to place you on a manageable plan instead of having you forfeit the bill and not pay. If you are placed on a payment program for a specific period, you can still ask to receive more savings through available discounts. Some hospitals will try to assist you. In fact, many of them offer charities to heavily reduce your bill or even erase it your bill when you have low income or extreme financial hardship.
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File a Complaint
If you cannot agree on a payment plan with the hospital, or still believe that your insurance should provide more coverage, you can file a complaint with your insurer. Each insurer handles complaints differently, but you often find the steps for the appeal process on the company's website. If you get a denial for the appeal, don’t give up. It is worth making other attempts at filing a new appeal.
With your decision not to give up, this is enough to make someone notice that all you are trying to do is to lower your medical bill or dispute it. Notify the hospital as soon as you have filed the appeal. In some hospitals, your bill will be placed on hold so that payment won’t be expected until there is a verdict for the appeal.
Find an Liaison
Research consumer assistance programs in your area. If you live in a state or region with limited resources, your State Insurance Department may be helpful. You can contact the hospital and your insurance company to act as your liaison.
There are also national organizations that support free attorneys on behalf of patients. They relate to the Patient Advocacy Co-pay Assistance Program and the Financial Assistance Fund that provides financial support to individuals who meet certain income and health-related criteria. Getting professional help can be the best option for people who are prone to having health issues and not being able to afford treatment. It might work out better for you to have an attorney representing your case to negotiate medical bills on your behalf.
Contact the Hospital Department or Doctor’s Office
So you've done your research, maybe you've even taken out health insurance if you haven't had it, and you keep looking at a bill that doesn't seem to be entirely correct. Receiving the bill may seem catastrophic, but experts agree that you shouldn't panic or pay right away. The biggest mistake people make is that they see the bill and pay automatically. Consumers are so tired they think they have no recourse. However, there are often solutions.
Contacting the accounting department at the hospital or doctor’s office is a good first step. Healthcare technology is known to be outdated, so it is plausible that the high number you see is a mistake. There are many places where things can go wrong. People make mistakes. Even the first wrong step can lead to problems.
In addition, nonprofit hospitals must provide financial assistance to qualified patients who demonstrate low income. You must have the proof of this, and you can get your bill canceled or costs reduced considerably. The question is looking for options to negotiate medical bills.
Your Doctor
Start by calling your doctor's main phone line and the hospital and ask to speak to the billing department. Ask the right questions to learn more about your bill:
Request a breakdown of all charges – This should include equipment, medications, tests, readings, and other services provided.
Ask what services are covered under your room and hospital facility charges.
Ask what treatments were provided – You want a detailed explanation of the purpose and need for each service.
Clarify the date and time of your entry – Be specific with dates and times to isolate billing errors based on time.
Ask questions about unclear medical terminology – This helps you avoid duplication of services or exorbitant costs for generic drugs (for example, a generic Tylenol tablet should not differ from market rates).
Make an appointment in person to discuss your bill with the billing professional or practice manager. Ask to remove items that you think are erroneous or unnecessary. You can also offer to pay a different price - an amount that you think is fair for the services received. Try to come up with a final figure that you can pay in a lump sum and avoid taking on a debt that must be paid monthly.
Conclusion
One in six Americans struggles with medical bills. Many Americans do not realize that they can negotiate medical bills. Up to 80% of medical bills contain errors, so it makes sense to examine the bills and be prepared to negotiate. If you want to know more about how to reach the goal of negotiating your medical bills, go to the Goalry platform and visit the Billry store.