Join Early Retirement Today
Reply
 
Thread Tools Display Modes
Any way to negotiate ER bill down?
Old 06-11-2016, 01:05 PM   #1
Thinks s/he gets paid by the post
 
Join Date: Aug 2004
Location: Houston
Posts: 1,448
Any way to negotiate ER bill down?

Went to the ER with a kidney stone - knew what it was because I'd had one before - total bill was $10k, after negotiated rate was $5k:

$100 pharmacy
$400 lab
$2,250 CT scan
$2,250 emergency services

I have 25% co-insurance so I owe $1,250. Are there any tactics (more specific than just asking for a lower bill) that might get the bill down?
soupcxan is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 06-11-2016, 01:14 PM   #2
Thinks s/he gets paid by the post
Senator's Avatar
 
Join Date: Feb 2014
Location: Williston, FL
Posts: 3,925
Let it go to collections, then negotiate a settlement.
__________________
FIRE no later than 7/5/2016 at 56 (done), securing '16 401K match (done), getting '15 401K match (done), LTI Bonus (done), Perf bonus (done), maxing out 401K (done), picking up 1,000 hours to get another year of pension (done), July 1st benefits (vacation day, healthcare) (done), July 4th holiday. 0 days left. (done) OFFICIALLY RETIRED 7/5/2016!!
Senator is offline   Reply With Quote
Old 06-11-2016, 01:40 PM   #3
Full time employment: Posting here.
mn54's Avatar
 
Join Date: Sep 2007
Location: mpls, mn
Posts: 763
if it goes to collections wouldn"t that cause your credit score to go down.
mn54 is offline   Reply With Quote
Old 06-11-2016, 01:41 PM   #4
Thinks s/he gets paid by the post
 
Join Date: Aug 2004
Location: Houston
Posts: 1,448
I'm not willing to let it go to collections for practical as well as ethical reasons. But I would negotiate it down in good faith. $2,250 for a CT scan is outrageous...that normally costs <$500 outside of the ER.
soupcxan is offline   Reply With Quote
Old 06-11-2016, 01:56 PM   #5
Moderator
rodi's Avatar
 
Join Date: Apr 2012
Location: San Diego
Posts: 14,169
I haven't figured out a way, yet. Perhaps call the billing department.

That said - your OOP ($1250) is only 12.5% of the original bill. IMO the biggest reason we have insurance is for the negotiated rates. I have a HDHP - and the final bill, like yours, is usually 50% of full charges... or less.
__________________
Retired June 2014. No longer an enginerd - now I'm just a nerd.
micro pensions 6%, rental income 20%
rodi is offline   Reply With Quote
Old 06-11-2016, 02:53 PM   #6
Thinks s/he gets paid by the post
zinger1457's Avatar
 
Join Date: Jul 2007
Posts: 3,222
Quote:
Originally Posted by soupcxan View Post
I'm not willing to let it go to collections for practical as well as ethical reasons. But I would negotiate it down in good faith. $2,250 for a CT scan is outrageous...that normally costs <$500 outside of the ER.
My local Radiology lab does CT Scans to check for the buildup of calcium in your arteries for $99.
zinger1457 is offline   Reply With Quote
Old 06-11-2016, 03:33 PM   #7
Moderator
rodi's Avatar
 
Join Date: Apr 2012
Location: San Diego
Posts: 14,169
Just a quick comment about why some imaging/testing is more expensive when done in a hospital. My husband did hospital architecture for several decades in 3 different states.

Hospitals are under different guidelines/building codes than regular commercial or residential spaces. Power has to be handled differently. Here in CA the normal "earthquake codes" are out the window in favor of much more stringent building codes.

My husband was involved in the moving of a CT scanner from one part of a basement to another at a Kaiser Permanente facility here in SoCal. It required approval and inspections from OSHPD (the California state agency that is in charge of hospitals, outpatient surgical buildings, nursings homes, etc...) It was a much bigger project than you'd ever imagine. Even moving blood analyzer equipment can require special OSHPD approval... especially if it needs to be plugged into power (which it does.)

That's not the only reason it's more expensive to get an x-ray, mri, or CT in a hospital - but it's one factor.
__________________
Retired June 2014. No longer an enginerd - now I'm just a nerd.
micro pensions 6%, rental income 20%
rodi is offline   Reply With Quote
Old 06-11-2016, 05:04 PM   #8
Thinks s/he gets paid by the post
Senator's Avatar
 
Join Date: Feb 2014
Location: Williston, FL
Posts: 3,925
Quote:
Originally Posted by soupcxan View Post
I'm not willing to let it go to collections for practical as well as ethical reasons. But I would negotiate it down in good faith. $2,250 for a CT scan is outrageous...that normally costs <$500 outside of the ER.
In order to make up for all the CT scans they have that they do not get paid for, or get paid less than they would like, they have to charge you, and others with insurance, more.

I would call the provider, but the odds of success are slim. The insurance company already shaved them down a bit. You can call the insurance company too, but that is likely a failed effort.

Have another kidney stone or two, the next one will be cheaper if you have met your max out-of-pocket cost. Sooner or later they are 'free', until next year.
__________________
FIRE no later than 7/5/2016 at 56 (done), securing '16 401K match (done), getting '15 401K match (done), LTI Bonus (done), Perf bonus (done), maxing out 401K (done), picking up 1,000 hours to get another year of pension (done), July 1st benefits (vacation day, healthcare) (done), July 4th holiday. 0 days left. (done) OFFICIALLY RETIRED 7/5/2016!!
Senator is offline   Reply With Quote
Old 06-11-2016, 07:29 PM   #9
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
pb4uski's Avatar
 
Join Date: Nov 2010
Location: Sarasota, FL & Vermont
Posts: 36,263
Many of our local hospitals will offer a discount if you pay immediately with a credit card. Some don't but those that do offer as much as 20%. Call the billing department and ask if they offer a discount for immediate payment. On our bigger hospital bills, I get 20% plus 2% from the credit card company. For a $1,250 bill I would expect 10% around here, perhaps a bit less.
__________________
If something cannot endure laughter.... it cannot endure.
Patience is the art of concealing your impatience.
Slow and steady wins the race.

Retired Jan 2012 at age 56
pb4uski is offline   Reply With Quote
Old 06-11-2016, 08:07 PM   #10
Thinks s/he gets paid by the post
 
Join Date: Dec 2015
Posts: 2,232
If you can't negotiate a lower bill, you may be able to negotiate some extended payment options. Very extended.
HadEnuff is offline   Reply With Quote
Old 06-13-2016, 08:24 AM   #11
Thinks s/he gets paid by the post
Sojourner's Avatar
 
Join Date: Jan 2012
Posts: 2,581
In my experience, hospitals and most other providers will not negotiate with you on price once the insurance company has submitted their EOB (explanation of benefits). They will say that they have a contract with the insurance company and that it forbids them from lowering the price. I've tried to negotiate on a few different occasions with various providers, and they've all said basically the same thing, i.e. "you have to pay us what your insurance says you owe."
Sojourner is offline   Reply With Quote
Old 06-13-2016, 08:58 AM   #12
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 3,054
ER bills are the first phase of a negotiation. They expect to be negotiated down.
jim584672 is offline   Reply With Quote
Old 06-13-2016, 09:22 AM   #13
Thinks s/he gets paid by the post
 
Join Date: Aug 2004
Location: Houston
Posts: 1,448
Quote:
Originally Posted by Sojourner View Post
In my experience, hospitals and most other providers will not negotiate with you on price once the insurance company has submitted their EOB (explanation of benefits). They will say that they have a contract with the insurance company and that it forbids them from lowering the price. I've tried to negotiate on a few different occasions with various providers, and they've all said basically the same thing, i.e. "you have to pay us what your insurance says you owe."
I called them today and this is exactly what they said - would not negotiate. They offered to put me on a 12-month no-interest payment plan but for only $1,200 it wasn't worth fooling with.
soupcxan is offline   Reply With Quote
Old 06-13-2016, 09:37 AM   #14
Thinks s/he gets paid by the post
 
Join Date: Jun 2014
Posts: 1,188
Quote:
Originally Posted by pb4uski View Post
Many of our local hospitals will offer a discount if you pay immediately with a credit card. Some don't but those that do offer as much as 20%. Call the billing department and ask if they offer a discount for immediate payment. On our bigger hospital bills, I get 20% plus 2% from the credit card company. For a $1,250 bill I would expect 10% around here, perhaps a bit less.
I second this, I had a similar hospital bill.. one hospital took 15% off if paid within 30 days, one hospital did nothing.

In the future, if you have united (not sure of other insurances), they have an app where you can put in your procedure (aka. kidney stone) and they will compare hospital prices for you..so you could maybe have found a cheaper hospital in your area. I know same standard bloodwork ranges from $150-$500 across 80 doctors/labs within 5 miles of my house. and it totally depends as I've seen MRIs super cheap at one facility, but their xrays were 3x what the other one was...I think they just play the system on what they use most often to game it to get the most money possible and insurances game the system the same way.. I'll pay you more for X, if you give me Y for cheap assuming less people will use X and thus overall cheaper for the insurance company.
karen1972 is offline   Reply With Quote
Old 06-13-2016, 10:15 AM   #15
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
ivinsfan's Avatar
 
Join Date: Feb 2007
Posts: 9,951
There again some of this can be income dependent. We hit our OOP when my DH had a cardiac valve repair. The OOP that year was 4000 and the hospital billed 3600 of it.

It's a large hospital with a Catholic connections. I just made one call, since they accepted CC to see if I could get a quick pay or a pay be check discount. They said no to that, but immediately asked about my family income and such. Under a certain income level they have assistance for bill reduction.
ivinsfan is offline   Reply With Quote
Old 06-13-2016, 11:51 AM   #16
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
travelover's Avatar
 
Join Date: Mar 2007
Posts: 14,328
Quote:
Originally Posted by ivinsfan View Post
.......... Under a certain income level they have assistance for bill reduction.
Under a certain income, they know they aren't going to get paid anyway.
travelover is offline   Reply With Quote
Old 06-13-2016, 12:20 PM   #17
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
ivinsfan's Avatar
 
Join Date: Feb 2007
Posts: 9,951
Yes, for a low income person and the hospital it's a win/win but those of us who pay for good insurance and have some income end up subsidizing those who don't.
ivinsfan is offline   Reply With Quote
Old 06-13-2016, 12:32 PM   #18
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
youbet's Avatar
 
Join Date: Mar 2005
Location: Chicago
Posts: 13,151
Quote:
Originally Posted by travelover View Post
Under a certain income, they know they aren't going to get paid anyway.
Yes. Your income/wealth level has a big influence on how much you'll pay and how hard you'll be chased.

A close friend in Florida has only a medium level of SS for income, owns a modest condo and has a few kilobux in an IRA. He had only Medicare Part A when he had a significant emergency surgery. I encouraged him to stay calm, not pay anything and just keep calling the providers and explaining the situation. He didn't really negotiate but rather just explained he couldn't and wouldn't be sending a penny, ever. That seemed to work.

The hospital was great and their financial office and social workers did the bulk of the work of getting him enrolled in aid programs. The state wound up picking up the portion of the bills that Part B would have covered and also put him on Part B going forward with the state paying the bill (nothing deducted from his modest SS). The hospital and docs wrote off (no longer consider him owing money) the portions that Part A and the state did not pick up. Only the private ambulance company was a pita chasing him harder for a few hundred bux than the hospital and docs did for many tens of thousands.

Now that he is on Part B, the docs he is seeing for follow-up have agreed to forgive the Part B deductible and 20% co-pay going forward.

I'm sure a person with, say, a combined pension and SS income of $50k and maybe a few hundred kilobux in savings would have been treated far differently.
__________________
"I wasn't born blue blood. I was born blue-collar." John Wort Hannam
youbet is offline   Reply With Quote
Old 06-13-2016, 12:42 PM   #19
Full time employment: Posting here.
Ronnieboy's Avatar
 
Join Date: Feb 2008
Posts: 748
Quote:
Originally Posted by Sojourner View Post
In my experience, hospitals and most other providers will not negotiate with you on price once the insurance company has submitted their EOB (explanation of benefits). They will say that they have a contract with the insurance company and that it forbids them from lowering the price. I've tried to negotiate on a few different occasions with various providers, and they've all said basically the same thing, i.e. "you have to pay us what your insurance says you owe."

This is what my PCP was just talking about at my last visit because we were complaining about 3rd party payors.

I had mentioned how we might sell 90 tabs of lisinopril for $10 cash but a patient with a $15 copay goes to Walgreens and their cash price might be $45 but through insurance they get a negotiated $35 payment ($20 from ins and $15 from pt copay) while if they come to our place, we only get the $10 (all from the patient) because we can't get more than our usual and customary price (i.e. cash price). You'd think that the insurance would say everyone just go to xxx pharmacy because they are cheaper, but no, they would rather have us raise the price 1,000x to get to a higher cash price.

My PCP said they were in a similar situation, they can only discount the office visit at the time of payment and not submit to ins, once it goes through ins they have to charge what the ins says is the patients contracted price.
__________________
I don't want to spend my entire life at work. I deserve more. - Want2retire aka W2R
Ronnieboy is offline   Reply With Quote
Old 06-13-2016, 12:57 PM   #20
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
pb4uski's Avatar
 
Join Date: Nov 2010
Location: Sarasota, FL & Vermont
Posts: 36,263
Not applicable to the OP's situation, but an interesting recent article nonetheless. Times are a changing.

How to Cut Your Health-Care Bill: Pay Cash - WSJ
__________________
If something cannot endure laughter.... it cannot endure.
Patience is the art of concealing your impatience.
Slow and steady wins the race.

Retired Jan 2012 at age 56
pb4uski is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
ACA premium changes for 2015 (some way up, others way down) FUEGO Health and Early Retirement 14 11-18-2014 11:43 AM
Can you negotiate a hospital bill? David1961 Health and Early Retirement 21 03-01-2014 03:12 PM
How to Negotiate? imoldernu Other topics 20 11-03-2013 07:36 AM
Possible for good payer to negotiate a low early morgage payoff? thefed FIRE and Money 14 10-29-2009 11:59 AM
In Atlanta: How to negotiate to... Tommy_Dolitte Young Dreamers 4 04-03-2007 07:52 AM

» Quick Links

 
All times are GMT -6. The time now is 05:02 AM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2024, vBulletin Solutions, Inc.