Can you negotiate a hospital bill?

[David1961]

I recently had a procedure and spent some time at the hospital. I won't go into the medical details, except to say everything went well.
I was a little surprised to get the bill from the hospital. My insurance payed most of it, but not as much as they had the last time I was hospitalized. In fact, not even close. Fortunately, I can easily afford to pay it but was wondering if it is out of line to ask if they can give a discount if I pay the entire balance. Normally, I don't like to haggle over things like this, but even a 5% discount would be a fair amount of money. Has anyone had any experiences with this? Or if anyone has worked in this field can say how common it is to give a discount for someone who pays in full. I'm not trying to nickel and dime this, but for someone who LBYM, this is a little more than nickels and dimes.

 

[MRG]

I think you can. My dentist gives a discount to full pay. Hospital's negotiate with insurance company's, why not individuals?

To that point one DR. my wife sees at a teaching hospital, says it's against their policy to do anything more than ask for payments. No collection agency bs. We've never tested that statement, as our copays are reasonable.
MRG

 

[rodi]

Doesn't hurt to try.... Worst case - you pay what they are billing you.

It might be hard since you had insurance - who in theory already negotiated down from the "book" price to the "reasonable and customary" price.

I have a friend who was uninsured and was able to negotiate down from the book price... by half.

 

[RHLnFLA]

DW recently had significant hospital procedures. Our share, after HI, was about 3K. I was willing to pay in full with discount but hospital said no can do. They do however allow low payments with 0% interest. Paying about $100/mo. I live 0% interest...except in savings and CD's

 

[Ginny]

Yes you can negotiate the bill. Prepare some song and dance (retired, fixed income...) and ask to pay 25% of the bill in full.

 

[clifp]

I can't hurt to ask. If they so no then...

I think as starting point you ask for the entire bill and start looking for discrepancies. You charged me $10 for aspirin in the AM, but I was actually in PT or talking to my family during that time. After several session like this with the accounts receivable department they may decide that giving you a discount is easier.

I'm finishing a book on failure by Megan McArdle. One the best chapter is her description of the time her mom had a ruptured appendix and she spend weeks in the hospital with her mom. She observed dozen of errors a day, not washing hands, trying to give the wrong medicine, not check charts etc. It is inconceivable to me that a similar errors aren't common in the billing.

 

[ERhoosier]

I think you can. My dentist gives a discount to full pay. Hospital's negotiate with insurance company's, why not individuals?

To that point one DR. my wife sees at a teaching hospital, says it's against their policy to do anything more than ask for payments. No collection agency bs. We've never tested that statement, as our copays are reasonable.
MRG

Agree that it can't hurt for OP to ask about discounts, or no-interest payment plan.
But IIRC CMS (and some private carriers) has reg's for providers/facilities having written policies for collection actions & when charity/hardship considerations are granted. Co-pays/deductibles are now considered an integral part of the system, and from what I gather arbitrarily or consistently ignoring patient non-payment ain't as easy as it used to be.

 

[Ally]

In the past year, we have negotiated a lower hospital bill when we paid it in full immediately. We also negotiated a much lower bill for the outpatient part of the hospital for a cardiac screening test. If we filed it on the insurance, it would have gone towards the deductible and cost $1500, but the billing clerk happened to mention that if we didn't have insurance, they charge $150. So my husband went that day and wouldn't give them his insurance info and wanted that rate. After some argument, they gave it to him. Then when I was sent to the hospital for a test, it was going to my deductible and would cost $1000. I called around and found an off site lab that would do the same xray for $100. I called my doctor and she changed the order and I paid $100. So yes, if you are trying to save, I think you can, but it's better to arrange it ahead of time than after the fact.
One more incident. My husband was sent to a cardiac doctor and he was in network. However, he sent the bloodwork to an out of network lab without mentioning it. When we went to the doctor that morning, it was our first visit, so we asked the office to make sure he was still in network and they assured us that he was. So then we received a bill for the labwork for over $3000 and none was paid, because it was out of network. We were not happy. My husband appealed it to the insurance company and also called the doctor. Soon in the mail we received the same bill with a balance of zero. It pays to argue, but we are also always respectful.

 

[franco45]

Most of the people who answer the phone are authorized to give as much as 25% off. They wont start with that but you can get there. They will require immediate payment with a credit card. If you want more, you have to get a supervisor. I have gotten 50%.

 

[Dave J]

My hospital gives 10% if paid within 30 days of first billing.
One clinic does the same and another gives no discount.

 

[pb4uski]

....Has anyone had any experiences with this? ....

I routinely call the hospital's billing office and nicely ask if they offer a discount for immediate payment. At one of our local hospitals I commonly get 20% plus I pay then and there over the phone with my credit card and get another 2%.

I have had some hospital and medical service vendors who refuse to budge though.

Nothing ventured, nothing gained.

 

[sengsational]

I think we all presume that your insurance company negotiated good rates, but you could check on health care blue book or whatever it is, to see if what the hospital got paid is in line...could help your pleading. But if the rates were negotiated well, then I'm not sure the hospital will be inclined to give you more than a small "let's get it over with" discount. What about the guy who got exactly the same services as you, but better insurance (no copay). The hospital got fully paid. So you had worse insurance, and get a discount? Just seems to me the hospital would not be inclined to reward people with insurance that probably costed less.

 

[Sue J]

I had a procedure done at a hospital and when I checked in and showed my insurance card they gave me a ballpark figure of what my final responsibility would be after the insurance coverage. Then they offered a 30% discount if I paid that day. I asked how long that was good for and they said that if I called within the first 30 days after receiving the Explanation of Benefits they could still apply the 30% discount. As soon as I saw the EOB online I called and paid the discounted rate.

 

[Pleeplus]

I have to agree with sengsational. MOST of the negotiated rates between insurance companies and providers/ hospitals are lower than what the "sticker" price would be. If you were paying directly out of pocket (e.g. no insurance) you would probably have a much better chance of getting the charges reduced. However, as others have said you may be able to get small discounts for immediate payment or some Other small discount. Worth a shot anyway.....good luck.

 

[pb4uski]

I have to agree with sengsational. MOST of the negotiated rates between insurance companies and providers/ hospitals are lower than what the "sticker" price would be. If you were paying directly out of pocket (e.g. no insurance) you would probably have a much better chance of getting the charges reduced. However, as others have said you may be able to get small discounts for immediate payment or some Other small discount. Worth a shot anyway.....good luck.

FWIW the 20% I mentioned getting regularly from our local hospital is 20% off the insurance company negotiated rate, not the rack rate.

 

[Pleeplus]

FWIW the 20% I mentioned getting regularly from our local hospital is 20% off the insurance company negotiated rate, not the rack rate.

Interesting... I have worked for a large BCBS for the last 14 years and have never heard anyone getting discounts of negotiated rates. Good for you. All I ever hear is how the hospitals believe that they can't survive on the negotiated rates. But I think that is a different discussion.

 

[Moemg]

My last job was at an Outpatient Surgery Center and they did negotiate .

 

[Dave J]

My discount was on my co-pay or deductible.

 

[pb4uski]

My discount was on my co-pay or deductible.

Good point - in case I wasn't clear before, since I have a high deductible policy in my case the negotiated rate and what I owe are the same since I never get close to my deductible.

 

[travelover]

Great thread. Reading these anecdotes just makes me shake my head.

 

[pb4uski]

FWIW the 20% I mentioned getting regularly from our local hospital is 20% off the insurance company negotiated rate, not the rack rate.

We had a small bill come in while we were away on vacation. The hospital's rack rate for the test was $216 and negotiated discount was $49 so the bill the hospital sent was for $167. A $17 discount for a 2 minute call - sweet! I called the hospital billing office and asked if they still offered an additional discount for immediate payment. The CSR asked for the reference number, looked up the bill and offered me a 10% discount. I put it on my Discover card and got an additional 2%.

I think for larger bills they will offer a bigger discount.

 

[EastWest Gal]

Our hospital gives discounts all the time. I would definitely try. I also have found questionable and blatantly over billing almost every time I've looked.

Example: my son was billed a critical care fee by the ER doctor for a broken arm. The hospital also up coded their ER charge due to administration of one Tylenol with codeine pill. I successfully challenged the doctor fee, not the ER fee.

Look at the bill and consider challenging the items line by line. You're likely to save some bucks. Be nice but persistent!