Massachusetts Personal Injury Library
Hospitals negotiate patients medical bills
Massachusetts attorney Thomas M. Kiley, http://www.tomkileylaw.com, concentrates on legal issues surrounding children’s health. As more people are losing their jobs and therefore access to health insurance, hospitals and doctors are noticing more patients are struggling to pay their medical bills, according to an article in the New York Times.
The American Hospital Association members are reporting an increase in the number of patients needing help with paying their bills, and that was before the unemployment rate hit 8.1%. Some doctors now begin their appointments by asking the patient if they have a job and health insurance. If not, they let the patient know that the bills are negotiable.
According to the article, doctors, hospitals, and medical labs negotiate rates all the time with insurers. An official from the Continuum Health Partners, nonprofit hospital system in New York, said a hospital may have a dozen or more rates for one procedure, depending on whether Medicare, Medicaid, or a private insurer is paying the bill. No one involved with health care wants to deal with bill collectors, least of all the patients.
For people who want to negotiate a rate with a doctor, hospital, or lab, they should not be intimidated but realize that most will try to help. According to a new book, "Stay Healthy, Live Longer, Spend Wisely," by Dr. Davis Lieu, a family doctor in California, patients should not be intimidated by doctors, but they could also talk to the billing manager about their financial problems. Some billing managers may be willing to offer a discount of 10-30%, or make an installment plan with no interest.
Some doctors will be willing to give a small discount if patients offer to pay some cash upfront toward their bill. Doctors lose money each year when patients don’t pay their bills, and they also have to spend time with insurers over reimbursements. They will like a plan that includes paying something right away. Another suggestion is to be respectful of the negotiation and not treat it like they’re comparing prices at a used car lot.
Before checking into a hospital for a procedure, patients should call the hospital billing department and explain that because of the financial situation the patient would like to pay the lowest rate the hospital gives an insurance company. Like doctors, hospitals would rather receive some amount of the bill rather than none. Hospitals lost $34 billion in 2007 on unpaid bills, an increase of 55% from 2002. They will usually be willing to set up an installment payment plan to avoid this problem again.
Medicare pays less than private insurers for conditions or surgeries, so patients can compare rates by going to the Federal Department of Health and Human Services database.
Ms. Levin of Continuum Health Partners said that only a small portion of patients or insurers really pay 100% of hospital charges. For extremely large hospital bills, patients may qualify for charity care. To qualify, patients have to show the hospital proof of their income and financial problems.
Medical lab work bills can also be negotiated. Some labs, like Quest Diagnostics, the largest clinical laboratory in the country, offers a six-month interest-free payment plan. Each case is decided on individually, so the same negotiations as with doctors and hospitals will help convince the lab of the financial situation.
