Negotiating Medical Bills

Summary bills often show only a total. Ask the billing office for an itemized statement listing each service, its date, billing code and charge. Compare it line by line with your own calendar, your explanation of benefits from insurance and any notes from the visit. Look for duplicate charges, tests or medicines you did not receive, the wrong date of service or supplies billed separately that should be part of a procedure. If something looks wrong, ask the billing office to review the charge and explain it. Correcting a coding error can change what insurance pays as well as what you owe.

If the balance is more than you can pay, say so plainly and ask what options exist. Many providers offer financial assistance, self-pay discounts for uninsured patients or reductions for paying a portion promptly. Most will set up an interest-free payment plan if you propose an amount you can keep up with. Be realistic, since a plan you cannot keep can lead to collections later. Ask whether the account can be held while you apply for assistance or while insurance issues are resolved. A hospital financial counselor can often arrange these steps faster than a general billing line.

Write down the date, the name of the person you spoke with and exactly what they agreed to. Then ask for written confirmation of any corrected balance, discount or payment plan, and file it with your records. Written agreements protect you if the account changes hands, is sent to a collection agency by mistake or a new representative gives different information. If you reach a dead end, some nonprofit patient advocacy groups help with billing disputes for free, and professional medical billing advocates offer help for a fee. Check their experience and fees before sharing personal information.

1. 1

   Request an itemized statement for every large bill before making any payment.

2. 2

   Compare each charge with your explanation of benefits and your own appointment records.

3. 3

   Ask about financial assistance, self-pay discounts and interest-free payment plans you can realistically keep.

4. 4

   Get every correction, discount or payment agreement confirmed in writing and file it.