Negotiate Medical Bills

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How to Negotiate Medical Bills

More than ever, patients are starting to negotiate medical bills. If you receive medical bills that are far higher than you were expecting, there is probably a reason why. Two recent studies discovered that 80% or more of medical bills contain mistakes. Some of these errors are not accidental and some are honest mistakes. Every year, these errors result in millions of dollars of inaccurate charges on medical bills.

medical-billing_12413467Given that some patients may not be well-versed in the billing code system used by hospitals and insurance companies, it pays to get a medical bill review, which could help to negotiate your medical bills. This review will point out any errors in medical billing and will also offer an explanation of all charges on your bill. A detailed itemized medical bill (acquired by the medical billing advocate) will allow you to review all charges and compare them to all procedures, treatments, medications and supplies you actually received.

You may want to negotiate your medical bills that contain incorrect charges, but you might not be sure how to get started. A medical billing advocate will search for numerous possible areas in which errors are more likely to occur.  Charging much more than what is considered to be fair and reasonable is a frequent problem with medical billing in the U.S.

Unbundled codes cost you and your insurance company much more money than you should be paying. A bundled billing code leaves the patient with a significantly lower medical bill. When you are charged by the individual billing code for each part of the procedure, your bill is much higher. Sometimes your insurance company will catch this, but you should not rely on them to find these mistakes. This is something a medical bill review will reveal.

A medical bill review will compare what you were charged with to what is considered to be fair and reasonable in your area. Hospitals often charge very different amounts for the same service – even within the same community.  There are hospitals in numerous cities across the nation that charge an average of 200%-400% more than a neighboring hospital on various procedures, treatments and services.

Your medical bill review will alert you to charges that are far more expensive than the standard fee in your area.

Your medical bill review will also investigate medical bills for inflated fees for services and supplies. Unfortunately, it’s not unusual for patients to have highly inflated charges for basic supplies, such as $23 for an alcohol swab or $15 for a bag of ice.  You may not know if this has happened to you unless you request a detailed itemized statement of your medical bills.

The detailed itemized statement will reveal the quantity and number of units for each individual item or service you received.  . If your procedure required anesthesia, the anesthesiologist will record the time you were sedated and when the procedure was complete. Make sure you are paying only for the correct amount of time you were under sedation.  .


Let a Professional Medical Billing Advocate Find Hospital Bill Overcharges

Getting a medical billing advocate on your side will keep you from having to negotiate your own medical bills. This can be a difficult and time-consuming process if you are not experienced in the field of medical bill negotiation. You have the right to “True and Accurate” and “Fair and Reasonable” charges on your medical bills and you deserve to have an advocate stand up for those rights.

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3 responses to “Negotiate Medical Bills”

  1. Vivien Benedetti says:

    Hi! I wish I read this before I had my minor surgery. I was too naive and trusting that I let myself be led like a sheep to the slaughter. I went to my Gynecologist and she found a polyp close to my genitalia. She even took a picture of it and showed it to me. She said that if it weren’t quite big she would remove it right there in her medical office. She told me she had to perform it at an outpatient surgery clinic. I agreed to do so. I gave my complete trust to her and not even bothering to ask how much the whole thing would cost. She said it’s really a minor and quick snipping of the polyp but also cautioned me that anything can happen even with such minor procedure. And the polyp need to be biopsied afterward. In my mind the whole thing wouldn’t cost more than $3,000. Actually, before the surgery, I was ready to call it off because of very bad customer service from the Gyn staff. I had a follow-up appointment before my lab and pre-op schedule and they never bothered to call me. I had to call them several times to ask when I need to go for my lab before the surgery. They never returned my call and I had to call a very last one which if they didn’t clarify, I would have cancelled the surgery. Now I wished I did. I could have had it done for less through overseas medical surgery! To make the long story short, I got a bill of $13,964.85 with a $4,433.84 In Network Deductible. Insurance paid %5,165.82 and my patient responsibility is $4,365.19. Good thing I was able to save some money with my Health Reimbursement Account which took me 2 years to save. Now I have to pay $1,124.00. I don’t know if the Gyn surgery fee is already included in this bill. I called my insurance and they told me to get an itemized bill and submit a letter of complaint to them. My whole complaint is that the whole bill is whimsical, arbitrary, unjust and unfair! If you see the bill, they overdrugged me for a very minor and localized area. It wasn’t even a DNC or a preterm abortion and it costs an arm and a leg! With that price I could have had a package deal of breast augmentation, botox, tummy tack and facelift which is advertised for $8,000.00 in a magazine! This is just my analogy of how outrageous this bill is! On hindsight, was the general anaesthesia even a necessity? I wasn’t even given the option for another alternative form of anaesthesia like the one a dentist would put to the area he needs to work on. I feel I was robbed blind and caught blind-sided. But how can one know about these things until it hits one personally? My question now is how do I get a medical billing advocate to review my medical bill and help reduce my bill? How much would this cost? I already have the itemized billing from the hospital. I’m afraid more bills are coming from the Gynecologist. Please, please help me. Thank you very much. I look forward to your immediate response. I have less than 30 days to file my complaint to the insurance.

  2. Daniel says:

    My wife has been going through chemo and radiation and infusion since the end of Feb. We have BC/BS, but the co-pays are totalling over three thousand dollars. We get a statement of the hospital charge, the insurance payment, and what we owe for the co-pays after every appointment. Our records are about a thousand dollars below theirs! I know they are going to turn us over to collections. My wife is on SSI Disability, and I am on SSI and we get
    $1,980 a month….as homeowners! How much is it going to cost for a negotiator?

    • says:

      Hi, Daniel. Please give us a call so that we can get more information and try to assist. We can be reached at 855-203-7058.