The stress that takes over as soon as you receive an expensive medical bill can be overwhelming, but you may be able to panic at least a little bit less than you are right now. Read on to discover how to negotiate medical bills and what you should keep in mind when you do.
What is Medical Bill Negotiation?
Believe it or not, you may not actually owe the full amount of the medical bills you receive. Documentation errors and wrongfully denied insurance claims happen frequently and can cause you to receive a medical bill that seems unaffordable. That’s when medical bill negotiation comes in!
If there aren’t any errors in the medical billing or with your insurance provider’s claim denial process, negotiating medical bills may also mean getting a discount from the facility where you received care. Learning what options are out there for bargaining can empower you to take the situation into your own hands and pay off your medical debt at a rate that works better for you. If you’ve owed a large sum to a medical facility in the past, you know what a relief this would be.
Why Do You Have to Negotiate Medical Bills?
Medical debt can be extensive, so much so that it’s actually the number one factor behind individual bankruptcy in the US! Sometimes, medical debt may leave you with no choice but to try and reduce your medical bills. Dealing with an emergency health crisis can certainly bring an onslaught of medical costs, especially if you don’t have insurance. But even those who have thorough health coverage may need to negotiate medical bills.
That’s because health insurance claims don’t always get approved, and an insurance denial for a medical treatment you had assumed would be covered can drown you in medical debt. Discovering why your health insurance claim was denied and whether or not that denial was wrongful can lead you to medical bill negotiations.
When Do You Have to Negotiate Medical Bills?
If you’ve received an unexpected medical bill, you probably want to get to solving it right away. This is especially true if the bill is the result of an insurance claim denial, since you may only have around 180 days to file an appeal. Plus, the longer you leave a medical bill balance unpaid, the greater chance you have of your debt going to collections, which may lead to a dramatic drop in your credit score.
As you take on your medical bill negotiations, remember the following:
1. Take Notes
Negotiating medical bills is not easy—it’s a process fraught with stress, complex health insurance policies, and maybe even conflicting information from various sources. In order to avoid getting lost in a maze of confusing phone calls and official letters, it’s a good idea to take notes.
Throughout the medical bill negotiation, you’ll speak to a bunch of different people, whether it’s the receptionist at your doctor’s office or several customer service agents at your insurance company. Write down the specific information that each person gives you along with their name and direct phone number so you can reach them again. Note the incident number, claim number, or case number so you can quickly get through the phone tree each time you call.
2. Know Your Insurance Plan
In order to understand why your medical claim was denied, it’s a good idea to look through your explanation of benefits (EOB). This is the official document that comes with each insurance plan and lays out its terms. Those terms may include which services are covered and what your payment responsibilities are. Depending on the plan and service, you may have to shell out for a copay, coinsurance, or deductible before your coverage for a treatment or visit will begin.
Although the insurance jargon of your EOB can be unclear, going through the details of your plan is worth it, since it may be your best shot at figuring out whether or not you have the grounds to negotiate your medical bill.
3. Double Check the Bill
Remember, you don’t just have to take your medical bill at face value. There are lots of opportunities for error in the medical billing process, so you’ll want to double check every part of the claim and bill. Finding a digit missing in your date of birth or an incorrect insurance member ID number may just be the key to successful medical bill negotiations.
Since some experts estimate that 80% of medical bills contain errors, there’s a good chance that yours does, too. That’s why it is important to request an itemized statement for any medical bill that seems unusually high.
4. Know Your Rights
When negotiating medical bills, you’ll want to know your rights. Understanding what kinds of care your insurance is required to cover or knowing that you’re entitled to an appeals process for any denied claims can make all the difference. Ask your insurance directly what their appeals process looks like, read up on your state’s medical billing and health insurance laws, or speak to an expert to confirm whether or not you can negotiate your medical debt.
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5. Try to Bargain
A little-known fact about medical bill negotiation is that you may be able to bargain with healthcare facilities to get a discount on your bill. At the end of the day, healthcare is a business like any other, and the main concern of hospital billing departments is making money for the services the hospital provides. Therefore, if you call the medical billing department of the facility where you received care, you may be able to convince them to cut down your debt.
One strategy to try is asking for a better price if you pay off your debt right away. Alternatively, if you have determined that there were no errors made in the billing or your insurance correctly denied a claim—in other words, you’re stuck with the full bill—you can explain the situation to the billing department and ask for a better rate. Oftentimes they will agree to charge you an insurer, cash, or Medicare rate if you are unable to afford your bill as is.
The reason they are able to do this is you typically receive a bill with chargemaster rates, or the standard prices for services when they are being paid by private citizens. These standard prices vary greatly by hospital, but usually they are about three times the average amount that hospitals receive for care—quite an upcharge! It may come as a surprise, but hospitals typically don’t have just one rate for services, but several depending on the type of insurance provider that is being billed or the method of payment that is being used.
If you call and speak to the billing department, you can ask them for an insurer’s rate (which will be far lower than the chargemaster price) or a Medicare rate so that you are able to pay off your bills without breaking the bank. This kind of bargaining can be hard to negotiate without a thorough knowledge of the system, so you may want to seek out assistance from a professional medical bill negotiation service.
You Can Get Help Negotiating Medical Bills!
With these five things in mind, it’s also important to remember that you don’t have to negotiate alone. If reading about the negotiation process has added to your stress, it may put you at ease to know that there are professional medical bill negotiation services available to you.
With aJust, all you need is your documents (the bill you received, any relevant insurance documents, denial letters, etc.) and a few minutes of your time. Then, aJust takes it from there, handling all the medical bill negotiating for you. Since aJust’s wealth of knowledge includes how to comb through documents to look for mistakes, how to discover what coverage you’re entitled to, and how to properly negotiate medical bills, you can rest assured that your medical bills is in good hands.
Why Seek Help With Medical Bill Negotiation from aJust
When such a complicated negotiation process lies in between you and reducing medical debt that may have severe consequences for your financial situation, it’s important to get the process right. While the tips above can help you find your way through medical bill negotiation, the only way to ensure you have the highest chances of a successful outcome is to hand over the task to aJust.