How to Negotiate a Medical Bill

If you’ve ever faced expensive medical bills or had to go to the doctor because you couldn’t pay, you’re not alone. According to a survey by Healthcare.com, nearly a third of adults in the US have medical debt. In the US, it is estimated that there is more than $140 billion in medical debt nationally. There is more medical debt in collections than any other type of debt.

When you receive your medical bill after an office visit, diagnostic test, or a larger procedure, you may be surprised at how much you pay, regardless of whether you have health insurance. . Arguing the bill you just received can seem intimidating, difficult, and time-consuming, but doing so can mean saving hundreds or even thousands of dollars.

The first step in checking your medical bills is to find out what you’ve been charged. Interpreting a medical bill is like learning about how a credit card or checking account works, says Allen.

“We knew we had to check our credit card statements, because mistakes on them could cost us hundreds or thousands of dollars,” says Allen. “In healthcare, mistakes can cost us much more. And if you talk to professionals who look at medical bills for a living, they’ll tell you most. all of them have some sort of flaw.”

Some estimates suggest that nearly 80% of medical bills contain some type of error. After you receive your medical bill, you will want to request an itemized bill.

Your itemized bill will give you a list of billing codes for all the services your doctor provides. These payment codes are called Current Procedure Terminology or CPT codes. A CPT code is a five-digit code used to code and describe healthcare services and procedures. They are used by public and private health insurance providers and healthcare providers.

If you have insurance, you’ll also want to make sure a claim has been sent to your insurance company and that the price represents the amount you owe after the insurance company has negotiated with the carrier. medical. (Note: If a healthcare provider is considered ‘in-network’ for your plan, this means that provider has negotiated a discount with your insurance company , so you’ll usually pay less by going to in-network providers.)

To find out what your CPT code means, you can look it up online. The The American Medical Association maintains the full, copyrighted CPT code. Individuals are allowed to search for free CPT codes up to five times per day through the website. Do a search for 99395, and you’ll see it’s classified as a preventive exam for an individual between the ages of 18 and 39.

You will then want to make sure that the services you receive match the CPT codes listed on the invoice. According to Allen, doctors sometimes ‘encode’ patients. ‘Transcoding’ happens when a patient is charged for a more complex service or procedure than they actually received, he said.

Office or emergency room visits can range from level 1 to level 5, with level 1 being the least complicated and level 5 being the most complex, he said. Usually, the higher the level, the higher the cost.

“A visit to a level 3, 4, or 5 emergency room requires a thorough examination and requires an extensive history, so [the doctor] know all of your other medical conditions, all the different medicines you may be taking. It also requires medical decision-making to have some degree of complexity, says Allen. In other words, it requires intensive care.

If you feel like you’ve been ‘coded’ or the codes on your bill don’t match the services you’ve received, you should contact billing and explain to them why the services you received do not match. The service you receive is not reflected in the bill you receive.

In order to successfully negotiate your medical bill, Allen said, you may need proof that the care your doctor provides is inconsistent with the services you’re being charged for. You can file a request for medical records of your visit at your doctor’s office or hospital.

There may be an additional fee for your medical records, but you can sometimes negotiate with them, he said. You can also ask your primary care doctor directly to share them with you.

Once you receive your medical records, Allen says, you can use them to strengthen your records. For example, you might point to notes in your medical record to show that you were charged for a medical appointment that required a medical decision when the doctor’s notes didn’t show any evidence of that kind of care.

If the billing department doesn’t want to budge, you can report the problem by filing a complaint in a small claims court. In small claims courts, individuals can sue a person or a company without an attorney (this can vary by state). According to Allen, in some states like Texas, you can sue for up to $20,000. While you may be charged for filing, the fee can be small ($30 to $40) compared to your medical bill.

“And when you file that, it really upsets the balance of power,” says Allen. “The current [the hospital] have to go before a judge… to justify their unfair or incorrect rates. And they don’t want to do that. “

Fighting a medical bill can be time-consuming and frustrating, but Allen stresses that, depending on how expensive the bill is, it could be worth it.

When it comes to actually paying your medical bills, you shouldn’t choose to use a credit card unless you’re sure you can pay your balance in full and on time when it’s due. Using a credit card to rotate your balance from month to month can cost you a lot more in interest.

Ask about the hospital or doctor’s financial assistance policies first. Some hospitals offer discounts if you meet certain income requirements. If you don’t qualify for the discount, some hospitals may also offer you a payment plan to pay over time that usually doesn’t charge interest.

If you must use credit card to pay for your medical bills, consider using the 0% introductory APR credit card, which can give you 0% interest for up to the first 21 months of your investment. card membership way.

Two highly rated options are the Citi Simplicity® Card with a 12-month introductory period 0% 0% on purchases from account opening (16.24% – 26.24% change then) or the Card. Wells Fargo Reflect℠ offers 0% APR referral on purchases and qualifying balance transfers for the first 18 months from account opening; with a grace period of up to three months (up to 21 months in total) with due minimum payments during the referral and renewal periods (after that, can vary from 14.49% to 26, 49%.) Referral fee for Reflect card is $5 or 3% of each balance transfer, whichever is greater, for 120 days from account opening. Then up to 5% for each balance transfer, with a minimum amount of $5. (See rates and fees.)

Another option worth exploring is a health credit card like the CareCredit® or Wells Fargo Health Advantage credit card, which tends to work a bit like interest-free term cards: they often have a zero-interest promotional period. interest rate before the rate is raised.

If you want a financing option that allows you to pay in monthly installments, there are also ‘buy now pay later’ options for healthcare costs. Opy is a BNPL service dedicated to healthcare, education and auto repair and service. Before you sign up, you’ll want to check with your doctor’s office or hospital to make sure Opy is available to you.

Opy charges borrowers a fixed interest rate of 9.99% (or less depending on the seller) and the payment plan can last up to 24 months. Notably, Opy has a lower interest rate than the one offered on most credit cards. Unfortunately, you could still end up paying a lot of interest depending on how much medical debt you have to pay.

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CareCredit and Wells Fargo Health Advantage card information has been independently collected by Select and has not been reviewed or provided by the card issuer prior to publication.