Challenging hospital bills
April 6, 2017 10:46 AM Subscribe
A family member was recently in the hospital and we've just recently gotten all of the insurance claims back. While the bills that we're expected to pay (which haven't come yet - I'm just seeing 'amount you owe' on the insurance website) aren't eye-popping (high hundreds/low thousands) they're very significant and I'm wondering what to do about it.
Everything I've read advises you to make sure bills are accurate and challenge line items you're not familiar with, but everything seems to be lumped under one giant 'room and board' line item on the insurance claim so I'm not sure what to do with that. There's also seperate bills from the anesthesiologist for just 'anesthesia', with no other details.
Can I request an itemized list from someone and challenge those? Can I make an offer to the hospital or doctors for like 50% of what insurance says I owe? Push comes to shove I can probably come up with the money but I can't but help like it feeling like it's a super arbitrary amount the hospital is just asking me to post-insurance (i.e. co-insurance + hospital deductible).
Things that have worked for you all in the past would be great to hear. Thanks!
Everything I've read advises you to make sure bills are accurate and challenge line items you're not familiar with, but everything seems to be lumped under one giant 'room and board' line item on the insurance claim so I'm not sure what to do with that. There's also seperate bills from the anesthesiologist for just 'anesthesia', with no other details.
Can I request an itemized list from someone and challenge those? Can I make an offer to the hospital or doctors for like 50% of what insurance says I owe? Push comes to shove I can probably come up with the money but I can't but help like it feeling like it's a super arbitrary amount the hospital is just asking me to post-insurance (i.e. co-insurance + hospital deductible).
Things that have worked for you all in the past would be great to hear. Thanks!
Agreed with the first comment. Often you can get on a payment plan, if all negotiations fail. I'm sorry this has happened to you. :(
posted by ancient star at 10:56 AM on April 6, 2017 [1 favorite]
posted by ancient star at 10:56 AM on April 6, 2017 [1 favorite]
Once the actual bills come, you can request itemized lists. Be aware, though, that those might not make any more sense than what you're seeing now.
So:
-Request itemized bills
-Try your best to keep different provider's bills separate, but keep all the stuff together in the end.
-Once you've seen the itemized bills, do call the provider if you have any questions at all about an item. Take detailed notes of every single conversation: who you're talking to, what they said, etc.
-Once you've gotten all your questions answered, start calling the providers to negotiate. You might be offered a certain percentage off the final bill if you can pay in full, you'll probably be offered a payment plan (which will be whatever you can pay per month, no interest fees), but I have never heard of anyone getting 1/2 off their bill.
This is what my husband and I used to do when we had private health insurance and had to pay for nearly everything out of pocket. Please feel free to MeMail me if you have any questions or would like any help with this.
posted by cooker girl at 10:58 AM on April 6, 2017 [1 favorite]
So:
-Request itemized bills
-Try your best to keep different provider's bills separate, but keep all the stuff together in the end.
-Once you've seen the itemized bills, do call the provider if you have any questions at all about an item. Take detailed notes of every single conversation: who you're talking to, what they said, etc.
-Once you've gotten all your questions answered, start calling the providers to negotiate. You might be offered a certain percentage off the final bill if you can pay in full, you'll probably be offered a payment plan (which will be whatever you can pay per month, no interest fees), but I have never heard of anyone getting 1/2 off their bill.
This is what my husband and I used to do when we had private health insurance and had to pay for nearly everything out of pocket. Please feel free to MeMail me if you have any questions or would like any help with this.
posted by cooker girl at 10:58 AM on April 6, 2017 [1 favorite]
If everything is being processed in-network, you should compare the bills received against the EOBs from your insurance company. The amounts the hospital & providers say you owe should match what's on the EOBs from your insurance company. If you are being billed for more than your insurance says you owe, you should push back on that. On the other hand, part of being an in-network provider with an insurance company is the provider agreeing to accept the negotiated rates in the contract; allowing you to pay less than what was agreed in the contract could run the provider into contractual/legal issues (cite). You should ask if you can set up an extended payment plan- paying small amounts over time can take some of the sting out of the total due.
posted by ThePinkSuperhero at 11:01 AM on April 6, 2017 [1 favorite]
posted by ThePinkSuperhero at 11:01 AM on April 6, 2017 [1 favorite]
Similar questions were asked before on AskMe, so it might be helpful to do a quick search.
You should be able to ask for an itemized bill. Prepare for sticker shock when you see something like one aspirin cost $20. Yowza. My old standby advice for paying off medical bills to other friends and family members based on personal experience:
First, BREATHE. Wait until you actually receive a BILL from the hospitals / doctors / whatever. You might receive statements, but that means nothing until you receive a bill that shows what the insurance covered and what it didn't. In my case, I seemed to receive bills for several months afterwards.
Contact each "vendor" individually. Explain that you are not in a position to pay anything in full. Be nice. Be kind. It's okay if you cry a little. Just don't scream.
Ask if they can work with you to bring the bill down. In my case, I was able to negotiate pretty easily anywhere from a 15% to 50% markdown. If you are nice and calm, you'll be treated nice and calmly as well.
In almost every single case, I negotiated a monthly payment. Some as low as $10 a month, some as high as $150 a month. As soon as I paid the smaller bills off, I rolled over that payment to the next bill. The bonus? All the payments were INTEREST-FREE.
I am happy to say that within a year I PAID OFF ALL MY BILLS. Not a single red cent went on a credit card. It was hard, there were months when I ate a lot of spaghetti, but oh my god, am I proud of myself.
PRO TIP: When you call each "vendor" to discuss payment, you may be asked for proof that you have permission from the actual patient to negotiate on their behalf. It may be helpful to have the patient on the phone first to introduce you as the person s/he has designated to coordinate finances.
posted by HeyAllie at 11:13 AM on April 6, 2017 [1 favorite]
You should be able to ask for an itemized bill. Prepare for sticker shock when you see something like one aspirin cost $20. Yowza. My old standby advice for paying off medical bills to other friends and family members based on personal experience:
First, BREATHE. Wait until you actually receive a BILL from the hospitals / doctors / whatever. You might receive statements, but that means nothing until you receive a bill that shows what the insurance covered and what it didn't. In my case, I seemed to receive bills for several months afterwards.
Contact each "vendor" individually. Explain that you are not in a position to pay anything in full. Be nice. Be kind. It's okay if you cry a little. Just don't scream.
Ask if they can work with you to bring the bill down. In my case, I was able to negotiate pretty easily anywhere from a 15% to 50% markdown. If you are nice and calm, you'll be treated nice and calmly as well.
In almost every single case, I negotiated a monthly payment. Some as low as $10 a month, some as high as $150 a month. As soon as I paid the smaller bills off, I rolled over that payment to the next bill. The bonus? All the payments were INTEREST-FREE.
I am happy to say that within a year I PAID OFF ALL MY BILLS. Not a single red cent went on a credit card. It was hard, there were months when I ate a lot of spaghetti, but oh my god, am I proud of myself.
PRO TIP: When you call each "vendor" to discuss payment, you may be asked for proof that you have permission from the actual patient to negotiate on their behalf. It may be helpful to have the patient on the phone first to introduce you as the person s/he has designated to coordinate finances.
posted by HeyAllie at 11:13 AM on April 6, 2017 [1 favorite]
Wait for the final bill after all of the insurance has done all of the payments; call them; set up a payment plan. If the patient is on social security etc, the payments will be low, but they're usually very affordable anyway. Unless this is a spouse or child, the amount should not be something you come up with, but based on their actual financial income.
posted by DarlingBri at 2:27 PM on April 6, 2017
posted by DarlingBri at 2:27 PM on April 6, 2017
Confirming what ThePinkSuperhero said...do double check that everything was processed correctly (in-network, nothing denied inappropriately) but after your insurance has processed it, whatever is left is either deductible or coinsurance and you have already received a vastly discounted contract rate so it's unlike that they'll be able to negotiate further. Be nice to the biller you talk to and understand that their hands are frequently tied by hospital policy but I will say that I often set up payment plans for as low as $5-10 a month for people that are clearly struggling (because my employer has not set policy that doesn't allow me to go that low).
posted by kattyann at 8:18 AM on April 7, 2017
posted by kattyann at 8:18 AM on April 7, 2017
I asked a similar question recently and got a lot of advice about payment plans.
posted by AFABulous at 7:00 AM on April 10, 2017
posted by AFABulous at 7:00 AM on April 10, 2017
This thread is closed to new comments.
posted by epanalepsis at 10:51 AM on April 6, 2017 [6 favorites]