Cracking the Code: How to Lower Your Medical Bills and Take Control of Healthcare Costs

Did you know that nearly 1 in 10 American adults – approximately 23 million people – are struggling with unpaid medical debt? According to a survey by the KFF Foundation, 11 million of these adults owe over $2,000, while 3 million owe more than $10,000. In light of rising costs for essential items like groceries and the fact that 64% of families are living paycheck to paycheck, it’s no surprise that many people are finding it difficult to keep up with medical costs.

As a nonprofit focused on improving the care of pancreatitis patients, we’ve seen firsthand how medical bills can further impact a family after treatment or surgery. If you’re among the millions of people with unpaid medical debt, don’t give up hope. There are strategies you can use to navigate and reduce your costs. In this blog post, we’ll explore these tactics and address some commonly asked questions about navigating your medical bills.

  1. Shop Around
  2. Ask For An Itemized Receipt
  3. Look into Available Medical Bill Relief Programs and Services
  4. Ask to Lower Your Bill
  5. Set Up A Payment Plan

5 Ways to Lower Your Medical Bills

1. Shop Around

In an interview with Marshall Allen, author of “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win,” Kevin Vincent shared how he saved more than $8,000 for two MRIs. When Kevin needed two MRIs for his back, he knew he’d be paying out of pocket.

With a high deductible health insurance plan, Vincent would have to pay $10,000 before his coverage kicked in. But when he called a nearby hospital-affiliated imaging center, he was shocked to hear that the cost for the two tests would be $11,000 with his insurance or $9,000 in cash. Not wanting to go into debt, Vincent turned to Josh Butler, a health benefits consultant in Amarillo, who referred him to Green Imaging. This company contracts with imaging centers across the country to offer affordable cash prices for various imaging tests.

Vincent was pleasantly surprised to learn that Green Imaging could provide him with both MRIs for only $950, a savings of over $8,000 from the original price he was quoted. Although the cash payment wouldn’t apply to his deductible, he still opted for the less expensive facility and received quality care, even getting his images read by a radiologist and receiving copies for his records. Vincent couldn’t believe he saved as much as he did and wondered how many people were unaware they could be getting a better deal – all by “shopping around.”

Two resources that can help you “shop around” are MDsave and Turquoise Health. These organizations are committed to providing clear, upfront prices for the care you are looking for. Additionally, don’t be afraid to ask for quotes from several providers or facilities for a specific procedure or test. You may be surprised at the price differences between them. In fact, some providers may offer discounts or unadvertised cash prices. Doing your research can save you a significant amount of money over time in the long run. So, before choosing a provider or facility, take the time to explore your options and shop around for the best deal.

2. Ask for an Itemized Receipt

If you’ve already received treatment and are shocked by the price tag, another way to lower your medical costs is by asking for an itemized receipt. According to Pat Palmer, CEO and founder of Medical Billing Advocates of America, most medical bills have mistakes. In fact, the organization has found errors in 75% of the bills they review.

“Most every bill that comes through our office, when we analyze it, there is some type of error that has occurred, and it is usually not in favor of the patient,” Palmer said in an interview with New Jersey 101.5 FM radio station.

When you receive a medical bill, it often includes a lump sum amount for services rendered. However, this doesn’t give you a clear breakdown of what you are paying for. By requesting an itemized receipt, you can see the cost of each individual service, medication, or supply that was used during your visit.

Once you have the itemized receipt, you can review it carefully to ensure that you were charged only for the services you received and that the prices are accurate. If you notice any mistakes, you can bring them to the attention of your healthcare provider or insurance company and have them corrected or removed from your bill.

If you believe you were overcharged for something, you may be able to find the correct price through your hospital’s websites. For many hospitals, costs are shared on a page named “price transparency.” A simple way to see if this information is available to you is by typing the hospital’s name into a search engine, along with the name of the service or medication you were charged for. If you’re having trouble locating this information, another possible resource is FAIR Health Consumers. This nonprofit provides cost estimates for medical bills based on more than 40 billion private healthcare claim records and 37 billion Medicare claim records, dating back to 2002.

3. Look into Available Medical Bill Relief Programs and Services

One important aspect to consider when trying to lower your medical bills is that some hospitals are nonprofit organizations. These hospitals are granted tax-exempt status by the government because they provide charitable services to the community. Under the Affordable Care Act (ACA), Nonprofit hospitals are required to provide a certain amount of free or discounted care to patients who cannot afford to pay their medical bills. Some states even require all hospitals to provide assistance to individuals with low incomes.

If you are facing a large medical bill, it’s worth checking to see if the hospital you received treatment at is a nonprofit organization or in a state that requires assistance. If it is, you may be able to qualify for financial assistance programs or charity care that can significantly reduce your medical bills. These programs may cover all or a portion of your medical bills depending on your income level and other financial factors.

It’s important to note that the eligibility criteria for these programs can vary widely from hospital to hospital. Some hospitals may require you to provide extensive financial documentation or undergo a credit check, while others may have more lenient requirements. Be sure to contact the hospital’s billing department or financial assistance office to learn more about the programs available to you.

If your provider does not offer these programs, don’t fret – there are nonprofits that can help.

Nonprofits that Help With Medical Bills

Patient Advocate Foundation (PAF)

The Patient Advocate Foundation is a national nonprofit organization that helps individuals with chronic, life-threatening, or debilitating illnesses overcome healthcare obstacles and access quality care. PAF provides case management, financial assistance, insurance counseling, and co-pay relief to patients and families.

The HealthWell Foundation

The HealthWell Foundation is a leading independent non-profit dedicated to improving access to health care for America’s underinsured. When health insurance is not enough, the HealthWell Foundation fills the gap by assisting with copays, premiums, deductibles, and out-of-pocket expenses.

Accessia Health

Accessia Health is a nonprofit organization that provides financial assistance for prescriptions, medical treatments and expenses, travel, and insurance premiums for those living with chronic medical conditions. Its program services include healthcare education, specialized legal services, and case management.

4. Ask to Lower Your Bill

If your hospital is for-profit, or you don’t qualify for its relief program, the next step is to directly ask the billing department to lower your bill (after you have corrected any errors on the itemized receipt and your claim has been processed through insurance). While it may seem scary, many hospitals have a vested interest in making sure that you pay your bill in full. This means that they may be willing to work with you to negotiate a lower payment amount.

Once you figure out the fair charge for the services you were provided and how much you can pay, call the billing department of the healthcare provider and ask to speak with an agent about your options for reducing the cost. Explain your financial situation and ask if they can lower the bill or provide you with a discount. You may be surprised to find that many providers are willing to offer a reduced rate.  However, this may take some time and repeated conversations with the billing department before you get to a price that you are able to afford. It’s important to be persistent while remaining kind to the person you are working with.

5. Set Up A Payment Plan

Once you have taken all the necessary steps to reduce your bill as much as possible, the final step is to set up a payment plan. Many hospitals and healthcare providers offer payment plans that allow you to make monthly payments over an extended amount of time, making it easier to manage your medical debt.

When asking for a payment plan, it is important to be direct about your financial situation and what you can afford to pay each month after all your monthly expenses. You may also want to ask if there are any interest or finance charges associated with the payment plan, as this can affect the total amount you will ultimately pay. You may even be able to set up a no-interest plan if you ask for one.

You may also want to consider setting up automatic payments to ensure that you do not miss any payments or collect late fees. Some providers may also offer discounts for setting up automatic payments or for paying your bill in full by a certain date.

Frequently Asked Questions About Healthcare Costs

Can medical bills lower my credit score?

Yes, medical bills can lower your credit score if they go unpaid and are sent to collections. Once a medical bill goes to collections, it is reported to the credit bureaus and can negatively impact your credit score. However, if you pay your medical bills on time, they will not typically have a negative impact on your credit score. As of July 1, 2022, medical debts that have been paid in collections will no longer be reported on consumer credit reports. Previously, it would have remained for a maximum of seven years.

Can I negotiate my medical bills in collections?

Yes, it is possible for you to negotiate your medical bills in collections. Contact the collection agency to discuss payment options or negotiate a lower payment amount. It may be possible to set up a payment plan or settle the debt for less than the full amount owed. Be sure to get any agreement in writing and keep records of all contact with the collections agency.

Can hospitals lower the cost of a medical bill?

Yes, hospitals can lower medical bills in certain situations. If you’re struggling to pay a high medical bill, the first step is to reach out to the hospital’s billing department and explain your situation. Be honest about your financial struggles and ask if there are any programs or options available to help you reduce the cost of your bill. Many hospitals have financial assistance programs, sliding scales, or payment plans available to help patients with high medical bills.

Can lawyers negotiate medical bills?

Yes, lawyers can negotiate medical bills on behalf of their clients. However, it is important to note that not all lawyers are equipped to handle medical billing negotiations. It is recommended to seek out a lawyer with experience in medical billing and healthcare law. These lawyers can help negotiate medical bills with healthcare providers, hospitals, and insurance companies. They can also review medical bills for accuracy and ensure that their clients are not overcharged for medical services. Keep in mind that lawyers may charge a fee for their services, so it is important to discuss this upfront before engaging their services.

Can I negotiate medical bills after the death of a loved one?

It’s possible to negotiate medical bills after the death of a loved one. One option is reaching out to the medical provider and proposing a settlement offer that can be paid either in a lump sum or through a payment plan. Settlement offers typically involve a lower amount than the original bill and may include forgiveness of added fees. It’s important to mention to the creditor that your loved one has passed away, as it could improve the chances of a successful negotiation. If the debt has been sold to a collection agency, negotiating charges may be more challenging, but it’s still worth attempting to reach a settlement. You may be able to secure a discounted amount if you can pay the debt off in one lump sum.

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