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Neal Templin: How to negotiate a hospital bill

Neal Templin, Rate.com on

Published in Home and Consumer News

Don’t negotiate prices with the first person you talk to. That person is probably not empowered to give you a break. Ask to speak to a director or a department head. Tell them that you want to make good on your bill, but you simply can’t afford it.

Stay polite and professional. Yelling at hospital bureaucrats isn’t going to lower your bill. If anything, it will have the opposite effect. Never forget: The hospital is under no obligation to give you a discount. You want to be that charming customer that the billing person decides to help.

After the procedure, request an itemized bill. Make sure you aren’t being charged for things that you didn’t receive, and that you aren’t being double charged for something you did get. Ask the hospital to remove any unwarranted charges before you begin negotiating the price.

Remember that hospitals have different margins for different services. Margins are higher on outpatient treatment and lower on inpatient treatment. Absent better information from FAIR Health or other sources, your starting offer might be to pay 50% of the charge on an inpatient bill but only 30% on a more lucrative outpatient bill.

Don’t agree to pay a bill over time until you’ve negotiated the lowest price possible. Hospitals will try to put you on a payment program, but their opening offer is often for you to pay the entire bill over a period of years. That’s a terrible idea.

 

Beware of hidden charges. A dozen years ago, I had surgery to remedy swallowing difficulties connected to a rare esophagus problem. It wasn’t done right, and two years later I went in for a redo of the operation from a top surgeon in New York City.

The surgeon was out of my insurance network. He wanted a $24,000 fee for a complicated operation that would take three or four hours. I had good employer insurance, which would only pay him $12,000. His business office assured me before the operation that the surgeon wouldn’t press me for the extra $12,000, and they were true to their word.

I didn’t quite cover my bases, as it turned out. The assisting surgeon still billed me $600 after the operation that my insurance wouldn’t cover. I called his business office, whipped out my credit card, and offered to pay $300 on the spot if the bill would go away. She said, “How about $350?” I said fine.

I was proud of myself. I shouldn’t have been. A friend of mine negotiates insurer contracts with hospitals. He says surgeons have fat margins, and my opening offer should have been 30% of the bill not half.

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