Medical Billing Practices

+1 888 123 4567


7 tips and tricks for negotiating medical bills

Imagine you go through your mailbox and find an envelope from your doctor's office or the hospital. You are anxious, because you are about to find out what your insurance could not cover from your last visit to the emergency room or even your routine visit Medical Billing & Coding Specialist.

Then you open the invoice and see a much higher amount than you can afford.

It's normal to panic, but take a deep breath. Remember that there are solutions to your problem. Here are some tips to help you negotiate those medical bills:

1. Keep a record of your conversations.
When negotiating an invoice, you probably have to talk to a lot of people in different departments. Ask for the name of each person you deal with. Write down the date they spoke, their phone number, and what they say. Also be sure to write down any incident numbers.

2. Make sure the invoice is correct.
Invoices are created by humans, and humans make mistakes. Check each line to make sure there are no errors. Make sure there aren't any procedures you haven't received or already paid for or that insurance should have covered.

If you find an error, call the company to have it removed from the invoice. Or, if you didn't receive an itemized invoice, ask them to send you one.

3. Compare it to your EOB.
Before receiving your bill, your insurance must send you an explanation of benefits (EOB). This is a breakdown of what it will cover and what you have to pay. When you receive the invoice, compare the prices and verify that they match. If not, call your insurance company.

4. Learn about costs for out-of-network care.
For a particular procedure, you may need to see more healthcare providers than your regular doctor. If they are not in the health insurance network, their services are more expensive. Therefore, they could charge you the difference.

However, if you live in California, Connecticut, Florida, Illinois, Maryland or New York, these states protect patients from what is called 'balance billing'. Require fees for out-of-network care to be the same as for network doctors. Even if you don't live in any of those states, find out what's allowed where you live or if you've been overcharged.

5. Call your insurance.
If you can't help talking to your doctor or hospital, call your insurer to find out why certain procedures aren't covered. They may have entered an incorrect medical code. If they decide not to cover something, file an appeal.

If your doctor also thinks that insurance should cover you (for example, for a medically necessary procedure), he or she can help you file an appeal.

6. Try to request a payment plan.
If your bill is accurate, but you just can't pay it right away, talk to the billing office to find out if there is anything that can be done. Ask if they offer any discounts or if they can waive the fees. Many hospitals have interest-free payment plans.

7. Request a waiver of the medical bill.
If you can't pay outright, even with a payment plan, ask if they offer financial assistance or a medical bill forgiveness program. If there is, you must show that you cannot pay the bill, either by submitting tax returns or documents that prove that you cannot work due to a disability or other reason.