Negotiating hospital bill

[KYFIRE]

Hi,

Wondering if anyone has advice.

I have a CDHP plan through my company.  In the last 3 weeks we've had two ER visits, one resulting in an ambulance ride (my little community hospital played the ultra safe card in having my son transferred to the larger, better hospital as they are ill equipped for toddler emergencies).  Everyone's fine and no lasting issues, just need to follow up with and allergist for my son.  Anyhow, the first round of bills arrived. 

With my plan, my deductible is $3k, $6k Max OOP. 

In the first ER visit, total charges were almost $7k for a total of 3 hours and non invasive testing.  The total billing, after "discounts" comes to about $3,100. 

While I have more than enough in HSA, I don't want to pay this on principle.  I don't expect healthcare to cheap, but that's ridiculous pricing.  I'm sure we could all go on a long ride about that but I'll get to my more specific question.

Has anyone ever negotiated the after insurance costs?  Do you think I could contact the billing department and try to negotiate a smaller lump sum payment?  And then reimburse myself through my HSA?  I'm sure in the long run it won't matter too much once the 2nd bill arrives but wondering if there is any experience with this.

Thanks,

[Anniemaygo]

I did have success a couple years ago, but it seems some policies have changed because I have had no success in the last 3 years with multiple doctors and hospitals
More than once I have called the billing department, tell them I have a number of bills and could pay more upfront with a discount.  They are quick to offer me a payment plan paying what I can afford.  Apparently they only negotiate if you don’t have insurance.  I have a hd plan and they explain I already have a discount.

[KYFIRE]

Yeah, that's what I'm thinking.  We had a lot of hospital visits when my wife was pregnant 2 years ago and I tried to call and offer lump sums but no discounts (she was actually still on her own plan since it was cheaper for us). 

It also doesn't help that my company is the primary employer for the area and everyone knows we have "good" insurance. 

I'm just gonna have to suck it up I guess.  At least pay with my CC to get the points and reimbursed through HSA. 

Just when I started reducing the contributions  since it was well built up......

[Sibley]

Requesting an itemized bill might be helpful. Hospital billing is complex, and errors are not uncommon. The process of them generating an itemized bill can catch some of those, plus then you can review it and compare to what happened.

[Dicey]

Glad everyone's okay now. Can you afford to pay this with funds other than your HSA? The mustachian preference is to do this and let the HSA money grow. There have been several threads discussing this strategy.

https://forum.mrmoneymustache.com/investor-alley/lets-talk-hsas/

[maisymouser]

I've had the same experience as others- hospital refusing to offer a discount up-front but negotiating a pay plan at 0% interest. Better than nothing, I guess.

[honeybbq]

Hi,

Wondering if anyone has advice.



While I have more than enough in HSA, I don't want to pay this on principle.  I don't expect healthcare to cheap, but that's ridiculous pricing.  I'm sure we could all go on a long ride about that but I'll get to my more specific question.


Thanks,

2 ER stays and an ambulance ride sounds expensive to me so 3k sounds like a bargain. What data do you have to suggest it's ridiculous pricing?

[therethere]

If 3k is only the first bill. And your deductible is 3k. Why do you want to negotiate it? Won't your other bills just end up bringing you to your deductible anyway? Sounds like you want to fight it just over principle. I guess you have a different definition of fun than me.

I'd use this as a reason to do anything and everything health related for your family in 2021. You're going to be at or near the deductible/OOP max anyway. Might as well take advantage of it. You're in a great position since it is so early in the year.

[SimpleCycle]

Your health insurer has a team of negotiators to get to the contracted rates you’re being billed.  I don’t think you’ll be able to do better unless you can demonstrate financial hardship.

[KYFIRE]

If 3k is only the first bill. And your deductible is 3k. Why do you want to negotiate it? Won't your other bills just end up bringing you to your deductible anyway? Sounds like you want to fight it just over principle. I guess you have a different definition of fun than me.

I'd use this as a reason to do anything and everything health related for your family in 2021. You're going to be at or near the deductible/OOP max anyway. Might as well take advantage of it. You're in a great position since it is so early in the year.

Your absolutely right.  It really won't make any difference and no, I don't look forward to any kind of fight, mostly just frustrated.  Last time this happened, had knee surgery in January, didn't get hurt for the rest of the year!

[KYFIRE]

Hi,

Wondering if anyone has advice.



While I have more than enough in HSA, I don't want to pay this on principle.  I don't expect healthcare to cheap, but that's ridiculous pricing.  I'm sure we could all go on a long ride about that but I'll get to my more specific question.


Thanks,

2 ER stays and an ambulance ride sounds expensive to me so 3k sounds like a bargain. What data do you have to suggest it's ridiculous pricing?

$3k is just the beginning for the first visit.  The ambulance ride is still to come!

[KYFIRE]

Glad everyone's okay now. Can you afford to pay this with funds other than your HSA? The mustachian preference is to do this and let the HSA money grow. There have been several threads discussing this strategy.

https://forum.mrmoneymustache.com/investor-alley/lets-talk-hsas/

Thanks for the link, I'll take a look at that.

We can afford to pay out of pocket, just never considered doing so with the HSA in place.

[Proud Foot]

Yeah, that's what I'm thinking.  We had a lot of hospital visits when my wife was pregnant 2 years ago and I tried to call and offer lump sums but no discounts (she was actually still on her own plan since it was cheaper for us). 

It also doesn't help that my company is the primary employer for the area and everyone knows we have "good" insurance. 

I'm just gonna have to suck it up I guess.  At least pay with my CC to get the points and reimbursed through HSA. 

Just when I started reducing the contributions  since it was well built up......

Now would be the time to look for a CC with a good sign up bonus.

[fuzzy math]

Whats your coinsurance after your deductible? Mine is 10%. So ignore the $3k and think of the future bills you're going to be getting and whether you'd be happier paying your deductible to them instead. If you have a low coinsurance you're ultimately arguing about that amount on your other bills, not the $3k you were going to pay either way to someone.

[ObviouslyNotAGolfer]

Tell them you're sending in your top negotiating team!

[KYFIRE]

I'm in Kentucky so it'd be more like this:

[ohsnap]

...
I'm just gonna have to suck it up I guess.  At least pay with my CC to get the points and reimbursed through HSA. 

Just when I started reducing the contributions  since it was well built up......

Now would be the time to look for a CC with a good sign up bonus.

That's one of the beauties of setting up a payment plan - it gives you flexibility on when you want to pay.  I had some medical bills late last summer that I put on a payment plan, just because it was easy to do on their website and it let me spread it over 10 months - then halfway through I got a CC with a signup bonus and paid off the remaining balance. 

[maisymouser]

...
I'm just gonna have to suck it up I guess.  At least pay with my CC to get the points and reimbursed through HSA. 

Just when I started reducing the contributions  since it was well built up......

Now would be the time to look for a CC with a good sign up bonus.

That's one of the beauties of setting up a payment plan - it gives you flexibility on when you want to pay.  I had some medical bills late last summer that I put on a payment plan, just because it was easy to do on their website and it let me spread it over 10 months - then halfway through I got a CC with a signup bonus and paid off the remaining balance.

That's brilliant. I will have to use that the next time I get a CC signup. Usually I just try to time getting the good signup bonuses around the times I pay our car/house insurance in one lump sum, or other major projects. Having a big medical bill effectively 'on the ready' for payoff is smart though, and I'm sure I will have some more of those in my future :/

[FL_MM]

Yes, I’ve negotiated my co pay. I got a 25% discount for a lump sum. Told them otherwise I’d pay $20 a month payments for who knows how long.  They took my offer.
If you know anyone who works in medical billing, it may be worth it to have them look it over before you pay. Some bills have unbundled or duplicate charges that are hard to recognize when you don’t work with it everyday.
Also does your policy have a stop loss amount?

[KYFIRE]

That's one of the annoying things about the situation, I basically got a bill with a single line item for $3000!  I'm trying to get an itemized list from them now.  I'd like to get that list to at least compare the two visits too, so far the second one is less expensive even though it included an ambulance ride for my son.

I took a quick look and there didn't seem to be many good sign up bonuses right now on CC, anyone know of one?  Otherwise I'd prefer not to open yet another account (I've used this strategy in the past especially for 0% intro rates on big purchases).