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Bargaining for medical care

One of the biggest expenses most families deal with is medical care. Whether it’s procedures that aren’t covered by insurance or just life’s little emergencies, can you get a better deal by negotiating?

Medical expenses can take a toll on your family finances even if you have excellent insurance coverage. Copayments are higher and costs for outpatient procedures have skyrocketed. You may be able to lower some of your health care costs by negotiating with the provider ahead of time.

Get a deal ahead of time

In order to truly negotiate your medical costs you need to do a bit of homework. Has your doctor ordered a procedure or outpatient testing? Do your research online to find out what the typical costs are in your area. Your state hospital association or state health department are both good places to start. Medical costs can vary significantly by region, so be sure to find costs that are specific to where you live.

Once you have an idea of what the procedure should cost, you have a basis for bargaining. Many physicians’ billing offices allow a percentage reduction in fees for cash payment in advance, which saves them the time and effort of billing you. “More and more billing offices, whether it’s a hospital or doctor’s office, are much more receptive to bargaining,” says Nancy Fase Guernon, director of operations at CareCounsel, a health advocacy firm. “There [are] definitely ways to negotiate the bill.”

Be up front about your situation

Having difficulty paying a large bill for medical services? Be honest with the physician or hospital billing office about your payment difficulties and see what you can work out. Many medical providers will offer patients a no-interest payment plan. Offer to make monthly payments in an amount you can afford or offer a lump sum to settle the debt at significantly lower cost. Your physician is competing for your business and most are more willing to negotiate than consumers realize.

Check your bills

In addition to negotiating your overall costs, start paying closer attention to your medical bills. Medical codes and jargon make the bills anything but easy to understand. Many people simply pay the bills when they arrive, not really knowing if they are completely accurate. Become familiar with your insurance coverage and deductibles or copays. Some insurance plans cover annual checkups at 100 percent, but if your doctor uses the code for a regular office visit you will be charged full price. “You want to make sure if it’s the insurance company’s responsibility to pay it, it’s paying what it should according to the plan,” says Fase Guernon.

Ask for itemized bills so you can check each line item for accuracy. It is common for bills to include duplicate charges for items or inaccurate codes that cause patients to be overcharged. Once you become familiar with checking your bills, you will have a better understanding of what you are paying for.

Don’t be afraid to ask

If you were interested in a pair of shoes without a price tag, you wouldn’t just buy them without asking the price. Medical care shouldn’t be any different — yet consumers are reluctant to ask about costs. If you are reasonable with your questions and informed you are more likely to be successful in negotiating with your medical providers.

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