Imagine that you end up at the nearest emergency room with a broken arm, an inflamed appendix, or a serious illness. When you leave the hospital, you’re focused on recovery. But at the worst possible time, you get slapped with an astronomical bill. It’s a nightmare scenario that’s all too common.
With rising health care costs and ballooning out-of-pocket charges even for those with insurance, medical debt is a massive burden for Americans. Of adults who have health insurance, 43% say they have trouble affording premiums and deductibles.
At the same time, three in ten Americans report difficulties in paying medical bills, and three-quarters of these individuals say medical expenses have forced them to cut back on basic necessities like food and clothing. If you’re struggling with hospital bills, rest assured that you’re not alone.
Facing a staggering medical bill can feel overwhelming, but you have an option you may not have thought of for making the debt manageable: negotiating with the hospital or provider. Medical bills aren’t always set in stone, and there may be wiggle room in the final price tag.
Since you probably didn’t learn negotiating tactics in school, here are some tips on how to negotiate medical bills, as well as intel on what happens if you don’t pay hospital bills.
How to Negotiate Medical Bills
You may have qualms about negotiating a hospital bill, worrying that it’s impolite or inappropriate. But keep in mind that this process is common and expected among providers. And the payoff can be huge—it can mean getting the expense under control and avoiding the risk of hurting your credit or getting sued.
Here are some general principles to keep in mind when you start negotiating:
• Move fast. Hospitals can pass unpaid bills on to a collections agency fairly quickly. Once that happens, your credit may be affected, and you’ll have fewer options for negotiation.
• Stay calm and polite. Despite how upsetting the situation is for you, try to keep your emotions under control while communicating with the hospital representative. Be confident, but not aggressive. Expressing your requests in a clear and collected way will make it easier for the provider to understand your situation and improve the chances they’ll want to help. If you’re angry or despairing, cool off before picking up the phone.
• Do your homework. You’ll have a better chance of succeeding if you’ve researched the average costs of the treatments you received in your area. You can find this information by calling up competitors or consulting resources like Healthcare Bluebook .
• Elicit empathy. Explain the economic or other hardships you’re facing and why you’re struggling with repayment. Calling on the other person’s sense of compassion and humanity may help your cause.
• Write everything down. Write down the date, name, and affiliation for every phone call, as well as reference numbers if applicable. It’s easy to forget what you spoke about and with whom, so keep good records. Make sure to get the final details of your agreement in writing, too.
• Don’t hesitate to escalate. Start with the contact phone number on your bill. If the person you’re speaking with seems unwilling or unable to help, don’t be afraid to ask for their supervisor. Don’t forget to explain the situation to each person you speak to, as well as the steps you’ve taken so far.
• If all else fails, apply a bit of pressure. While remaining courteous, note that you probably won’t use this provider or facility again if they can’t meet you halfway. Mention that you’ll share your negative experience with your network, including on social media.
Your Options for How to Dispute a Hospital Bill
When negotiating hospital bills, there are a few specific strategies you can adopt. The one that works for you will depend on your situation and the facility. If one tactic fails, simply move on to the next one.
• Dispute any errors. This is an obvious one, but errors are surprisingly common on medical bills. Look for duplicate charges, incorrect billing codes, charges for procedures that didn’t happen, errors in your insurance information, mistakes regarding whether a charge was in-network or out-of-network, or misstated quantities of medications. If you catch any errors that inflate your bill, file a dispute to get the charges reduced or eliminated.
• Offer to pay a lump sum in exchange for a discount. Many hospitals would prefer to get a slightly lower payment today than wait for a bill to drag out in collections. Propose to pay off the bill immediately—ideally in cash, rather than by credit card—if the provider will slash part of the cost.
A good rule of thumb is to start high when suggesting a discount, leaving room for the provider to negotiate downward. It’s perfectly reasonable to start by requesting 50% off. Even if you don’t pay everything at once, ask whether the provider offers a “self-pay” discount for those paying out of pocket.
• Argue that the provider overcharged you. This is where doing your homework comes in. If you can show evidence that you were charged more than average price points in your area, you have leverage for requesting a discount on your bill. Besides checking online resources and calling competitors, you can also cite the cost Medicare pays for the service. Frame this request as your desire to pay what is “fair.”
• Negotiate a payment plan. Many facilities will agree to a payment plan that replaces the original due date with a schedule that is feasible for you. See if you can sign on to a plan with zero interest. If that’s not an option, try to ask for a lower interest rate. And just because you negotiate a payment plan, doesn’t mean you shouldn’t try asking for a discount on the total as well.
Check whether you qualify for financial assistance programs. Many hospitals offer discounts or other financial supports, such as forgiveness, for people whose incomes fall below a certain threshold or who are uninsured. These limits aren’t always as low as the poverty line, so it’s worth checking even if your income isn’t extremely low.
• Ask for help. You don’t have to go it alone. If you’re struggling, contact a patient advocacy organization, such as Medical Billing Advocates of America , or reach out to a debt settlement provider. Paying an expert can be expensive, so exhaust all your free options first.
What Happens if You Don’t Pay Hospital Bills
The worst thing you can do with overwhelming medical bills is ignore them altogether. If you don’t make a payment by the due date on your bill, what happens next depends on the laws in your state. Depending on where you live, your provider may charge late fees or interest.
After a few months, if you still haven’t paid, the hospital may pass your bill on to a debt collections agency. If they do, it can immediately appear on your credit report and affect your credit score. The debt collector will take steps to collect the bill. If they fail, your provider might decide to take legal action.
If a court issues a judgment in the hospital’s favor, your wages could be garnished. This means that money could be taken directly from your paycheck and sent to the creditor, even without your consent. Fortunately, U.S. law doesn’t allow people to go to prison for most unpaid debts, including medical bills.
Paying Medical Bills with a Personal Loan
Even if you use all the strategies described above, negotiation won’t always work. If you can’t get your bill reduced or eliminated by negotiating, you have another option: taking out a personal loan. These loans are available from banks, credit unions, or online lenders.
They come with relatively low-interest rates, particularly if you have a healthy credit score, and can be used for many personal purposes and repaid in fixed increments, usually over a term of three to seven years. If you qualify for a personal loan with a manageable interest rate and monthly payment, you can use it to pay off your medical bills immediately and could avoid accruing late fees or having the bill move into collections.
If you’re staring a scary medical bill in the face, don’t ignore it. Armed with the right tactics, you can dispute or negotiate hospital bills to make the expense manageable. If that doesn’t work, consider taking out a personal loan to prevent medical bills from dragging you into a vicious cycle of debt.
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