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Medical bill sticker shock: How to reduce the cost

"Three quarters of people with medical debt attempted to negotiate their bill and 93 percent were at least somewhat successful," one expert said.

SAN ANTONIO — The bill for your medical services can be a bit of shock. Do not just pay the balance, no questions asked.

“It’s a whole big, complex system and there is a lot of possibility for error in there,” said Robin Saks Frankel, a personal finance expert for Forbes Advisor.

“Three quarters of people with medical debt attempted to negotiate their bill and 93 percent were at  least somewhat successful in getting their bill reduced or got on a payment plan,” said Erika Giovanetti, a debt expert with LendingTree.

Billing errors are common, so start by making two calls:  One to your medical provider and one to your insurance company.

“You’ll want to ask for an itemized bill from the medical provider who gave you the service, as well as an explanation of benefits from the health insurance company and a summary of benefits and coverage,” Giovanetti said. “A couple of common billing errors that people find are charges for preventive care, double billing, incorrect coding and probably, most importantly, if your insurance company was supposed to cover something and they didn’t.”

Ask both politely for a price adjustment if you find an error.

“How can we work this out?” said Saks Frankel. “How can you help me get the right coding or the right amount billed so me so that I can settle this, but for the right amount?”

You can file an appeal with your insurance company if you believe a charge was mishandled.

“That’s not always successful,” Giovanetti said. “If you feel like your appeal wasn’t sufficiently handled, then you could go to your state’s insurance commissioner to further escalate it.”

The correct price can still be steep, so ask the medical provider for a discount.

“Just say this is more than I can afford. Is there anything you can do for me?,” Saks Frankel said. “Many hospitals will often have a fund to help those who can’t afford to pay their medical bills. They’re not advertising these programs because then everyone would take advantage but if you can prove financial need, there might be a way to get a discount on your bill.”

Do some research to see if you can negotiate a better price. Healthcarebluebook.com is a good place to compare prices for procedures.

“Or call around to get quotes just to see how much other places are charging,” said Giovanetti. “You can use that as leverage when trying to negotiate down your medical bills.”

Ask for a discount if you pay a lump sum upfront.

“They kind of rather just have the money right now and be guaranteed to have the money,” Giovanetti said.

You can also negotiate a payment plan.

“Most medical providers are going to have an interest free payment plan,” Giovanetti said. “So that way you can break it up over months, maybe even it’s a very large bill a number of years.”

Make sure you understand the terms of the payment plan and get a copy of it in writing. 

A nonprofit patient advocate can also help you navigate a complicated system. 

“There are for profit patient advocates who will take a piece of whatever you save and then there are nonprofit ones,” said Saks Frankel. “I highly recommend seeking a nonprofit patient advocate to help you out if you’re having trouble. There are also lots of different charitable organization to look into that might be able to assist you, depending on what your medical scenarios is, even your church or other house of worship or a local community club. Sometimes they have funds to help members or affiliated members in times of need.”

The process can be confusing and challenging, but do not give up.

“There’s no magic solution. It’s literally just being persistent and you know that you’re right,” Saks Frankel said. “Keep all the documentation, a keep a list of everyone you speak to and just keep pushing. Because as long as you keep calling and saying, you know, ‘I’m willing to pay the correct amount, but I don’t think this is the correct amount,’ they’re not going to send you collections. You usually get sent to collections if you’re just like ‘nope, not paying.’”

In the future, always try to find out the pricing before a procedure or service and clear it with your health insurance or negotiate the cost beforehand.

If you have a question for Eyewitness Wants To Know, email us at EWTK@KENS5.com or call us as 210-377-8647.

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