Hospital Bill Higher Than Expected? Here's the Script To Ask for a Reduction
If a hospital bill comes in higher than you expected, don't automatically resign yourself to paying it in full. Instead, call the hospital to verify the charges and find out if there's any wiggle room on the balance.
But before you pick up the phone, here are five pieces of valuable advice from two patient advocates that can increase your chances of success.
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Review Your Bill and Insurance Benefits
Before you call the hospital to negotiate, Julien Nakache, CEO of Granted Health, recommended comparing the itemized bill to your insurance company's explanation of benefits. Next, he said to pull up the hospital's financial assistance policy so that you're aware of it. All nonprofit hospitals are required to have one posted, he added.
Teri Frykenberg, an RN and board-certified patient advocate, recommended marking any charges on the bill you think are wrong to remind you to ask about them during the call.
Set Yourself Up for Success
Ask for a financial counselor or patient financial services rather than talking to whoever answers the general billing line, Nakache said. Unfortunately, whoever picks up the 800 line usually has no authority to reduce anything, he added.
Frykenberg recommended taking notes, being polite and avoiding sounding desperate during the call. Also, if you want to record the call, ask permission, she said.
Ask About Options To Lower the Bill
Once you confirm the charges are correct, Frykenberg said to explain why paying the total balance will be difficult and ask what options are available.
She also advised against telling the hospital what you can afford right away. The exception, she said, is if the bill is reduced enough that you could reasonably pay the remaining balance with a credit card.
Nakache said to say something like the following when calling.
“Hi, I got a bill for $X, and it came in higher than I expected. I am unable to pay it. I’d like to apply for financial assistance. Who do I need to talk to for that?”
If you have some money available, Nakache said you can ask whether the hospital will take a lump-sum payment for less than the full balance.
A payment plan may be another option. Nakache noted that hospitals commonly offer interest-free plans lasting 36 to 60 months.
Don’t Agree Unless You're Satisfied
During the first call, don't give your credit card number or agree to a payment plan before you've reviewed the bill for errors and checked your eligibility for financial assistance or a one-time discount, Nakache said.
Tell the representative you need to think it over if you're unsure about a payment arrangement, Frykenberg said.
Ask for Someone Else If the First Person Can't Help
Getting a no from the first person doesn’t mean it's the end of the road.
Nakache suggested saying the following.
“I understand you can’t approve that. Can you tell me who can, and note on my account that I’ve requested a financial assistance application?”
Frykenberg said the next person to try is a supervisor. If you still don’t get anywhere, she said patient relations or a private patient advocate may be worth considering.
Nakache also said to ask for the payment deadline in writing so you know when the bill is due while you continue working to get the bill reduced.
How Much Could the Bill Be Reduced?
Nakache said hospitals have more room to negotiate than people might realize. "The charge sheet isn't tied to what the hospital actually accepts; insurers pay a fraction of list, and self-pay rates are often negotiable toward that range," he explained.
He added that when his company, Granted Health, gets a bill reduced, it's by an average of 74% and typically almost all bills can be reduced by 20% to 30%.
This article was provided by MoneyLion.com for informational purposes only and should not be construed as financial, legal or tax advice.
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