7 Steps to Negotiating Your Medical and Dental Bills

by Contributor

Before I started teaching people how to earn more money, I was working in a medical practice.

Doing the cool stuff like helping in the operating room during 30 surgeries and analyzing x-rays for spinal patients was fun, but the most useful skills I picked up where in the billing department. That’s because I learned how the process worked for negotiating lower medical and dental bills.

A word of warning

While the following tactics can save you hundreds of dollars, that doesn’t mean that they work every time. Furthermore, if your negotiations don’t lead to success it doesn’t mean that the employees are lying to you.

I can tell you that most doctors and most medical practices are not trying to cheat you out of money. They are swamped with patients and constantly hassled by insurance companies. Nine times out of ten, they are just trying to get their work done, not screw you over at the same time.

Plus, getting upset and demanding a discount almost never works. No one likes being told what to do. You’re not helping your cause by losing your temper.

How Medical Billing Works

As you can imagine, there are all sorts of procedures and events that can take place during a medical visit or operation. To categorize these events, there are billing codes for every action that occurs during a visit.

However, there are many combinations of possible codes because there are different sequences that can be performed and different professionals that can perform them. For example, the same procedure might be billed differently if it was done by a physician’s assistant as opposed to a physician. With so many possible combinations, it’s easy to see why some people make their entire living entering billing codes.

How does this help you? Well, it’s possible for things to be recategorized with different codes and (sometimes) it can save you money.

Additionally, each code has a quoted price attached to it. When you receive your bill, you are often asked to pay the full price. When an insurance company receives a bill, however, they are asked to pay a previously agreed upon percentage of the full price.

More and more, the price that insurance companies pay is the Medicare price. Medicare is becoming widely accepted as the standard payment rate within the industry. If you know this, then you can often ask for the Medicare rate and reduce your overall bill.

Steps to Negotiate Your Medical and Dental Bills

Using all of the information above, this 7-step process can sometimes knock hundreds of dollars off of your medical and dental bills.

1. When you get your bill, get in touch with someone that can take care of it. You need a decision maker, not the secretary at the front desk. This is usually someone in billing. If your practice has a Patient Advocate, then it’s possible that they may be able to help as well.

2. Regardless of who you talk with, be friendly. People like doing business with those that they know and trust. The easiest way to gain trust is to engage with someone and talk with them. (They are a real person after all.) Don’t just barge in there and start complaining about how high your medical bill is.

3a. Go line by line through your bill and ask about alternative options. In many cases, there is a different way to charge the item or a different rate you could be charged. Furthermore, sometimes items are included with each bill, but aren’t necessary for your particular situation. This doesn’t happen often, but it has happened before. Make sure everything that you are being charged for is required.

3b. If it’s a bill you received in the mail, make sure to double check the date. When it comes to long-term treatment like physical therapy, it’s very common for bills to be mishandled. For example, you may cancel your physical therapy session at the last minute, but the bill may be sent out before that department is notified of the change. I’m guessing that paying for treatments you never receive isn’t something you want to do.

4. Ask for the Medicare rate. Some of you will already be receiving the Medicare rate, but for everyone else it’s a way to possibly decrease the price. Insurance companies can always negotiate for the lowest rate because they are so large and powerful. If you let the billing department know that you understand this process and you’re looking for a lower rate that is similar to what the insurance companies get, then you will often be able to save some money.

5. Ask for an updated price once you have gone through each item and asked about discounts, alternative options, and other price decreases. It’s important that you get your lower bill in writing … unless you want to negotiate all over again.

6. If you can afford it, finish by offering to pay in full and asking for a discount. Ask, “What is the discount for paying in full right away?” Paying in full saves a big headache for businesses because they don’t have to manage your payment plan or call you in the future to get your money. It’s important to do this after you negotiate down the individual items because you can often get an extra 5% or 10% taken off of your already reduced bill.

7. Keep your cool, but be persistent. It’s ridiculous to say, but in many cases the system makes it intentionally hard for you to get a lower rate — even if you were billed wrongly in the first place. If you’re persistent and remain calm you can eventually get to a lower price in most cases. You may have to call back four times … but you also may save $200.

For more ideas, I put together a comprehensive list of tips to help you learn how to negotiate.

Have you negotiated for a lower medical or dental bill? How did it work? What are your best tips?

About the author: James Clear is the voice behind PassivePanda.com, a site for people that are serious about earning more. To get even more negotiation tips as well as proven strategies to help you earn an extra $500 in the next 5 weeks join Passive Panda’s Free Newsletter on Earning More.

Published or updated March 8, 2011.
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