Facing a staggering medical bill can feel overwhelming, but if you find yourself struggling to pay, don’t give up hope. You may be able to work with the hospital, doctor, ambulance service or other healthcare provider to negotiate a lower price tag. The costs involved aren’t always set in stone, and there might be some wiggle room if you just ask.
Here are some things to consider as you work your way through the negotiation process.
Related: Choosing an individual health insurance plan
Preparing for Medical Bill Negotiation
Save Your Explanation of Benefits
A few weeks after you’ve received medical care, you should receive an explanation of benefits (EOB) from your insurance provider. It may look like a bill, but it isn’t; it’s a breakdown of recent medical services you were provided, what the doctor or hospital charged, what your insurance covered (and didn’t cover), what your insurance company agreed to pay your providers, and the amount you’re expected to pay.
This document can help you be sure you’re receiving the full benefits to which you are entitled under your insurance plan. And it can be useful to compare the information your insurance company has to the actual bill (or bills) you receive.
Your EOB also may offer a better description of the services you received than what’s on your medical bills. If your EOB seems incomplete, it may be because it doesn’t reflect the most recent charges or payments made to or by your insurance provider. If you’re confused or if there seems to be an error, you can call the number listed on the EOB to get help.
Be sure to save your EOB when it comes in the mail. You may need it when you speak to your insurance company or your health care provider.
Be Clear About Who’s Billing You
It can be confusing when medical bills start showing up in your mailbox. For example, you might be billed by several different providers (the hospital, a specialist who saw you, or the ambulance, for example) for just one visit to the emergency room.
Adding to the complexity, the invoice you receive may come from a provider’s internal billing department, or it might come from a company that’s been hired to handle all invoicing and payments for a hospital, physician or physician’s group.
To avoid mix-ups, it can be useful to carefully track who sent each bill as it arrives, to note if the billing was outsourced or done in-house and to mark down who you’ve talked to about errors or making payments. Don’t forget to keep a copy of your EOB with those statements so you’re always prepared with the information it contains.
Don’t Delay Getting Help
As soon as you realize there’s a problem with a bill—either because it’s incorrect or it’s just too high for you to manage—it’s a good idea to get in touch with the provider who sent it.
As long as your medical debt remains with the original service provider, it won’t show up on your credit report. But if the bill goes to collections, it could eventually affect your credit score. You also may have fewer options for negotiating once the debt goes to collections.
Ways to Negotiate a Medical Bill
Can you negotiate medical bills? Absolutely, and there are a few different strategies you can adopt when negotiating a medical bill. If one tactic fails, you don’t have to give up — you can simply move on to another. The method that works effectively for how to negotiate a hospital bill down may depend on your situation and the provider. Here are a few to consider:
Disputing Any Errors
Errors on medical bills are surprisingly common. Look for things like 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. The provider’s billing representative can answer questions you have regarding your bill, so don’t hesitate to ask what certain line items are. If you catch any errors that inflate your bill, you may want to file a dispute to get the charges reduced or eliminated.
Offering to Pay a Lump Sum
Many hospitals would prefer to get a slightly lower payment at the time of billing than wait for a bill to drag through collections. You can offer to pay the bill immediately, ideally in cash rather than by credit card, if the provider will accept less than the total amount due.
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 a 50% discount. Even if you don’t pay the entire bill at once, ask whether the provider offers a self-pay discount for those paying out of pocket.
Showing Evidence of Overcharges
This is where doing your homework comes in handy. If you can show evidence that you were charged more than the average price points in your area, you may have leverage for requesting a discount on your bill. Besides checking online resources and calling competitors, you also can cite the amount Medicare allows for the service. Consider framing your request as your desire to pay what is usual, customary and reasonable.
Negotiating a Payment Plan
Some facilities will agree to a payment plan that replaces the original bill’s due date with a schedule that’s feasible for you. See if you can sign on to a plan with zero interest. If that’s not an option, you can try asking for a lower interest rate. And just because you’ve negotiated a payment plan doesn’t mean you shouldn’t try asking for a discount on the total as well.
Researching Hospital and Government Resources
If you’re struggling, you don’t have to go it alone. There are several resources you may be able to tap for assistance.
Hospital Help
Hospitals often offer discounts or financial relief programs, such as forgiveness, for patients whose income falls below a certain threshold or for those who are uninsured. The hospital may refer to this help as “charity care,” “bridge assistance” or simply “financial assistance.”
Even if you don’t meet income guidelines for government programs, it’s worth checking on what’s available at the hospital level.
Government Financial Assistance
If you weren’t on Medicaid but would have qualified for it when the original medical charges were generated, you may be able to get retroactive help. Depending on the state you live in, Medicaid (a federally authorized, state-administered insurance program for low-income individuals), may cover bills received up to three months before the month you apply for the program.
Ask for an Advocate
If you feel as though you need additional help negotiating with your insurance company or medical provider, you may want to contact a patient advocacy organization, such as the Patient Advocate Foundation or a state or local consumer protection agency.
Come Prepared to Negotiate
If you’re new to negotiating, here are some basics that could help:
Try to Stay Calm and Polite
Do your best to keep your emotions under control while communicating with billing department representatives. Expressing your requests in a clear and collected way will make it easier for the provider to understand your situation and could improve the chances the representatives you deal with will want to help. If you’re angry or despairing, cool off before picking up the phone.
Do Your Homework
You may have a better chance of succeeding if you’ve researched the average costs of the treatments you received, especially if you use data that’s specific to your area. You can find this information by contacting competitors, with a little online searching or by consulting resources like Healthcare Bluebook.
Don’t Underestimate the Power of Empathy
Explain economic or other hardships you’re facing and why you’re struggling with repayment. Perhaps you’ve recently lost your job, or you just got out of college and you’re on your own for the first time. Calling on the other person’s sense of compassion and humanity may help your cause.
Write Down Everything
Keep clear notes with the dates, names and affiliations for every phone call you have, as well as reference numbers if applicable. It’s easy to forget what you spoke about and with whom. Keep everything in one place. And ask to receive the final details of any agreement you make in writing.
Don’t Hesitate to Escalate
Start with the contact phone number on your bill. But if the person you’re speaking with seems unwilling or unable to help, don’t be afraid to ask for a supervisor. Be prepared to explain the situation, over and over again, to each person you speak with.
If all else fails, apply a bit of pressure. While remaining courteous, state 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.
What Happens If You Don’t Pay Medical Bills?
The worst thing you can do with overwhelming medical bills is ignore them. If you don’t make a payment by the due date on your bill, what happens next depends on the laws in your state. After a few months, if you still haven’t paid, the hospital may pass your bill on to a debt collections agency, and that agency may report the past due balance to the credit bureaus that put together your credit reports.
From there, individuals with medical debt have about six months to fix insurance or billing problems. Once that grace period is over, however, an unpaid bill can impact your credit score for years. And if a court issues a judgment in the hospital’s favor, your wages could be garnished. This means money could be taken directly from your paycheck and sent to the creditor, even without your consent.
Taking on Debt to Pay Medical Bills
Even if you use all the strategies described above, negotiation doesn’t always work. If you can’t get your bill reduced or eliminated by negotiating, there are other options, such as taking on debt by using a credit card or taking out an unsecured personal loan.
Using a credit card to pay medical bills is not generally recommended because of credit cards’ typically high-interest rates. However, if you’ve exhausted all negotiating tactics and are still having trouble paying your outstanding balance after the six months’ grace period given by credit reporting agencies, it might be better to pay the balance with a credit card than to have your account sent to collections and have an adverse effect on your credit score.
Another option that might be considered is taking out an unsecured personal loan to pay the medical bills. Personal loans’ interest rates can be significantly lower than those of credit cards, particularly if you have a healthy credit score. They can be used for many purposes, and since a fixed-rate, unsecured personal loan is installment debt—in contrast to the revolving debt of credit cards—the balance is paid on a fixed payment schedule.
If you qualify for an unsecured personal loan with a manageable interest rate and monthly payment, you can use it to pay off your medical bills immediately and avoid accruing late fees or having the bill move into collections.
The Takeaway
Medical bills can be stress-inducing, especially when added to the stress of having medical treatment to begin with. But it’s best not to ignore them. Armed with the right tactics, you may be able to negotiate the amount due or get assistance to make the expense manageable.
Learn more:
This article originally appeared on SoFi.com and was syndicated by MediaFeed.org.
SoFi Loan Products
SoFi loans are originated by SoFi Lending Corp. or an affiliate (dba SoFi), a lender licensed by the Department of Financial Protection and Innovation under the California Financing Law, license # 6054612; NMLS # 1121636. For additional product-specific legal and licensing information, see SoFi.com/legal.
Checking Your Rates: To check the rates and terms you may qualify for, SoFi conducts a soft credit pull that will not affect your credit score. A hard credit pull, which may impact your credit score, is required if you apply for a SoFi product after being pre-qualified.
External Websites: The information and analysis provided through hyperlinks to third party websites, while believed to be accurate, cannot be guaranteed by SoFi. Links are provided for informational purposes and should not be viewed as an endorsement.
Third Party Brand Mentions: No brands or products mentioned are affiliated with SoFi, nor do they endorse or sponsor this article. Third party trademarks referenced herein are property of their respective owners.
More from MediaFeed:
Can medical bills affect your credit report?
Medical costs can sneak up on you. They’re often confusing and even frustrating.
Billing statements may be hard to read. So can an insurer’s explanation of benefits (EOB). Sometimes there’s a coding error or the charges are mistakenly denied. Or maybe there just isn’t enough money in the bank to pay the bill all at once.
Meanwhile, time may pass while you’re making phone calls, asking questions and waiting on some kind of resolution — and the bill might go unpaid during that time. Maybe forgotten. Maybe ignored. Maybe impact your credit.
Most doctors and hospitals don’t report unpaid bills directly to the agencies that determine a person’s credit status. But if a bill becomes delinquent while you dispute an insurance claim or try to negotiate a payment, it eventually could land in the hands of a debt collection agency.
And if that bill collector reports it to one or more of the major credit bureaus, it might result in a ding to your credit standing and/or a decrease in your credit score.
Before we get started, a brief note: As with any credit-related tips in articles like this one, your mileage may vary.
The views in this article are very general in nature and based on assumptions, and it’s likely your situation will differ and have all sorts of variables we can’t account for. Never rely on a blog post like this one for financial, legal, or tax decisions.
SPmemory / istockphoto
Nearly three in 10 insured Americans have had an unpaid medical debt sent to a collection agency, according to a 2019 Consumer Reports survey.
Of the 1,000 adults surveyed, 24% said they didn’t realize the bill was owed, and 13% said they never received the bill. Another 10% said the bill was sent to collections mistakenly, even though they had already paid.
What constitutes a delinquent account may vary between medical and medical insurance providers.
Also, according to the same Consumer Reports survey, nearly one-fifth of Americans say their credit scores have been negatively affected by unpaid health care bills.
A low credit score may make it more expensive to borrow money (at a higher interest rate) or more likely that a loan application could be denied.
Determining how an unpaid medical bill will affect your credit standing could get complicated. The credit models lenders use to gauge their amount of risk in working with borrowers typically include things like payment history, amounts owed, length of credit history, credit mix and new credit.
But the current models may give different weights to various categories when making their assessments. It’s also good to note that different lenders may employ varied credit scoring models.
jittawit.21 / istockphoto
There’s good news for those struggling with medical debt, however. With FICO Score 9, the newest version of FICO credit scores, as well as VantageScore 3.0 and 4.0, medical debt now has less impact on a person’s score because it carries less weight in the calculation.
Another recent change is that the three credit reporting agencies now have to wait 180 days before including an unpaid medical bill on a credit report.
That grace period is meant to give consumers, health-care providers and insurance companies an opportunity to sort out their differences before the bill damages a person’s credit.
Once that six-month period is over, however, if the bill is over $100, it can go on a person’s credit report. That said, the credit agencies remove medical debt from a person’s credit history once it’s fully paid off.
DepositPhotos.com
Even with these new changes, it’s still important to take an active role in making sure medical bills don’t crush your credit. It may be worth considering these steps:
Damir Khabirov / istockphoto
Just because you left a doctor’s office without forking over more than a copay, doesn’t mean you’re done. The bill’s submission to your insurance company doesn’t automatically mean it will be accurate or even paid.
Reading the bill and the insurance company’s explanation of benefits to be sure there aren’t any errors — and to see if you’re still responsible for paying some part of the remaining balance — could prove helpful. Following up with monthly or even weekly calls to make sure the bill is paid may also be key.
If the time has passed without resolution and your health-care provider is threatening to turn the bill over to a collection agency, one general recommendation is seeing if you can negotiate a payment schedule instead — while continuing to pursue reimbursement from your insurance company if you feel you should be covered.
DepositPhotos.com
If you know ahead of time that you won’t be able to pay the entire amount owed, it’s recommended to contact the healthcare provider’s billing office or financial department and try to negotiate a lower amount or a payment plan. If you can come to an agreement, it’s a good idea to get it in writing.
insta_photos/istockphoto
If a collection agency employee contacts you about a bill you think has been paid or should have been paid by insurance, stay calm and ask if you can call back with information that shows there’s no open balance.
If you do, in fact, owe some money, one option is to ask if you can send the money right away to avoid any damage to your credit. Again, it’s recommended that you get everything in writing.
fizkes / istockphoto
If your bill went to collections by mistake, you can take steps to have it removed. Collect as much evidence as you can to prove your case: Dig up copies of old credit card or checking statements or ask for payment records from your medical provider’s billing office.
If your insurance company shows you as already having paid the bill, provide whatever paperwork you have. Another common step is to file a dispute with the credit bureau that’s reporting the error.
The credit bureau will need to investigate and respond to you within a prescribed period of time — 30 days. You may also receive email updates from the credit bureau regarding the status of your dispute.
fizkes / istockphoto
If the balance on your medical bill is yours to pay, you can look for ways to make that process manageable. If there’s room in your budget to pay it off immediately without borrowing money — even if you have to make some adjustments — then that may be your best bet. Or maybe you can take on a temporary side hustle to cover the cost.
If that’s not possible, you may wish to explore other avenues, such as a zero-interest or low-interest credit card, as long as you can be disciplined about making on-time payments and are able to pay off the balance before the introductory rate goes up.
Or you may consider an installment loan such as an unsecured personal loan to pay off the balance of your medical bill before it goes to collections. A personal loan might have a lower interest rate than your credit cards (depending on your credit record and other factors) and may offer additional options for repayment.
A personal loan may be beneficial when negotiating with your medical provider, who may prefer to be paid in a lump sum rather than over months or years.
Key to maintaining a solid credit record is to pay bills on time — long before they reach collections. Staying on top of medical bills can mean extra vigilance — but the effort has the potential to make a real difference to your financial future.
Learn more:
This article originally appeared on SoFi.com and was syndicated by MediaFeed.org.
Disclaimer: Many factors affect your credit scores and the interest rates you may receive. SoFi is not a Credit Repair Organization as defined under federal or state law, including the Credit Repair Organizations Act. SoFi does not provide “credit repair” services or advice or assistance regarding “rebuilding” or “improving” your credit record, credit history, or credit rating. For details, see the FTC’s
website.
External Websites: The information and analysis provided through hyperlinks to third party websites, while believed to be accurate, cannot be guaranteed by SoFi. Links are provided for informational purposes and should not be viewed as an endorsement.
Financial Tips & Strategies: The tips provided on this website are of a general nature and do not take into account your specific objectives, financial situation, and needs. You should always consider their appropriateness given your own circumstances.
SoFi Loan Products
SoFi loans are originated by SoFi Lending Corp (dba SoFi), a lender licensed by the Department of Financial Protection and Innovation under the California Financing Law, license # 6054612; NMLS # 1121636. For additional product-specific legal and licensing information, see SoFi.com/legal.
fizkes / istockphoto
EzumeImages / istockphoto
Featured Image Credit: jittawit.21/istockphoto.
