It is no secret that hospitals charge outrageous amounts of money for services. One reason is because insurance companies reimburse hospitals as little as 30 cents on a dollar. That means a hospital charging $10,000 for services will receive approximately $3,000 from medicare or an insurance company as full payment. Unfortunately, hospitals have to charge patients with no insurance the same amount ($10,000 in this example) or they would be committing insurance fraud. This raises the obvious question...why don't hospitals accept 30 cents on a dollar as full payment from uninsured patients the same way they do from medicare and the private insurance industry? Well, hospitals claim that they give insurance carriers a volume discount which leaves uninsured or under-insured patients in a poor bargaining position.
Another problem with hospital billing is that of overcharges. Some call this bill "padding ". Whether or not this problem is intentional can be judged on an individual basis. In any case, this can present an even greater hardship for a patient who is having enough trouble paying their artificially inflated hospital bills.
Hospitals may not want the word to get out but they can, and sometimes will, negotiate payments with uninsured and under-insured patients. They know it is better to get a partial payment rather than nothing at all. Patients can also review their hospital records for inappropriate charges in order to reduce their debt. If you look in the right places, you can find large overcharges on many hospital bills. These two strategies can save you thousands of dollars.
Now, lets talk about the two choices you have to utilize these strategies. One way is to hire a lawyer or patient advocate who will work with the hospital on your behalf. They can, however, charge you a fee as high as 50% of the amount they save you. That means a $10,000 hospital bill with $2,000 in overcharges can cost you $1,000 in fees to the lawyer or advocate. That doesn't save you much money. Also, if they are successful in negotiating a lower fee settlement, you will pay even more. The second option is to do it yourself and get all the savings that are due to you. I can help you try for free.
Step #1 is to get an itemized bill from the hospital. This has all the charges listed by department as well as individual item. This will be several pages long and the hospital will provide it to you for free (by law they can't charge you).
Step #2 is to review the bill and focus on the "big ticket" items such as surgeries, diagnostic tests, number of days in the hospital/ICU, expensive drugs, etc. and record any discrepancies. You may have been charged for a procedure or test that was not performed, charged twice for the same test or procedure and even charged for too many days in the hospital or ICU. Make sure you review the itemized pharmacy bill for medications that you may not have been given and for ridiculous charges such as $20 for two Tylenol tablets. If you don't recognize the drug names, look them up on-line so you know why they are prescribed.
Step #3 is to review lesser charges and note any charges that you don't understand or items that you don't remember using while in the hospital.
Step # 4 is to call the billing department at the hospital to arrange a review of your medical record with hospital representatives (most likely from both the billing and medical record departments) to verify your claims of inappropriate or unclear charges. If the billing or medical record departments gives you a hard time, ask for the Director of Operations for that department. If you still can't get anywhere, call the main number of the hospital and ask to speak with a Patient Advocate, Customer Service Representative or Ombudsman. They will intercede for you.
Step #5 is to work with the billing/medical record reps. to have your charges adjusted. Just use common sense about the discrepancies. The burden of proof is on them to justify their charges.
Step #6 is to negotiate a settlement. If you can prove to the hospital that you can't pay the entire bill, they may accept a partial payment as full payment (remember, they accept as little as 30 cents on a dollar from the insurance companies as full payment). If you can pay in full, however, it would be appropriate for you to do so.
Step #7 is to negotiate a payment plan that you can realistically afford. If you make regular payments, they will keep it off your credit report and, most likely, not charge any interest.
Step #8 If you feel the hospital is billing you unfairly, you should contact your state's Office of the Attorney General to file a complaint.
I would like to hear from those of you who are uninsured or under-insured and have hospital bill debt. Let me know if the above steps helped to reduce your hospital bills.
It can be done!!!
Hope to hear from you soon.
Sincerely,
The Patient Protectors
P.S.
Those of you with insurance coverage can have your insurance company do all the above for you at no cost.
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