How To Negotiate Lower Medical Bills

When it comes to medical bills, it pays to negotiate. Yet most people never challenge them. A 2021 survey found that 60% of people have attempted to negotiate lower medical bills, and 90% of them were successful.

Furthermore, medical bills are notorious for containing billing errors and overcharges: Some estimate that as many as 80% of medical bills contain errors.

But there are things you can do to protect yourself against overcharges and empower yourself as a healthcare consumer.

Here are some of the most important steps you can take.

Negotiate Up Front, If Possible.

The best time to negotiate medical costs is before you receive care.

That’s when you still have “walk away” power – the most important form of leverage for a consumer. 

Once treatment is complete and you’ve already been billed, your leverage decreases significantly. Hospitals and clinics know that after-the-fact negotiations are more difficult for patients, especially if they believe you are financially obligated to pay the full amount.

They also know that they must offer competitive pricing to people who are shopping around.

Sometimes emergencies happen, and negotiating in advance isn’t always possible. But when you can schedule a procedure in advance, it’s always a good idea to shop around. 

Healthshare Members Can Benefit Even More

If you’re on a health sharing plan, providers often assume you’ll be paying cash. This gives you extra flexibility to negotiate a lower rate upfront since you don’t have to go through insurance networks. Always ask for self-pay discounts before receiving care to get the best possible deal.

Taking control of pricing before treatment gives you the strongest position to reduce your bill and avoid surprise charges. Always negotiate before committing to a provider whenever possible.

Tip: If your health insurance or health sharing company has a pre-authorization or price negotiation service, or a healthcare concierge service, contact them to help you find and negotiate the best available price. 

Ask for a Cash Discount

Many hospitals and healthcare providers offer significant discounts to patients who pay cash upfront. These cash-pay discounts can reduce medical bills by 30% to 50% or more, making them one of the most effective ways to lower costs.

Hospitals and clinics prefer cash payments because they avoid the administrative costs of insurance billing and eliminate the risk of unpaid balances. Since price transparency laws now require hospitals to publish their cash prices online, you can look up the cost of a procedure before negotiating.

Health Sharing Members and Cash Pricing

If you are a healthshare member, you typically qualify for cash-pay pricing because health sharing plans do not operate like traditional insurance. Many providers prefer cash-paying patients over dealing with insurance claims, making this an advantage for healthshare members.

When using a healthshare plan:

• Tell the provider upfront that you are a self-pay patient.
• Ask for the lowest available cash-pay price. Some providers automatically assume patients will use insurance and don’t mention cash discounts unless asked.
• Compare prices between hospitals. Healthshare members have the flexibility to choose providers based on affordability rather than restrictive insurance networks.

How to Negotiate Before Treatment   

1. Ask for a Price Estimate – Call the hospital or clinic’s billing department and ask:

• “Can you provide a cost estimate for this procedure?”
• “What is the cash-pay rate for self-pay patients?

2. Tell Them You’re Comparing Providers – Let them know you’re considering other facilities. Say: “I’m looking at other providers that offer lower pricing. Can you match or beat their rates?”

3. Negotiate Payment Terms – If they won’t reduce the price, ask for an interest-free payment plan or a partial cash discount for a larger upfront payment.

Request an Itemized Bill

Don’t settle for a “summary” bill and assume that insurance will take care of it.

Always ask for the full, itemized billing statement. And go line-by-line through every bill and make sure you understand every line item. Do you remember receiving the service? Does the service or procedure make sense in the context of your medical situation? Is the amount charged reasonable and customary for the area?

Overcharges, duplicate charges, and incorrect billing codes can add hundreds or even thousands to your bill. And with so many bills including errors, going over each bill in detail is a worthwhile investment of time.

Lisa from Arizona received a $4,200 emergency room bill. After requesting an itemized bill, she noticed a $900 charge for a medication she never received. She called the hospital, pointed out the mistake, and they reduced her bill accordingly.

Call the billing department and ask for corrections. If they refuse, request to speak with a supervisor.

Leverage Price Transparency Laws

Thanks to recent price transparency laws, hospitals are legally required to disclose their prices on their websites.

This makes it easier for you to shop around and compare pricing between different providers.

Hospitals must also disclose any discounts they offer for cash payers, as well. All this is very useful information for anyone looking to save money on medical care.

You can find pricing information on the hospital’s website, in most cases. You can also use websites such as www.healthcarebluebook.com to easily compare prices.

Tip: Consider independent surgery centers. These are often much less expensive compared to hospital stays and can be a great option for relatively minor, straightforward procedures like cataract surgery and knee replacements.

A patient needing an MRI in Dallas found one hospital charging $2,500 while an imaging center across town charged $450 for the same scan. Always compare prices.

Consider Professional Bill Negotiation Services

If you’re overwhelmed, or if the bill is large, you can engage a professional medical bill negotiator to act on your behalf.

Hiring a professional is a great way to “level the playing field” between you and the hospital, who are always more experienced at it than individual consumers.

Use Hospital Financial Assistance Programs

Nonprofit hospitals are required by law to offer financial assistance to lower-income patients.

In some cases, assistance programs are available for households earning as much as 400% of the federal poverty line.

The best way to engage in financial assistance programs is to ask for a referral while you’re still in the hospital. A hospital liaison or patient advocate should be able to provide you with a financial assistance form. You may need to provide proof of income.

There are also foundations and programs for people diagnosed with specific conditions. You can contact the relevant organizations like the American Cancer Society and the American Lung Association, for example.

Pharmaceutical companies also frequently have patient assistance programs that can help you – especially if you’re uninsured or you’ve chosen a health sharing plan that doesn’t include a prescription drug benefit. 

Click here to schedule an appointment, or call 800-913-0172 to get started.    

To your health and wealth,

Wiley P. Long, III
President - HSA for America

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