Consumers may feel their medical bills are unyielding, inflexible, set in stone. But that is not at all times true: A recent study shows patients can often reap financial advantages by disputing charges that appear erroneous or by negotiating for financial relief.
Of consumers who don’t reach out to query a medical bill, 86% said it’s because they didn’t think it will make a difference — but “the experiences of those that did reach out provide evidence on the contrary,” based on a recent University of Southern California study.
About 26% of people that called because they disagreed with a charge or couldn’t afford to pay it got their medical bill corrected after the outreach, based on the study, published in August. Roughly 15% got a price reduction, 8% got financial assistance and seven% saw their bills canceled outright.
“Of the individuals who did reach out, most of them got some recourse through self-advocacy,” said report-co-author Erin Duffy, a research scientist on the USC Schaeffer Center for Health Policy and Economics.
Researchers polled 1,135 U.S. adults from Aug. 14 to Oct. 14, 2023.
About 1 out of 5 respondents reported receiving a medical bill with which they disagreed or couldn’t afford throughout the prior 12 months. About 62% of them contacted the billing office to handle the priority.
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“In the event you cannot afford to pay something, or [if a bill] doesn’t seem right or match what your care experience was, you must call and ask questions on that,” Duffy said.
Savings can extend into the a whole lot and even hundreds of dollars, depending on aspects like a patient’s medical insurance and the form of medical visit or procedure, said Carolyn McClanahan, a physician and licensed financial planner based in Jacksonville, Florida.
Bills ‘go in every single place’
A 2023 Consumer Financial Protection Bureau evaluation of medical bills for adults age 65 and older found that patients “face a fancy billing system with a high likelihood of errors and inaccurate bills.” Often, inaccurate bills result from erroneous insurance claims and occur more steadily amongst consumers with multiple sources of insurance, the CFPB said.
Common errors included missing or invalid claim data, authorization and pre-certification issues, missing medical documentation, incorrect billing codes and premature filing of claims, the report found. Such mistakes contributed to the “rejection of claims that might otherwise be paid,” it said.
“[Bills] go in every single place,” said McClanahan, the founding father of Life Planning Partners and a member of CNBC’s Advisor Council. “And there is no transparency or rhyme or reason for a way [providers] resolve to charge.”
Doing nothing and avoiding payment of medical bills is probably going not a great plan of action: It could have negative financial consequences, equivalent to late fees and interest, debt collection, lawsuits, garnishments and lower credit scores, based on a separate CFPB resource.
“If something seems egregious, query it,” McClanahan said.
Methods to manage medical bills
Consumers should ask up front what a medical visit or procedure will cost, or inquire what the estimated cost can be, she said.
Sometimes, consumers can pay “a heck of loads less” in the event that they pay in money fairly than via insurance, McClanahan said. Nevertheless, cutting a check could produce other consequences just like the sum not counting toward one’s annual deductible, she added.
In the event you feel you were overcharged, request an itemized bill from the provider or hospital, and search for errors or duplicate charges, based on PatientRightsAdvocate.org. Research the fair market price for a service and use that information to barter, the nonprofit group said.
If something seems egregious, query it.
Carolyn McClanahan
physician and licensed financial planner based in Jacksonville, Florida
The phone number to your medical provider’s accounting or billing office can be in your billing statement, the CFPB said.
Listed here are three other questions to contemplate asking about your itemized bill, based on the regulator:
- Do charges reflect the services you received?
- If you will have insurance, do the bills reflect the payment by your insurance and reflect what the provider understood could be covered?
- Do any of the fees indicate a service was “out-of-network” when it wasn’t?
When calling a provider a few medical bill, keep a journal in regards to the communication, McClanahan said. Write people’s names and what was discussed, and get a commitment of once you’ll hear back.
