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Medical bill negotiators can negotiate lower medical and hospital bills.

Hospital and medical bills are usually difficult to understand, and most people just don’t know how much a health care service should cost. So people just pay the bill on blind faith that they are being charged fairly. This is where a medical bill negotiator can help.

Recent studies show medical bill negotiators have up to an 80% success rate in getting patients' bills lowered. These specialists will negotiate with medical providers and hospitals to get lower bills on behalf of the patient. Also most of them will not charge you a fee for their service unless they save you money, at which point they will take a percentage of what they save. So in effect their service is free and there is no risk to trying this.

While this is a newer industry, most of the companies that operate in this industry hire as negotiators people who are attorneys, specialists who worked for insurance companies, or other people who have experience in the medical profession. They have experience and they know how to negotiate a lower medical or hospital bill  on your behalf by providing data showing how much the same procedures cost in the area as well as across the country. They also stress that it is also the medical provider or hospitals best interest to reduce a bill, or they may risk not getting paid anything.

While it is rare for patients to know how much a procedure will cost before walking into a hospital, especially if it is an emergency, a medical bill negotiator will help people lower their bills after the have received their care.

How much does a medical bill negotiator cost?

As indicated above, most of these companies do not charge upfront fees for their service. What they do instead is they charge a percentage of whatever savings they get, and will usually charge anywhere from 25 - 35%. So they work on a contingency basis, and customers don't pay if no savings are found. Here's an example of how the process works.





Say you submit a bill for $1000 and it is negotiated down to $700. So they save you $300. In this case, you  will be responsible for paying the $700 to your medical provider. The negotiators 35% cut of the $300 savings is $105. So they get paid the $105. However, your net savings will be $195. As you will only need to pay the $700 bill and the negotiator $105, for a total of $805, which is less than the original bill of $1000.

Some people will try to receive a discount on their own. They can always try to negotiate a bill on their own, without using an outside company. Find how to negotiate medical bills on your own.

As indicated, this is a relatively new service being provided by some local and national companies as well as attorneys. So be cautious in who you agree to use, and read the fine print of any contract. Or, for a more established organization that may be able to assist with the negotiation of any medical bills, explore the programs offered by a non-profit credit counseling agency.

What types of medical or hospital bills apply?

This depends on the company. However, most bills are for $1,000 or more, although some negotiators will handle bills for as little as $200.

The most typical types of bills that are negotiated are for elective surgeries, such as cosmetic surgeries and gastric bypasses that out-of-network providers must perform because in-network doctors aren't covered under most health insurance plans for these type of services. Also, large surgeries that are known about ahead of time are also popular types of bills submitted. However, almost any hospital or medical bill can be negotiated.

What else can I do to save?

It is recommended that families and individuals get a tax deferred health spending account through work to help pay medical bills, and to always check for what type of coverage you have before you have to go to a hospital. If someone has time before an operation people should check how much insurance coverage they have for it and how much they may be responsible for paying. Also, be aware that out-of-network prices are like the first offer a car salesman makes, so it's worth negotiating to try to save on that service.

Many people are not billed correctly for the services they received. Therefore always review your medical bill, looking for any errors. Learn how to find errors on medical bills.




Here is an example of a negotiation

A Florida woman recently had knee replacement surgery, and the total bill came to $53,000. This particular patient had so called “catastrophic”, high deductible medical insurance, and her insurer paid only $3,000 for the operation, which is all that it was legally obligated to pay under her type of health insurance plan. She hired a negotiator to assist, and they reduced woman's hospital bill from $53,000 to $22,000, for a total savings of $31,000! They were able to do this because it was determined that the "market oriented rate" for a knee surgery in that area of Florida was closer to the $22,000. After putting some “pressure” on the hospital and negotiating with them, they agreed to a lower price. In many cases it is in the medical providers best interest to negotiate as well, as they will risk not getting paid anything if they overcharge.


By Jon McNamara

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