Negotiating Medical Fees: How to Shop…… Before you Drop.

William Johnson, President and CEO

CIBC of Illinois, Inc.

www.CIBCINC.com

One of the best things we have gained in the digital age is consumer freedom. Researching and shopping globally has become a critical part of the buying process, and the online world is your complete marketplace. Almost everybody goes online to look up reviews about one product or another, and to shop around for the best prices…even if they intend to purchase in a brick and mortar business. We do our homework, and it is empowering to say the least.

So why do we walk into the doctor’s office, or get a procedure done in the hospital with no regard for what the charges are going to be?

We are all guilty as charged. We have the procedure, and then lose our mind when we get the billing and find that were charged $2400 for this and that. “I can’t believe this! I was only in the office for 20 minutes! All she did was give me one shot!”

Worse yet, people treat a bill from their provider like an edict from their pastor. It is what it is, so pay it…right? Not so fast.

First of all, consider this: According to Consumer Reports, 80% of all medical bills contain errors. Also consider that there is an estimated $500 billion spent in duplicate processing, bad coordination of benefits and fee schedules that are out of date (source: Bloomberg). Think about the fact that 1 in 4 Americans go into credit card debt for medical bills. Well, just like shopping online, you also have the power to shop for health care services.

How To Negotiate Medical Expenses

Here are a few tips on how to take the power back from providers.

First, you need to comparison shop. Use resources like the Healthcare Blue Book to find out what prices should be, and then make sure your providers charges are in line with what’s on the bill. Don’t try and shame the provider into reduced prices by telling them that Joe Doctor at the end of the hallway is cheaper, but do mention that their pricing seems to be a little out of line with usual and customary charges.  Get itemized estimates up front if you can. It’s easier to hide a 2000% profit margin in cotton swabs and gauze if it is listed as a single line item, so get the detail broken out.

Be sure to keep all of your explanation of benefits from your carrier, and all of your bills. As mentioned before, there is a LOT of billing errors, and frankly, providers love it when you pay for something the insurance company has already paid for. Think about it: When did a provider ever call you and offer a refund for overpayment?

Another good tactic is to speak to the billing office. Don’t expect a reduction of 50%, but getting 10% to 20% off a bill is better than the proverbial “stick in the eye.” Also, solicit a deeper discount for immediate payment. If you can pay for it on the spot, providers will trade margin for cash flow. Think about how many people DON’T pay their bill. Recent figures estimate that providers write off roughly 40% of all procedures due to default by carriers and patients.  Take advantage of this if you can…it works.

When your provider writes a script for you, ask for samples as much as possible. They have them, so why not give them to you?  You can also call the drug companies directly or go online and request coupons or reductions. Anything helps in these tough economic times.

Finally, insist on a manageable payment plan for what you can’t address immediately.  Consider that providers do absorb a great deal of bad debt, and due to this, they work really hard to get you to pay as much as possible as quickly as possible. They are quite, ahem, “persuasive” in their approach to this. If you can only afford $50 per month, then tell them that…but for goodness sake, keep to it. They will try and get you to agree to a much higher plan, and it is in their interest to do so. Keep in mind that their end game is to get paid for services, and without you paying the bill, that doesn’t happen. You are holding more cards than you realize in this game.

 We hope this helps. While we don’t think there will ever be online medical providers, we do think that the digital age has shifted a lot more resources in the consumer’s hands.

Now, if we could only get patients to start thinking of themselves as consumers!

This article is intended for informational purposes only and should not be construed as legal advice. Please consult with a legal professional for legal opinions.

 To get more information on CIBC of Illinois, visit us at www.CIBCINC.Com or call toll free 877-936-3580.

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About CIBCsolutions

CIBC is a leader in the development and implementation of innovative employee benefits plans. Headquartered an hour south of Chicago in Kankakee, CIBC has branch offices throughout Illinois serving private sector clients, non-profit organizations, governmental agencies and Taft-Hartley health and welfare funds across the Midwest. Over the past two decades, we have creatively addressed the employee benefits needs of hundreds of organizations — some with as few as two employees and others with as many as 25,000 employees around the globe. A relationship with CIBC gives you access to a team of employee benefits experts who are among the most knowledgeable consultants, analysts and account managers in the industry. With more than 75 years of experience, our team commands the respect of insurers and health care providers nationwide.

Posted on April 26, 2013, in Plan Utilization and tagged , , , , , , , , , , , , , , , , , , . Bookmark the permalink. Leave a comment.

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