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Haggling with doctors and health insurers

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How to Haggle

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  1. Don't be ashamed.
  2. Stay cool.
  3. Be prepared to leave empty-handed. If you must have an item, you'll accept a higher price.
  4. Use charm. Haggling is a personal interaction
  5. Pay cash.
  6. Do market research.

OFFER TO PAY CASH UP FRONT: People don't think they can do this, but doctors say the hardest thing they have to do is collect payments. If you're willing to pay up front and not be billed, it makes it easier for them. They may be willing to give you a break.

There are also organization that can help you to lower the bill (you toght me that I should look for professional in any area and do not try to do everything by myself): The service, Health Advocate, is a call-in center that helps customers find the right doctor, haggle over insurance coverage and manage other medical system headaches.

The April 2008 Edition of Smart Money Magazine contains an article entitled "Under the Knife: Cutting Medical Bills", by Angie C. Marek. The article describes how "haggling" for better deals on medical costs is on the rise. The article describes 6 ways to get better deals and lower your medical costs.
  1. Ask for it early- Ask for a price break before the procedure, not after the bill comes in. Surgeons may offer a discount on the surgery fee, or a "two-fer" if you are getting more than one procedure done, such as with plastic/cosmetic surgery. The author was also successful in getting 8 out of 10 mental-health professionals to offer some sort of discount on therapy sessions by approaching them and asking for a break on the price.
  2. Pay in cash up front- Not surprisingly, paying in cash was the number one incentive to offer a discount, according to doctors questioned. Ask the doctor or medical care provider up front for a discount for paying cash in advance, you certainly have nothing to lose. Another good reason not to use a credit card, I would think!
  3. Do your homework- The article describes how it can be difficult to bargain when you are not sure of the real cost of something. One web resource listed was, where you can search for medical care cost data by state. Another technique I have used is to use my health insurance provider's member website, which can offer prices for drugs and other services as well. Also, I have found a simple Google search can often turn up information.
  4. Butter up the billing staff-It is the people in the back office, running the business side of things, not the doctors' themselves, who often hold the power to reducing your medical bills. Just by speaking with the office coordinator and fretting over the bill, the author was able to get a 66% price break on a skin tag (small growth) removal procedure.
  5. Go at an off-peak time- Go to a plastic surgeon after the summer bathing suit season, and you may be able to score an "off-season" deal. Also, offer to fill in for a cancellation at the last minute, or schedule an appointment at lunch time and they may cut you a break as well.
  6. Hire an advocate- Hiring a professional to review your bill and negotiate a better deal for you may save you money, even after paying their fee. A "Health Care Advocate" may have experience in health care billing which may result in savings for you. Do your homework before hiring one though, checking references and with the Better Business Bureau.

In these times of soaring medical costs, it certainly never hurts to ask for a discount, especially if you are underinsured or do not have health insurance, and the more informed you are about any medical costs you may incur, the better off you will be. This past January I changed my family's health plan to a high deductible plan with an HSA (which I will discuss in the near future) where I pay a the first $2500 in costs out of pocket up front, so over the past few months I have been trying to educate myself on medical and prescription drug costs. I will certainly be trying out some of these tactics when the situation arises in the near future.

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Old News ;-)

5 tips for haggling over medical bills - MSN Money

Insurance companies aren't the only ones who can negotiate a lower price -- you can, too. Here's how.

By U.S. News & World Report

Sanjiv Luthra of Los Altos, Calif., suffered from the pain and fatigue of rapid-onset arthritis so severe that he couldn't walk 10 feet until he underwent double knee-replacement surgery in 2006. Now, two years later, he can walk and run, but he still suffers the fallout from another ailment: medical bills.

Six hours in an operating room, two knee replacements, medications and a five-day hospital stay added up to a bill of $80,000, Luthra estimates. That's not counting bills for an anesthesiologist, physical therapy, additional medicines and special exercise equipment to help him recover.

"One should know what the cost of the procedure is, and that is something that is just impossible to figure out before or after the procedure," Luthra says. "I had no way of knowing beforehand there were going to be these six different types of providers . . . sending me bills."

Luthra's insurance company was able to negotiate with the hospital so that it paid about $20,000, and he parted with about $5,000, including expenses outside the hospital.

But individual patients can haggle for lower medical bills, too. Here are tips on how to go about it.

Work up the courage to ask

It's not just insurance companies that can negotiate.

"The typical insurer gets about a 60% discount," says Gerard Anderson, the director of the Johns Hopkins Center for Hospital Finance and Management. "If you go into the hospital and ask the chief financial officer, you may get a 30% discount, but you have to ask for it. It's totally up to the discretion of the CFO how much they or the person in the billing office are willing to give you."

Although it's common to negotiate with a real-estate agent or car salesperson you probably never will see again, it's much more difficult to negotiate with a doctor you trust to make you well and to provide continuing care for your family. Only 31% of Americans have tried to negotiate the price of medical bills, a survey by Consumer Reports National Research Center indicated. But of those who tried, 93% have been successful at least once, and more than a third saved more than $100.

Explore low-cost treatments

Many doctors incurred large loans to finance medical school and probably understand the need to get a fair price as well as you do.

But even though almost 80% of physicians will prescribe a generic medication over a brand-name drug to save patients money, far fewer consider patient costs when recommending diagnostic tests (51%) or choosing between hospitalization and outpatient treatment (40%), according to a survey of physicians by the Center for Health System Change and the University of Chicago.

If money is an issue, you need to ask your doctor if cheaper, medically sound options are available. The trick is to keep it friendly and ask nicely. For minor health ailments such as ear infections and pinkeye, drugstore clinics list reasonable prices upfront, with no negotiating required.

Find the correct person

Although they are heavily involved in treatment decisions, doctors may not be directly involved in other billing issues, so you need to find a person with the ability to adjust your bill.

"I would suggest the consumer go to the office manager," says Timothy Cahill, a health-care consultant in Louisville, Ky., who has negotiated hospital bills on behalf of patients. The office manager should be able to direct you to the person in charge of billing.

Offer cash payments

This could be a mutually beneficial solution for you and the medical establishment.

"Paying cash is worth a lot to a doctor in terms of time and trouble, and it is a lot less complex for the hospital to deal with," says Shankar Srinivasan. He is a co-founder and the chief technology officer of, a company that uses public records to figure out what prices insurers negotiate with hospitals. Cash, he says, saves hospitals the trouble of negotiating financing terms, paying credit card transaction fees and sending collection agencies after patients who fail to pay.

Scrutinize the bill and your insurance

If you don't have the cash to pay a large medical bill, you need to educate yourself about what your insurance should cover and try to negotiate a discount off the sticker price.

"As a consumer, just like a detective, you have to really understand the specifics of your insurance benefit plan, take the initiative of setting up conference calls (including yourself, the hospital and your insurance company) proactively, and you have to document everything," says Luthra, who is chief operating officer of the health-care-consulting company Benu. "You don't just pay the bill as is."

This article was reported and written by Emily Brandon for U.S. News & World Report. - How to haggle for a lower price with your doctor

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