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How to Haggle with Your Doctor

These days, everything’s negotiable – even health care, if you know how the system works. You may be able to negotiate a 20 percent discount or more on costs at the doctor’s office. A few pieces of advice:

Where to start:
Never try to negotiate a medical bill without getting a bit of background information. Read the details of your current or previous insurance plan to get a sense of what will and won’t be covered in your upcoming visit.

It’s also worthwhile to find out what Medicare pays physicians—since it is usually substantially less than what they charge private insurance providers or patients themselves—to perform whatever procedure you’ll need. This will help you determine the bottom floor of what a physician will accept. You can do this by calling the doctor’s office, asking for the procedure’s “CPT code,” and going to the American Medical Association’s CPT search engine to look up the typical payment for that procedure based on where you live. When it comes time to bargain, it’s perfectly reasonable to offer a payment that is 25 percent above the Medicare rate for services.

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Who to talk to:
Even if you go to a doctor with a solo practice, the physician himself may not be the best person to talk to about cutting your costs, since he probably isn’t involved in billing issues. Instead, check in with the office manager, who can get you the right contact information for the employee who’s in charge of billing.

What to say:
Insurance companies usually negotiate a 60 percent discount on services, and the discount that Medicare has managed to negotiate with medical offices and hospitals is even deeper. That leaves patients without insurance as the only ones paying full sticker price, which is why you shouldn’t be afraid to bargain a bit, too. When it comes time to negotiate, it pays to be sweet but firm. Stroke the egos of the physician and office manager by explaining why you like coming to their practice so much, but also be firm in letting them know that you won’t hesitate to take your business elsewhere in the future if they refuse to lower your bill.

Cash is king:
There are a number of tactics to use to lower a bill you have already incurred—as opposed to asking for lower-cost services in advance. Generally, the most successful of these tactics is offering to pay in cash. Not only will this save the office the time and cost of billing an insurance provider, but it also saves the billing department at larger practices the hassle of setting up payment options later down the road.

The pen is mightier…:
If paying in cash isn’t an option and your request for a lower price is denied, it may be worth sending a well-worded letter pleading your case to the physician himself, or a hospital administrator. Outline a specific payment plan, and note the reasons why you deserve special treatment.

Hire someone else:
If all else fails, let someone else to do the negotiating. Companies like Medical Cost Advocate, or MCA, have an 80 percent success rate of getting their clients’ medical bills reduced after the fact. The downside, however, is that these companies generally charge their clients a percentage of whatever savings they’re able to snag—35 percent in MCA’s case. So while hiring a negotiator is better than nothing, the savings can be much more significant if you’re able to negotiate medical bills on your own.

Tags: bills, health care, health insurance, Spending and Saving