Consumers may feel that their health care costs are immovable, inflexible, and set in stone. But that’s not always the case: A new study shows that patients can often gain financially by disputing charges that appear to be in error or by negotiating for financial relief.
Among consumers who have not questioned a medical bill, 86% said it was because they thought it would have little impact — but a new study from the University of Southern California says “the experiences of those who reached out provide evidence to the contrary.” study.
About 26 percent of people who called because they disagreed with the charges or were unable to pay were corrected after outreach, according to the study published in August. About 15% received price reductions, 8% received financial assistance, and 7% had their bills canceled entirely.
“Of those who reached out, the majority gained some recourse through self-advocacy,” said report co-author Erin Duffy, a research scientist at the USC Schaeffer Center for Health Policy and Economics.
Researchers surveyed 1,135 U.S. adults from August 14 to October 14, 2023.
About one in five respondents reported receiving a medical bill in the past 12 months that they disagreed with or could not afford. About 62% contacted the billing office to resolve the issue.
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“If you can’t afford something, or (if the bill) doesn’t seem correct or consistent with your experience of care, you should call and ask questions,” Duffy said.
Carolyn McClanahan, a physician and certified financial planner in Jacksonville, Fla., said savings can run into hundreds or even thousands depending on factors such as a patient’s health insurance and the type of medical visit or procedure. Dollar.
Bills ‘all over the place’
A 2023 Consumer Financial Protection Bureau analyze A survey of medical billing for adults 65 and older found that patients “face a complex billing system with high potential for errors and inaccurate bills.” Inaccurate billings often result from erroneous insurance claims, the CFPB said , and are more common among consumers with multiple sources of insurance.
Common errors include missing or invalid claim information, authorization and precertification issues, missing medical documentation, incorrect billing codes and claims not being submitted in a timely manner, the report found. Such errors resulted in “the denial of claims that should have been paid,” the report said.
“(Bills) are all over the place,” said McClanahan, founder of Life Planning Partners and a member of CNBC’s advisory board. “There’s no transparency, rhyme or reason as to how (providers) decide what to charge.”
Taking no action and avoiding paying medical bills may not be a good idea: According to another report, this can have negative financial consequences, such as late fees and interest, debt collections, lawsuits, garnishments and lower credit scores Bureau of Consumer Protection Resources.
“If something looks bad, question it,” McClanahan said.
How to Manage Medical Expenses
Consumers should ask beforehand how much a medical visit or procedure will cost, or ask how much they can expect, she said.
McClanahan said sometimes consumers pay “much less” if they pay with cash rather than through insurance. However, cutting the check could have other consequences, such as the amount not counting toward an individual’s annual deductible, she added.
If you feel you have been overcharged, Require According to PatientRightsAdvocate.org, review detailed bills from your medical provider or hospital and look for errors or duplicate charges. The nonprofit said it researches fair market prices for services and uses that information to negotiate.
If something seems unusually serious, question it.
Caroline McClanahan
Physician and Certified Financial Planner in Jacksonville, FL
The phone number for your healthcare provider’s accounting or billing office will be on your bill, on the CFPB explain.
The regulator says there are three other questions to consider asking about your itemized bill:
- Do the charges reflect the services you receive?
- If you have insurance, does the bill reflect payment from your insurance and reflect coverage as understood by the healthcare provider?
- Are there any fees that indicate a service is “out of network”?
McClanahan says when calling a health care provider to ask about medical bills, document the communication. Write down people’s names and what was discussed, and commit to when you’ll hear back.
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