We all know the cost of health care in the US is somewhere between exorbitant and extortion.

But it’s difficult to know how high because medical bills are so purposefully opaque. Is there any other industry where buyers literally have no idea how much something is going to cost?

Typically patients won’t even see a bill until they get it in the mail. After seeing the sum they owe even after insurance, they almost have a heart attack.

So what can we do? First, don’t pay this aggregate bill. Ask for an itemized bill with individual billing codes so you can see all the different charges that made up the total cost. Whether it’s a hospital or medical clinic, all patients have this right.

With these billing codes in hand we can look up price comparisons online to see if we got ripped off or not. Sometimes we can even see the cash price for these procedures and line items on a hospital or clinic’s own website.

Call up the hospital or clinic and talk with someone in the billings department who can accept payment. This will usually get us through to someone we can negotiate with.

Don’t scream at them, don’t belittle, don’t swear. Be friendly and polite. Ask for their help. It’s unlikely they own the hospital or clinic. Or shares in the insurance company. Let them help.

Explain how other hospitals or clinics charge so much less for the same procedure and line items. Offer to settle the bill now for that lower figure or ask for a new bill for the cash price.

Insurance companies, hospitals and clinics negotiate rates where they can all profit. This is never in the patient’s best interest. Sometimes this borders on outright theft.

Take the woman who nicked her finger in a kitchen accident and went to the emergency room for three stitches. The price her UnitedHealthcare insurance plan had negotiated for her to pay was - wait for it - $5,805. Her health plan paid about $3,100 and the hospital was hounding her for $2,700 more.

The cash price on the hospital’s website for the examination and treatment she received was only $256.

Just the sort of evidence that prompted her to file a case in the small claims court.

And for the hospital to wipe her slate clean without even going to trial.

References

“Here’s exactly what to do when you get an outrageous medical bill” Slate (2022)

“How to negotiate your medical bills and debt with your hospital” The Wall Street Journal (2021)