How To Negotiate With Hospital

Submitted by diviner_of_data t3_125nevw in personalfinance

I have been fighting with a hospital about a bill that I don't feel that I should have to pay. I had a sleep study done while having insurance A, but then I had a follow up sleep study when I had insurance B. Prior to going in, I asked the people at the front desk if they accept insurance B. They said yes so I proceeded. Insurance B is a major insurance provider so I took them at face value.

It turns out that they actually didn't take insurance B so now I'm stuck with $3,200 bill. I have tried doing appeals and never heard back from the hospital. On a different call the customer service rep accused me of lying. She said "That would never happen. What type of payment plan do you want to set up?"

We are at the point where they are going to send it to collections. I think that I want to pay up instead of trying to get them to admit their mistake. However I want to try to talk them down from the full amount.

I'm not in a precarious financial situation so The only leverage that I can think of is to explain to them that I my credit score is 820 and I have no intention so take on any more debt in the next seven years so I could default on the payment and it wouldn't have a real impact on me, but it would have an impact to them.

How can I negotiate the best deal with them?

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freecain t1_je4xv2b wrote

Start by looking up the policy on insurance B - you may be able to file your claim directly with the insurance as out of network. Probably with reduced coverage - but it would be an improved situation. I would also clarify that the issue is the hospital isn't in network, as opposed to the claim was rejected. If the claim was rejected you want to know why - because it could easily be a wrong diagnosis code, or just missing paperwork.

Your biggest issue is that you're near being sent to collections. The most effective lobbying on your behalf starts early on - since they know you aren't going away for months (however long they have to wait to send it to collections). Still - the general rule applies when seeking help - take lots of notes, be persistent, always be polite and ask to escalate.

You could look up what Insurance B would have covered if they were in network - but that's abstract to the hospital. Instead, I would look up what Insurance A actually paid and push to have it written off to that amount.

If someone says "we wouldn't do that" - agree. "I know, which is why I'm so confused that it happened". or ask for clarification "Right, so why would I have been told that? Did this change recently?"

In the end - know the date you'll go to collections. If it's getting really close - I would consider the payment plan option since it's usually interest free.

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wanttostayhidden t1_je4zthy wrote

>Prior to going in, I asked the people at the front desk if they accept insurance B. They said yes so I proceeded.

Can't help with the negotiation, but in the future, never rely on what the provider tells you. Always verify with your insurance company.

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Azpathfinder t1_je5yv6j wrote

You owe the money. The responsibility to determine coverage is yours, not the hospital’s. “Go ahead and ding my credit” is bad leverage because it’s not like the people you’re speaking with are going to lose out on anything - their compensation isn’t based on one client’s collections. You, on the other hand, can be forced to deal with the credit hit, collections calls to family and employers, etc. it’s a mess.

Contact the hospital and see if they will lower the $3200 to a rate for people without coverage (since that’s technically what you were). Then ask for a payment plan.

Best of luck to ya.

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Greenappleflavor t1_je4wg3t wrote

You’ll be surprised how big of a drop collections can have and it’s not just the score, it’s a mark for all to see—so as long as you don’t plan on taking credit AND don’t come across any landlords that would need your credit report or employers (I’m in an industry where this is a must, but some employers check on this even if they’re not in an industry that expects it’s employees to not have any collections/judgement/felonies).

If you have the date/time and name of person you spoke that says it, may be long shot but even then you’d probably have signed paperwork to the effect of if insurance doesn’t cover you’re on the hook.

Which means yes you owe and you should see if there’s a way to cut that down—start by asking for itemized bill, and reviewing.

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ThrowawayTink2 t1_je80vlt wrote

Hindsight is 20/20, but the responsibility is on you to verify coverage with your insurance provider, not your healthcare provider. Same goes with dental coverage.

Hospital does not care about your credit score. Their job is to get money or write it off/send to collections and move on. Also as an example, a hospital sued my stepdad for 900$ when he was brought into their ER, unconscious and uninsured. He never even signed anything or agreed to go to the hospital.

Your best bet is ask if they offer any discount for paying in full. That usually nets my parents 10-20% off.

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