Next Time You Get a Medical Bill, Try These “Three Magic Words”

Hospital prices for working Americans are not rooted in what’s fair or reasonable. You may be able to save a lot of money by challenging them.

Laurie Powsner had recently left her full time gig as a social worker, so this year she and her husband got their insurance coverage on the individual market. 

The health benefits came with a hefty deductible. That led to sticker shock after she got an echocardiogram at a hospital near her home in Princeton, New Jersey. 

Her portion of the bill came to $1,650. Laurie, 60, has been reading my Allen Health Academy newsletter, so she called the hospital to challenge the bill. She politely asked the billing representative what she now calls the three magic words: “Is this negotiable?”

I love the way Laurie framed the conversation. She could have been pushy and demanded a discount, but that would have likely made the billing rep defensive. She could have asked directly for a discount, but that gives the billing rep the opportunity to simply say, “No.” 

Asking, Is this negotiable? is a non-confrontational way to propel the debate in the patient’s favor. That’s because there’s only one truthful answer when you ask whether hospital prices are negotiable: “Yes.” 

If you’re a working American who is self-pay or covered by a commercial or individual health insurance plan - those hospital prices are all negotiated. Laurie’s bill is a typical example. The hospital initially charged $19,375 (!) for her echocardiogram. That’s the chargemaster rate, the made-up sticker price that nobody is supposed to pay. That made up charge is merely a starting point for insurance companies to negotiate discounts.

Laurie’s insurance company put its “allowable amount” – the discounted price it agreed to pay – at $2,282. The insurer paid $632, leaving her with the bill for $1,650. 

Laurie doubted she would get a break when she asked if the bill was negotiable. She knew she had a high deductible – the portion you have to pay before your insurance kicks in. She figured she had to pay it.

“I can give you a 50% discount,” the woman said, like it was no big deal.

With those three magic words, Laurie saved $825!

Welcome to the absurd world of medical billing. Where a 50% discount is as matter of fact as putting on your pants in the morning.

Laurie felt an immediate thrill. It couldn’t have been easier. That’s how it often happens. It can be incredibly simple to save big money when you challenge the health care status quo. 

But often it’s not enough to just ask if something is negotiable. In my book, “Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win,” and in my “Never Pay Pathway” health literacy videos, I show patients how to contest medical bills with evidence. I walk through the process of obtaining an itemized bill, with the billing codes, and contesting any inaccurate or overpriced charges. Making your argument with evidence weighs the negotiations in your favor. If necessary, it also gives you the evidence you need to lower the bill by suing in small claims court.

Will you always get a discount? Probably not! But you will never get one if you don’t ask.

Is this fair to patients? Absolutely not! But the business of medicine will continue its oppression until we practice self-defense. We need our employers to get engaged, too.

Laurie Powsner’s “three magic words” paid off big.

The thrill Laurie felt from saving $825 was quickly followed by anger. She and her husband could have paid the full bill, which she knows puts them in a privileged class. About 4 in 10 Americans would not be able to pay a $500 medical bill, or would have to pay it over time, according to a recent Kaiser Family Foundation poll I wrote about in a previous newsletter. As a social worker, Laurie has helped clients and friends with their medical bills. Many lower-income Americans would never ask for a discount, she said, because they don’t know that they should, or would feel ashamed. Most of them would be put on a payment plan and mired down by the debt, she said. 

Let’s not let this happen. Laurie’s story is such a clear example of how easy it can be to reduce a medical bill. Let’s spread the word. Just remember, it starts with those three magic words. 

Takeaways: 

1. Ask if your medical bill is negotiable. 

2. If you’re offered a discount, ask if they can make it a better one. 

3. Check to see if you qualify for financial assistance. The policies can be generous.

4. Obtain your itemized bill, with the billing codes, and check to make sure it is accurate and fairly priced. This information could be the evidence you need to negotiate a reduction in the bill. 

5. Share your Victory Story with me, so others can be informed and inspired to save money on health care.

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Dr. Eric Bricker calls The Never Pay Pathway videos “fantastic”

I’m a huge fan of Dr. Eric Bricker and his instructive AHealthcareZ videos. I’m honored that he featured my new health care literacy videos, The Never Pay Pathway, in a recent video called, Health Literacy and its Role in Financial Literacy.

“I’ve watched these videos myself, they’re fantastic,” Bricker said of The Never Pay Pathway. “…Incorporating health care financial literacy into corporate wellness programs, in my opinion, should be required.”

Thank you, Eric! I agree! 😉

Health care financial literacy has not previously been considered an essential part of employer sponsored health plans. Employers typically let their employees fall into the financial traps set by the health care system. Let’s change this!

We are breaking new ground here at Allen Health Academy, by equipping and empowering working Americans to be savvy health care consumers. It is possible! The Never Pay Pathway videos are engaging and accessible and we are excited to see people enjoying them and learning from them. Contact me if you want more information!

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David Beats Goliath. Again!

There’s nothing that brightens my day like people putting the advice that’s in Never Pay the First Bill and The Never Pay Pathway into action — and saving HUGE money. I love this Amazon review from “badyoga” because it shows that patients can be empowered health care consumers. It’s so satisfying to see them overcome the health care giants. Let’s gooooooo!!!

I don’t know “badyoga,” so if it’s you, please reach out to me so I can savor the victory with you. And if you or others you know have Victory Stories, please share them with me. Let’s normalize our rejection of these unfair health care business practices.