How to Get a Hospital Bill Reduced
Five tactics that actually work, in the order they work in. Itemized bill first, financial assistance second, negotiation last.
The bill is on the kitchen counter. Twelve thousand dollars. You opened it three weeks ago and you have not opened it since. The number is large enough that paying it would empty your savings, and small enough that the hospital expects you to find a way. You feel stuck between two impossible choices: pay it or wreck your credit.<br/><br/>There is a third option, and most people do not know it exists. Hospital bills are negotiable in ways that almost no other bills are. You just have to do the steps in the right order, because skipping ahead loses you leverage you would have had.
The reduction sequence, ordered by what works first.
Request the itemized bill before negotiating anything
What you got was a summary. The itemized bill — every code, every charge, every supply — is what you actually have to fight. Hospitals are required to provide it on request. Studies have found that 70 to 80 percent of itemized bills contain errors: duplicate charges, incorrect codes, services billed but never received. The errors alone often reduce the bill 20 to 30 percent. Ask in writing for the itemized statement before you even discuss payment.
Apply for financial assistance — most hospitals are required to offer it
Nonprofit hospitals are required by federal law to have financial assistance programs and to publish the eligibility criteria. Many for-profit hospitals offer them too. Eligibility is usually based on income relative to federal poverty level, and the assistance can range from a discount to full forgiveness. The hospital is not going to tell you about it unprompted. Ask for the financial assistance application and submit it before you make any payment plan.
Ask for the cash discount
Hospitals charge insurance companies one rate, accept a much lower rate after negotiation, and have a separate "prompt pay" or "self-pay" discount for uninsured patients. Even if you have insurance, if you offer to pay a lump sum, hospitals often discount 30 to 50 percent. Call billing and say: "What is your self-pay or prompt-pay discount if I settle this today?" The first number they offer is rarely the best one.
Negotiate the remainder, in writing, with a counter-offer
After errors are removed and discounts applied, take whatever number remains and write a letter offering to pay a lower amount as full settlement. Be specific: "I can pay [X] within 30 days as full settlement of this account, with the remainder forgiven and not reported to collections." Hospitals would rather get partial payment now than chase you for years. Get any agreement in writing before you send money — verbal deals get forgotten.
Set up a payment plan only as a last resort, and read it carefully
Payment plans sound generous, but they often come with interest, late fees, and clauses that send you to collections after one missed payment. Some hospitals offer zero-interest plans; ask. Set the monthly payment at the lowest amount they will accept — you can always pay more, but you cannot easily renegotiate down. Get the terms in writing and keep records of every payment, because billing systems lose payments and then send the unpaid balance to collections.
Get the full hospital bill rescue plan.
Enter the bill details. Bill Rescue gives you scripts, letters for every step, and a practice mode to rehearse the negotiation call before you dial.