Welcome to Saving Money with Andrew!
Everyone has a crazy story from our dysfunctional health care system. Hopefully, this one can help you the next time you face an unexpected bill.
Three months ago, my wife needed a test for a potentially serious condition. The doctor ordered the tests, which came back negative a week later. The doctor was in-network and our copay was low. End of story, right?
Three weeks later, a curt statement came back from our insurance company. The tests were “not medically necessary” and, as a result, our responsibility would be $4000.
At this point, panic set in. The doctor’s office was unhelpful and unwilling to help us contest the charge. The insurance company dismissed our calls and appeals and went so far as to bring in a “board-certified” specialist who backed up their decision to deny the claim.
Finally, after many hours of trying to figure out what to do, we stumbled across a technique that might help others facing down a similar large and unexpected medical bill. We called the company that made the test (and had submitted the claim) and started negotiating, asking if they would offer a discount if we agreed to pay them directly.
Ultimately, the company gave us three options:
Payment Plan - They offered us an 80% discount if we agreed to pay off the account over time.
Prompt Payment - They offered us an additional 10% discount (off the payment plan) if we agreed to pay off the account immediately.
Financial Assistance - They offered to write off the entire bill if we provided evidence of financial need.
Before paying, I tried one last thing—I asked if they would intervene with the insurance company on our behalf and file another appeal. They agreed to do so, and said that if they were unsuccessful, they would just come to us for the discounted rate. At the moment, we haven’t yet been billed, but if we are, we will pay the significantly discounted rate we worked out with the company.
These techniques are often useful with unexpected hospital bills as well. More and more hospitals are willing to negotiate on cash payments, and others have significantly expanded their financial assistance programs. This recent WSJ article discusses a major hospital chain that now offers free care to any patients earning less than ~$29,000/yr, and discounts for patients earning less than ~$58,000/yr.
The next time you are facing down an unexpected bill for medical services or tests, consider trying to negotiate a reduced rate.[1]
And now…Andrew’s pick(s) of the week:
The O.C.
The O.C. was one of the culture-defining shows of the early 2000’s, and with the new O.C. podcast, it’s the perfect time to watch/rewatch the show (free on HBO Max, or elsewhere for a price). Still extremely entertaining and engaging, and almost as interesting to see how much our culture has changed in the past 18 years.
I hope this has been helpful. If you liked it, please share it on social media! Also, please send me your feedback, requests, and success stories.
[1] Far beyond the scope of this post—discussing why we put up with a medical system in which surprise bills for thousands or even tens of thousands of dollars are common.
Great article! OC season 1 definitely holds up as really good. The later seasons go off the rails…but still good entertainment!