Can I negotiate medical bills with my doctor or hospital?

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When evaluating whether to seek medical care during the Coronavirus/Covid-19 pandemic, the last thing you want to stand in the way of a potentially life-saving decision is the cost of health care. Whether you're being treated for Covid-19 or another medical issue, your life is too important to forgo essential treatment because of cost.

While it might appear that medical costs are set in stone, there are usually ways of educating yourself about the price of your treatment and working with health care providers to reduce the out-of-pocket expense to you, whether you're worried about Covid-19 or another issue.

Paying for Covid-19/Coronavirus testing and treatment

Fortunately, the cost of Covid-19 testing is free due to The Families First Coronavirus Response Act. However, the burden of paying for treatment still lies with the patient. The good news is it may be possible for you to negotiate some of the cost of your treatment with a doctor or hospital if you can answer three very important questions:

• If you need a particular service, what is it going to cost and what is its Healthcare Bluebook value?
• Are you eligible for any discounts?
• Do you know how to read your medical bills to make sure you haven't been overcharged?

Figure out the Bluebook value

In some ways, paying for medical care is surprisingly similar to shopping for a car: Every procedure has a Bluebook value. That value is the price that providers are willing to accept for performing a procedure, test or other service. The problem is that this price can vary significantly. A hospital might charge $500 to one insurance company, $1,000 to a different insurer and even more to a patient with no insurance — all for the same procedure.

If you are facing a medical emergency, you likely won't have the time to shop around to find the cheapest insurance option available and should prioritize getting the treatment you need above all else.

If you're able to anticipate the care you need, however, or are looking to cover a non-emergency procedure, doing research ahead of time may help reduce your final bill.

1. Before you schedule a procedure, test or other service, consult your doctor. Find out the exact name of the procedure, its billing code and your diagnosis code(s). Your insurance company uses the codes, or CPTs, to identify each procedure and decide whether or not it will pay for the service.
2. Once you have the codes, ask the doctor or hospital what you will be charged for the procedure, and if there are any other fees. This includes follow-up visits and rehabilitation. If a hospital stay is required, give the hospital billing department a call to find out how much your room, surgeries and other treatments will cost.
3. Do your research. Look online to see how the price your doctor and hospital quoted you compares to the norm for your area. Healthcare.gov is a useful resource to help you find this information.
4. After you determine what the procedure will cost, call your insurer. Get as much information as you can about the amount your insurance company will and won't cover after you have met any deductible or reached your maximum annual or lifetime out-of-pocket expenses. If the procedure is surgical, be sure to ask if that includes all of your expected fees, including every health care professional in the operating room, such as an anesthesiologist or specialist, as well as any other fees related to the procedure that you might not have considered. If you negotiate a fee with any providers before a procedure, be sure to get it in writing – with a signature – and have it mailed or emailed to you.

Ask about possible discounts

Once you know what the procedure is going to cost and what your insurance will cover, you'll have a better idea of your out-of-pocket expenses. If you didn't have time to ask about discounts before getting emergency treatment, many billing departments are willing to work with patients after they've been treated and adjust the amount owed, even if they've already received a bill.

You can begin with your doctor or, if you'd rather, with the person who handles your doctor's billing. Many physicians offer discounts to patients who are uninsured, whose insurance will not cover a particular procedure or who agree to pay the bill in full or in cash. Alternatively, call your hospital to find out if there are any discounts for which you may be eligible, no matter your income level. This includes the hospital's charity care program, which is designed to help offset the cost of a medical bill. One thing is true whether you're being treated for Covid-19 or a more routine procedure: It never hurts to ask.

Examine your medical bills

One of the most difficult parts of a medical procedure can be trying to decipher the bill. Now that you've done your homework, you can review the charges yourself. If you didn't receive an itemized bill, call and request one.

Here are a few things to watch out for:

• The right amount. Make sure the charges for the procedure, your room and physician's fees match the amounts that were quoted to you. If there are discrepancies, let your physician, hospital billing department or insurer know that a mistake was made.
• The correct CPT codes. Did your insurance company deny payment for anything on your bill? If so, check the item to make sure that the procedure code matches the one you were given. If not, this might be the reason the charge was denied.
• Unreasonable charges. This applies primarily to items that look like they don't belong. For example, if you were charged for three X-rays but only received two, or if you were billed for medical supplies you know you didn't receive or use, don't be afraid to speak up. Question any charges on your bill that you don't understand or recognize.

When it comes to medical bills, it's important to know that you may be able to work with your health care providers to reduce the total cost of your treatment, so seek out help if you need it. Don't forgo treatment to prevent a hospital bill; your health is too important.