Paying for healthcare services is similar to buying a new car; all is negotiable. Many consumers may be surprised to learn that healthcare services are negotiable. Consumers, in 2014, are estimated to pay $3,301 out of their own pocket for healthcare expenses. For all healthcare consumers, the annual out of pocket price tag is $328.2 Billion as reported by the National Health Expenditure Accounts Association in 2012. Yes, I said Billion. Let’s further say Healthcare Consumer Navigator can save the consumer 1% of the $328.2 Billion; that translates into a $328 Million in saving. Healthcare Consumer Navigator is exploring programs that are offered by Doctors and Hospital that can save the healthcare consumer money. These little known programs are available to all consumers if you know about them and if you ask. Our goal is to educate the healthcare consumer with practical advice and tips to help navigate the complex world of healthcare.
“PROMPT PAY” DISCOUNTS IF I HAVE HEALTHCARE INSURANCE
Prompt Pay discounts are offered by hospitals and doctors if the balance is paid in full within 30 days after the health insurance has paid. The following are tips and advice on how to negotiate your healthcare bill.
For most of us, when we receive a bill from a hospital we pay it. In fact, we can ask for a discount if we are savvy consumers. What do I mean? The following is a step by step process consumers can follow to secure a discount.
- You receive a bill from the hospital after your health insurance as paid and you want to pay the balance off now.
- Within the first 30 days after receiving the bill, call the hospital Business Office and ask for a “Prompt Pay” discount. Most hospital offer and sometimes advertise this discount on the billing statement you received. The discount can range from 10% to 20% or higher.
- If the Business Office associate says yes, we offer a discount, find out the amount of the discount. (Any discount offered is a bonus since you do not have to pay the full amount) If you are satisfied, secure the Business Office associates’ name and confirm the amount of the discount and how much you are required to pay after the discount is applied against your account. If the Business Office associate says no, ask them why. Tell them you are willing to pay the bill in full now. If they still say no again, ask for a Manager and go through the same discussion. It can’ t hurt; it’s your money.
- Most hospitals accept credit cards via the telephone. Pay the bill immediately; this will insure you receiving your discount.
Why do hospitals offer prompt pay discounts:
- They want the cash flow now
- Payment plans cost hospitals’ money to manage; the longer the payment plan the higher the probability of defaulting on the payments
- It costs the hospital $.55 to $.65 per statement sent to you a billing statement
- Personnel costs are reduced
Use the arguments above when discussing “Prompt Pay” discounts with hospital personnel. They will know you are an educated consumer.
Doctor bills are significantly smaller than hospital bills. Since they are, “Prompt Pay” discounts are harder to receive. Generally, if you have healthcare insurance, the out of pocket payment to the Doctor is what called a co-payment; a fixed amount per doctor visit. Co-payments can range from $10 to $50 per office visit usually based on the specialty of doctor you are seeing. Co-payments are usually collected from the consumer either before or after the office visit. Receiving a discount is worth a try; the following are the steps
- When the receptionist is asking you to pay your co-payment amount, ask her if this office offers “Prompt Pay” discounts. You may be surprised.
- If not, pay the amount and see the doctor. Nothing ventured; nothing gained.
DISCOUNTS IF I DO NOT HAVE HEALTHCARE INSURANCE
The vast majority of us have some type of healthcare insurance. The typical types of insurance plans are offered through where we work, through the Federal Government or insurance plans we purchase ourselves. There are, however, about 48 million people living in the United States that do not have healthcare insurance. This population segment is at full financial risk for paying for their healthcare services. The average emergency room bill in 2013 was $1,957 as reported by the National Institute for Health; The average per day cost of a hospital stay was $2,025 with an average stay of four days which translates into a per stay cost of $8,000 to $9,000 per Becker’s Hospital Review in 2012. A typical doctor’s office visit can range from $80 to $150 or higher depending on the doctor’s specialty. These costs will only go higher and can be stressful for any healthcare consumer without healthcare insurance.
As some consumers know, healthcare insurance companies do not pay 100% of the amount billed to them from the hospital or doctor. Insurance companies negotiate a discount with hospitals and doctors. If a consumer does not have health insurance, why should they 100% of bill when insurance companies pay significantly less. They should not. Use this as an argument when talking to hospitals or doctors.
Most Doctors and Hospitals offer discounts to consumers who do not have healthcare insurance. Discounts can range from 20% to 50% or higher. Always be proactive; better you controlling the conversion than the hospital or doctor. The following is a step by step guide to securing your discount.
- If your doctor has ordered services at the hospital, prior to receiving healthcare services consider using the following process:
- Contact the hospital Business Office and explain to them your doctor has scheduled healthcare services and you have no insurance.
- Ask the Business Office associate what is there no insurance discount amount. It should be in the 20% to 50% range or higher.
- Ask the Business Office associate what are the terms for you to receive the discount; Payment in full at the time of service, Payment plan over what period of time or other terms offered by the hospital.
- If a discount is offered only if you pay the full amount at time of service ask if they are willing to make payment plan arrangements. If they are, see step e below; if not pay the full amount
- If a discount is offered and the hospital is willing to accept payments, this is a very good arrangement since most hospitals do not charge interest. Best use their money not yours.
- Make sure you receive all terms in writing form the hospital and secure the associates name.
- If you received emergency services and did not talk to the hospital prior to the service, consider using the following process:
- Always be proactive; if you can go to the hospital Business Office the same day of service do so and discuss your situation; you have no insurance. If you can’t go to the hospital Business Office, call them 5-7 days after you received the service. It takes the hospital that long to gather all the charges in order to bill you.
- Use the same process as outline above; steps B-F.
Like hospitals, most Doctors will offer some type of discount if you have no insurance. The consumer can consider using the following suggestions:
- Prior to scheduling a visit with the doctor, discuss with the doctors practice manager discount options if you do not have healthcare insurance.
- Make sure you relay to the practice manager that most insurance companies do not pay 100% of the doctor bill and you would like them to match the discount.
- Offer to pay at time of service; be very proactive.
- Always try to secure the arrangement in writing.
Out Patient Services: Laboratory, Radiology, Physical Therapy, etc….
As like hospitals and doctors, these services providers will probably offer the consumer a discount if the consumer does not have insurance.
Use the process outlined above.