Sixteen percent of Americans unable to pay medical bills, according to Consumer Reports’ Trouble Tracker Index

October 24, 2011April 13, 2012 admin

Medical Cost Advocate recently appeared in the September issue of Consumer Reports. One of the key points of this article is the assertion that consumers should line up a medical billing advocate or their own alternatives proactively. Don’t wait until its too late to do your research and find a health care negotiator.

Consumer Reports: How to Haggle With Your Doctor or Hospital

YONKERS, NY — When we visit our doctors, we don’t typically think of ourselves as “consumers” or buyers of health care, but in these tough times, that is precisely the role a patient needs to play to avoid drowning in a sea of medical bills. What are the best strategies for haggling with your doctor or hospital? A new report in the October issue of Consumer Reports and online at www.ConsumerReportsHealth.org features advice from Consumer Reports’ medical expert and M.D., John Santa.

According to the latest Consumer Reports Index, which gauges the health of the economy from the consumer perspective, 16.3 percent of Americans are unable to afford medical bills.

“Americans are overwhelmed by health costs and many people simply can’t pay their bills, can’t afford their medications,” says John Santa, M.D., M.P.H., director of the Consumer Reports Health Ratings Center. “The last thing most patients want to do is haggle with their doctors, but a little bit of negotiating can go a long way. It’s also important to know that there are tremendous variations in health care costs—knowing this can help a consumer get a hand up and politely insist on the fairest possible price.”

Here’s Consumer Reports’ advice for three possible scenarios:

You’re healthy.The optimal time for patients to talk with their healthcare providers about costs is before any have been incurred. While doctors have a professional obligation to take a patient’s financial resources into account, patients should raise the issue with their doctors to let them know that costs are important to them. “For a variety of reasons, doctors are likely to suggest the most expensive options first. But you might be surprised by your doctor’s willingness to change course, for example prescribing fewer expensive brand name drugs or choosing watchful waiting over a costly diagnostic test,” says Santa.

The unexpected occurs. A patient lands in the hospital without the benefit of any planning and gets slammed with a huge bill, say $15,000 for a coronary angiogram, and insurance ends up covering only a fraction of the bill. Consumer Reports recommends these approaches to get the greatest reduction to their bill:

Sit down with the doctor who ordered or performed the hospital services to find out how the hospital costs ran so high. Were all the services needed and reasonably priced? Consumers can judge for themselves by checking www.healthcarebluebook.com which lists the going rates for many medical services for free. Closely examine each bill to identify errors, which are common.
Consumers should not assume the price on their bill is set in stone. Providers often discount rates substantially to insurers and others, so why shouldn’t a consumer ask for the same rate reduction? Consumers should dispute any charges they think their insurance company ought to cover.
Patients should not pay their bill until they have exhausted all of their options, but they should make clear to the hospital’s billing department that reaching a resolution is important to them. They might consider making a discounted offer they think would be manageable within a set time period. Consumers can consult one of the reputable groups that, for a fee, can help reduce the size of medical bills, such as Medical Cost Advocate (localhost/wp1).

You’re having an elective surgery. This situation allows for more planning and research into the best procedure, doctor, hospital, drug or other option. “Use your time wisely to do the research because variations in health-care costs can be significant, and providers will gladly let you overpay for a service that you could get for less,” says Santa. Keep in mind the following advice:

Consumers should shop around, talk to different providers, and bargain for what they think is a fair price.
Consumers shouldn’t hesitate to ask for the price upfront and get it in writing. Request an itemized list of all potential charges.
As with any purchase, consumers should beware of any offer that sounds too good to be true. If a provider suggests a shortcut, be wary and ask a lot of questions, and check out providers that are unfamiliar.

Care costs continue brisk growth in 2011

May 16, 2011 J Roberts

Another study revealing the ever increasing rise in healthcare costs. Tell us something we don’t know. Will costs ever level off and maybe even decrease or is that just wishful thinking? At this point, I’ll take no increase over the double digit rise in premiums and the greater out-of-pocket expense. Americans continue to pay more and get less. What’s wrong with this picture?

By Tom Murphy

AP Business Writer

Health care costs have more than doubled for some American families over the past nine years, and they show few signs of dropping, according to a

The employee portion of costs paid for a family of four covered by the most common form of employer-sponsored health insurance will climb to a projected $8,008 this year from $3,634 in 2002. That amounts to an additional $84 a week from household budgets for health care.

Preferred provider organization plans are the most common form of employer-sponsored coverage.

The rise in health care costs is slower in 2011 compared to recent years, but they are still rising much higher than costs in other consumer areas, said consulting actuary Lorraine Mayne, one of the report’s authors.

“We don’t see anything on the near-term horizon that’s going to bend that downward,” she said.

The consulting firm compiled its annual health care cost measurement, known as the Milliman Medical Index, by studying provider fees, benefits and average health care use in all 50 states. Health care costs include insurance premiums for health care and other costs that come out of an employee’s pocket like co-payments, deductibles and co-insurance payments.

Employers still pay most of the total health care cost for families, but Milliman said the portion paid by the worker reached an all-time high of almost 40 percent this year.

Counting employers’ contributions, this year’s total health care cost for a family of four more than doubled to $19,393 from $9,235 in 2002. The 2011 figure represents a 7 percent increase compared to 2010.

Health care costs are rising mainly due to price increases in categories like pharmacy, inpatient or outpatient hospital care and doctors’ office visits. Mayne said these charge increases are a bigger factor than changes in health care use.

The national health care overhaul, which started unfolding last year and aims to eventually cover millions of uninsured people, had virtually no impact on health care costs for this year, Mayne said. She also doesn’t see the new law having any “direct, immediate impact” on the trend.

The Milliman report revealed nothing surprising to Helen Darling, CEO of the National Business Group on Health, a non-profit organization that represents large employers on health care issues. Darling, who was not involved in the study, said it offers more evidence of the “serious economic and financial dysfunction of the health care system.”

“The health care system continues to outstrip everything in its growth,” she said, noting that the economy “simply can’t support this kind of expense.”

Milliman said the total for health care costs varies around the country and doesn’t represent the total for all health care plans. Variables like costs and use can differ for government-sponsored Medicare and Medicaid coverage or other forms of commercial health insurance.

Control of health costs up to you

May 11, 2011May 13, 2011 J Roberts

By Robert Nelson WORLD-HERALD STAFF WRITER

Medical Cost Advocate is in the news. This time CEO, Derek Fitteron talks with a reporter from the World Herald about consumer medical liabilities. Read on to learn how Medical Cost Advocate can assist you in reducing some of those large medical bills.

I recently had part of my neck rebuilt with corpse bone and titanium. A week ago, the itemized bill arrived for my surgery.

At the end of page 4, I found the “sub-total of charges”:

$48,303.44.

The only charge that seemed to have any connection to any free-market reality was about $15,000 paid to the world-class spine surgeon.

Well, OK, the nurses certainly deserved to be paid well. And the room was comfortable and modern. From arrival to departure, my stay was Nebraska-friendly with German-like precision.

And I guess the fellow who managed to keep me between oblivious and oblivion during surgery should be well compensated also.

But still, outrageous.

Especially when you start digging into the “smaller” charges.

I paid $369 for what must have been a very special dose of vitamin D. Something that covered my feet was $149.28.

I see a $16 charge for a pill I have been taking every night for several years at a cost of 8 cents per pill.

Seventy-five itemized charges.

Including $1,200 for each of six titanium screws used to bolt down two small titanium plates that cost $4,918.

Feeling disconnected from the free market, I went online, joined a medical trade organization, identified the eight pieces of medical-grade titanium alloy in my neck and then emailed one of the manufacturers of the equipment in China – Zhejiang Guangci Medical Device Co. – requesting a price quote.

I’m not a doctor, or an international importer, but I’m pretty sure my sources in China could get me identical parts to those in my neck for under $50.

It’s apples to oranges for all sorts of reasons, not the least of which are the huge costs of making sure safe objects are put in your body by the right people using the right equipment.

Still, I feel ripped off.

“A lot of what you’re seeing in that bill is you paying for all the people who can’t pay,” said Derek Fitteron, president and CEO of Medical Cost Advocate localhost/wp1, a New Jersey-based company made up of health care attorneys who negotiate with providers to lower the bills of patients they represent.

“Most of the problem really isn’t greed,” he said. “You’ve got a host of reasons that drive even those providers with only good intentions to give you bills that look outrageous.

“You might notice that some of those numbers that seem outrageous to you are even a negotiated price that your insurer has agreed to.

“That doesn’t mean a provider isn’t going to try to make you the person who covers the extra costs they’re seeing or the debts they aren’t getting paid,” he said.

His company makes its money because his staffers know the wholesale prices and going rates for all things medical.

His people argue with the provider. Then, like an attorney who wins a settlement for a client, his company takes a percentage of the money it saved the client.

Fitteron said that controlling outlandish medical costs ultimately is up to the consumer. You need to study the details of your health coverage. You also need to discuss with the provider the costs of a procedure prior to having the work done, he said.

“It’s the old adage: Five different people walk into the hospital with the same problem, and all of them pay vastly different amounts to get the problem fixed,” he said. “You have to be a smart and savvy shopper to be the one who pays less.”

Less? I asked. Seems like the wrong word choice considering the huge numbers.

“That’s a relative term,” he said. “That’s ‘less’ of an increasingly huge amount of money.”