help with hospital bills

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

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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.

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Doctors tack on ‘a la carte’ fees for patients

J Roberts

It appears that physicians are now charging ‘a la carte’ fees for services not traditionally covered by insurance or Medicare. The extra fees mean greater out-of-pocket costs for consumers. Read on to learn more.

By Alison Young • USA TODAY •

A growing number of doctors across the country are boosting revenue by asking patients to pay new fees for services they say insurance doesn’t cover, insurance and physicians’ groups say.

The extra payments include no-show fees of $30-$50 for missed appointments, widely varying charges for filling out health forms for school, work or athletic teams, and annual administrative fees of $35-$120 or more to simply be a patient in some practices, medical associations and doctors say.

“It’s not unlike the airlines,” said William Jessee, president of the Medical Group Management Association, which generally advises against extra fees that may anger patients or run afoul of insurance contracts. “They’ve gone from all-inclusive to a la carte. That’s what you’re seeing with physicians.”

Doctors who charge extra fees are in the minority, he said. Some have done it for years, but more are joining them because they say they need the fees to offset the rising costs of practicing medicine.

Allen Greenlee, an internist in Washington, sent a letter in March to 7,000 patients in his group practice asking for a voluntary $35 annual administrative fee for costs insurance didn’t cover. He said he got only two angry letters and dozens paid extra to help others. “I’m trying to stay solvent,” he said.

WellPoint, the nation’s largest insurer by membership, is receiving more inquiries from doctors seeking to charge annual administrative fees.

“We have seen some increase in that type of activity,” said John Syer, a vice president over provider contracting at WellPoint, which operates 14 Blue Cross and Blue Shield plans. “The vast majority do not engage in that,” Syer said, noting such fees may violate provider agreements if doctors charge for items insurers consider included in their payments.

Though no national data are available on how many practices charge extra fees, Jessee said primary care doctors face increased financial pressures as insurance reimbursement hasn’t kept pace with costs. The result has been a growing shortage of primary care physicians as medical students choose more lucrative specialty fields. Primary care is critical to the nation’s new health law, which will give 32 million uninsured Americans coverage.

Office visits are the main source of insurance payments to primary care doctors, yet physicians spend much of each day on activities they’re not directly compensated for, such as phone calls and prescription refills, a study in The New England Journal of Medicine in April found.

“A lot of doctors are trying all kinds of experimental things just to survive,” said Gary Seto, a doctor in South Pasadena, Calif., who charges an annual $120-per-family “non-covered benefits fee.”

Sue Braga of the Arizona chapter of the American Academy of Pediatrics said she’s hearing of more practices charging for no-shows and health forms.

Susan Wheeler, 33, said her kids’ pediatrician near Atlanta recently started a $10-per-child form fee. “I don’t like it,” she said. “It’s part of their job.”

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