Got a medical bill that seems too high? First step: Ask if there’s been a mistake. Next step, fight back.
The tips below come from a dozen experts in law, medical billing and patient advocacy.
They agreed on many points, including this frustrating one: None of these strategies is guaranteed to make a big — even blatantly excessive — medical bill go away. They represent a scattershot approach for people with urgent bills now — who can’t sit around and wait for Congress to pass reforms to medical billing.
‘Don’t just let the bills pile up and don’t just ignore them.’
George Nation, a professor of law and business at Lehigh University, says your biller can argue later that you never contested the charge and essentially admitted you owe it.
“Put in writing (to them) that you’re contesting the bill, that you’re saying it’s unreasonable,” he says. “That it’s too high and that you would like to discuss how they came about this amount and what a reasonable amount would be.”
You don’t necessarily owe what the biller says you owe.
You got an appendectomy. The folks at the hospital deserve to get paid. But how much? They asked you in advance to sign a form that might look something like this, effectively promising to pay the eventual bill. But they didn’t give you a price.
Duke University professor of law and business administration Barak Richman says that’s an incomplete contract. So you can push back if the bill is outrageous.
“They are not allowed to extract an extraordinary price based on a contract that leaves no price specified,” he says.
Investigate the market value of your care.
Under contract law, the justifiable price in this situation is market value, professors like Richman and Nation say.
So you want to know the market value for a treatment or procedure — what hospitals normally get paid for, say, an MRI in your area. What price do they agree to with insurers when they strike in-network deals?
Some websites help you explore the going rate near you. Check out the Health Care Cost Institute and its Guroo site. Try Healthcare Bluebook and FAIR Health. Check what Medicare would pay, too.
Then call your biller and negotiate.
