We have WC but have never made a claim in order to keep costs down (don’t you love that about insurance?). My wife is a RN and we recently talking about the difference in what insurnace companies pay vs. the general public.
A thought dawned on me- since we’re a business and paying these doctors directly, should we attempt to negotiate an amount instead of paying face value? I don’t know for sure, but the bill that I recently recieved for just shy of $1,000 (by far our biggest issue to date) may have been negotiated down to a lessor amount.
Maybe Andy E’s tagline about the futility of teaching a pig to sing applies in this situation, but I think it is still interesting to ponder.
So, if faced with a bill, would you play the game?
Replies
I would absolutely ask for a discount for cash payment. I have an occasional medical bill that is out of pocket, and my doctor's office has literally called me and told me that I can pay X if I pay cash at the time of service, and a higher amount if they bill me.
From time to time I listen to a consumer advice radio show, Clark Howard.
He as long been a proponent of medical savings accounts and high deductable plans. Which often means that you are paying cash for routine medical expenses.
He has long suggested negoatiating the terms.
And it makes sense. If they are paid by insuracne then there will be a copayment and a negotiated reimbursement rate and they have to apply for that and sometime multiple times before geting paid.
With cash in hand no forms, no wait. So they should take less than what there negoiated insurance rates are.
googling found this.
http://www.healthsymphony.com/bluenote2.htm
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Hey every group has to have one. And I have been elected to be the one. I should make that my tagline.
After carefully tracking my dentist charging fees per hour my bottom line fees were 800 per hour. Now I know many here will laugh hard at this figure but it is accurate. This did not include his assistants time which was usually the majority of it.
I know all about his overhead, and cost of his education, but 800 per hour?
Health care is a serious issue...It is not going away. I feel many of us will spend enormous amonts of our savings for marginally effective health care. BillHartmann stay healthy and continue listening to Clark Howard.
From what I've heard, it's good practice to ask for a detailed bill, and then ask for discounts if you're paying cash. Of course, it can be kind of like the homeowner who wants an itemized estimate so they can question the markup on the light fixtures, but within reason it would be good practice.
I think you'll get farther by negotiating before you get the treatment, if it's not an emergency. You can make sure the doc knows that you'll be paying cash, you'd like a discount, and you'd like to hear about other cost saving measures that might exist.
zak
"When we build, let us think that we build forever. Let it not be for present delight nor for present use alone." --John Ruskin
"so it goes"
Having just finished paying off 87k in medical bills I found that I could always get 25% off just by asking and if it was a large sum (51k was my largest) I could get a little more. But 25 seemed to be the going rate for cash/pay it right now payments. I would always ask. The only bad answer is no and it will only take a second for the question so no time or effort is lost. DanT
Dan, how did you get caught with 87k out of pocket expenses?!! Was there a hole in your coverage or did you get caught with some insurance lapsed?
I'm not trying to be nosy, but if this is going to happen to me, I want to try to fix it (the coverage) or at least be ready for it if something dreadful happens.
You already went through hell, i"m sure it doesn't help to be facing 87k in medical bills!
blue
We had (have) a managed care carrier. When you are out of their negotiated area they pay the rate they would in your area. Not the rate in the area of your accident. We also hit some of the limits of the policy. I would have never guessed that was possible but it is.
I was able to get it down to right at 64k. The total bill before insurance was just under 400k. My wife was in the Special Trauma unit that has a nurse per patient. Personally it agravates me to have someone b*tch after the fact at the price of good care. They really worked hard to save her and treated me with all the respect and care someone could ask for given the situation. I am not thrilled to pay the money but once negotiated down I am glad to pay for what I consider the best care we could have gotten, even though it didn't work.
I know many won't share that view. But I am grateful to feel as though all that could have been done was done and they were also decent enough to level with me when hope ran out. So it could have been a lot more expensive and I would never have known the difference. But they told me there was little left to work with and said I might want to consider disconnecting her from life support. I did. Probably saved me from bankruptcy so I can't feel animosity toward their efforts. I paid the money and am glad to do so. DanT
Good attitude Dan. I think you are right about the whole thing.
I'm going to look at the limits of our policy. That is something that I never really thought about.
blue
PPO caught me what ever that is but I learned it only pays for a list of providers in their system which is basically what it means.
I had a heart attack and entered emergency room and they fought like hell to save me and it worked. They paid 80 percent of that .
They asked me where I wanted to go and I said well, I guess , heart hospital in Little Rock. So I get shipped there and after 38 grand before my surgery the next day DWs secretary calls her on the cell phone and says Ah, I thought you might want to know that hospital is not in out PPO. That actually means they will only pay 60 percent of their covered charges.
So the surgeon says no problem . I operate at two hospitals in LR and we will ship him to Baptist as they are in Blue Cross Blue Sheild PPO. Ill have the same team over there as here . So we did and it was done .
I was admitted in a hospital in Shreport La, in an emergency as I was having a heart attack driving down to a family reunion. Much the same deal here as Dan probably. You dont go shopping for a hospital when its life or death. It was life and out of our PPO and we paid 40 percent of that one .
So you see from the thread I made before , I dont understand what happens to people with out insurance .
Tim
So you see from the thread I made before , I dont understand what happens to people with out insurance
Bankruptcy.
I think the #1 reason for bankruptcy is medical bills.
blue"...if you just do what you think is best testing those limits... it's pretty easy to find exactly where the line is...."
From the best of TauntonU.
Dan, my condolence on your loss,
Geoff
Yes, absolutely. But you'll need to do it before you get the health services.
Have you considered a Health Savings Account (the replacement for the older Archer Medical Savings Accounts). For the self employed without eligibility for any other healthcare coverage, it is a great deal.
BruceM
I have a classmate who works for Blue Cross and Blue Sheild.
BCBS gets discounts from providers by guaranting they will get a check in 10 days from billing if they accept their prices.
My buddy does the same thing on expenses not covered by his ins.. He takes his checkbook out and offers to pay on the spot for a discount.
If you have insurance, even high deductible insurance, get the care provider to send the bill throught your carrier. You will get the bill back and the "new bill" will be at the insurance carriers negotiated rate. Do this even if you will never reach your deductible. Someone had mercy on me and that is the way it works.
Good tip. Thanks!