When she came down with the stomach flu, MaryJane Sullivan, 52, was frightened -- not because she worried that the flu would do her in but rather she didn't think she could afford the trip to the doctor's office. Unfortunately, Sullivan ended up in the ER instead, as a result of dehydration.

"I got a bill for more than $10,000 for 18 hours in the emergency room," she says. Without insurance, Sullivan panicked. A friend suggested she try to "talk down" her bill. "She told me I might be able to talk to the billing department and get a discount," Sullivan says.

After months of "wheeling, dealing and pleading," Sullivan says she got the hospital to slash $2,700 off her bill. "I still owed a lot, but was grateful all the phone calls and letters shaved that much off."

Whether you're insured, under-insured or uninsured, it's possible to receive a substantial discount off the "full charge" rate when you negotiate, says Carrie McLean, consumer specialist with eHealthInsurance.com. "Some patients may even see discounts of up to 60% off the full price."

The uninsured can get as much as 20% off of a hospital bill purely by negotiating, she says. And, if you're able to pay the full tab within 30 days, they may knock off another 20% (paying the bill within 60 days could result in a 10% discount), says McLean. Offer to pay in cash and you could get another 20% off.

Even if you can't pay quickly or in cash, there are still ways to cut your medical bills.

Do your homework and act early
"Most doctors will be happy to negotiate, if not by lowering the price, at least by arranging a payment plan," says Dr. Margaret Lewin, medical director atCinergy Health, a health insurance provider.

"The ideal situation is to get a quote from your medical provider up front, shop it around, and negotiate an acceptable rate in advance, " says Jason Beans, CEO of Rising Medical Solutions, a medical cost containment company in Chicago. "Often for elective surgery or procedures [such as plastic surgery or fertility], this is normally how it's done."

Beans suggests patients research the rate Medicare reimburses a doctor for similar services. "Medicare might be too low, since they are the largest payer in the country and get nice discounts, or too high because they are the government, so they sometimes overpay. But this is a good baseline to see if your charges are reasonable or what the target range is you should try to negotiate down to," says Beans.

Hire a negotiator
If you don't think your powers of persuasion are up to snuff, there are services that you can hire to do the negotiating for you. Procedures for each medical negotiator vary, but generally speaking, they will review your bill, contact your doctor or other provider and request a lower price.

Of course, having someone do your bidding isn't cheap. But in most cases, you'll wind up paying a negotiation service a fraction of what you'd pay if they didn't intervene on your behalf.

"I paid 25% of the amount they saved me, but it was totally worth it. It took two phone calls and was very easy. I began the process with the yourinsurancenightmare.com folks by faxing my bills. They called me back with an offer from the hospital, which, naturally, I accepted." says Elaine Luther, a patient who cut a $5,000 bill down to $500.

Look for errors
"Unlike doctors' bills, hospital bills are rarely straightforward, because they can't estimate your costs prior to admission. That's why bills frequently contain errors and should not be paid at the time of discharge. You need time to go over the itemized bill in detail."

If billing errors exist or you can't understand the bill, speak with your carrier (if you have insurance) and with the hospital billing office for clarification. If you still aren't getting anywhere, you can turn to an advocacy group such as the Alliance of Claims Assistance Professionals. "Such groups are composed of professionals with backgrounds in insurance and medical billing who can negotiate on your behalf. They either charge an hourly fee or a percentage of your total bill," says Lewin.

Just keep in mind these groups aren't licensed, so you'll have to check them out carefully and do some comparison shopping.

Gina Roberts-Grey is a freelance journalist specializing in health, celebrity and consumer issues.


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Steve Hendershot

I had a $6000 bill. I had no insurance, used a service (http://www.klfinancialservices.com) they were able to lower it to $3500 which I luckily could afford. Now I smartened up and got insurance since then as well.

February 19 2012 at 3:26 PM Report abuse rate up rate down Reply