For the past couple of years, I’ve been putting off getting a bone-density scan, despite my doctor’s urgings. I have made efforts to bolster my bones (vitamin D, calcium, strength-training exercises) and haven’t broken any since my last scan six years ago, so I figured I didn’t need a new test. And I’ve been hesitant for another reason: Money.
My doctor wanted me to get the scan done in his office, but he’s not in my health insurer’s network, so it would've cost me $400. Not surprisingly, I decided to wait. But when a podiatrist recently said I had a stress fracture in my right foot, I knew it was time for another scan.
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How I Saved $200 on a Bone Scan
After checking around, I learned I could get it done nearby for less. So I asked my doctor if he’d reduce his price. He agreed pretty quickly, trimming $200 off the $400 fee, and I had the scan done in his office. Fortunately, my bone density had changed very little — and it turned out I didn’t have a stress fracture.
This experience taught me a valuable lesson about health-care costs: Sometimes you can reduce your doctor and dentist bills simply by asking.
Knowing how to negotiate medical costs can be especially useful this time of year since your annual deductibles have just started up again and you’ll be on the hook for out-of-pocket expenses until you cross the deductible thresholds.
Why It Pays to Speak Up
So the next time you’re visiting your doctor or dentist, remember this succinct advice from health-care-affordability expert Mark Rukavina of Community Health Advisors in Boston: “Many providers will negotiate on price — but generally not if people don’t ask.”
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Physicians and dentists (hospitals too) are used to negotiating. You can have the conversation up front, before the medical visit or procedure. Alternatively, if you get the bill and believe the fee was excessive or can’t afford it, you can try bargaining it down at that point.
Reluctant to talk dollars and cents with someone in a white coat? Don’t be, says Victoria Veltri, Connecticut’s health care advocate.
“Consumers need to become more assertive, change their mindset and review their medical bills just as they scrutinize their utility bills,” Veltri says. “People need to feel empowered to talk to their doctors and say, ‘I trust you as a medical provider, but I also have financial concerns.’”
6 Ways to Negotiate Doctor’s Bills
Here are six ways to negotiate effectively:
1. Do your research. If you need a medical or dental procedure, find out the going rates in your area, so you’ll have ammunition for bargaining.
Ask your doctor or dentist for the precise name of the procedure and, better yet, its billing code, known as CPT (that stands for “current procedural terminology”). Some procedures may involve more than one code; my bone-density scan had two.
Fortunately, the Internet has made it easier to research the cost. A handful of excellent sites provide local averages or a range of fees charged by nearby providers. Three worth checking out: FAIR Health, Healthcare Blue Book and New Choice Health.
If you have health insurance, call your provider to find out what your policy will and will not cover, as well as how much your out-of-pocket costs would be. Your health insurer or your company's human resources department may also offer Web tools that help you estimate what you’d pay at local providers.
2. Talk frankly and politely to your doctor about fees. Ask how much you’d be charged and whether there’s any room for accommodation. If you’ll need to have a procedure done and your doctor’s fee seems out of line with what you’ve found online, provide the figures you’ve seen.
If you’re too shy to talk money or your doctor refuses to discuss such things, ask the practice’s billing manager to explore potential discounts with you. Tell that person if you're not insured (a fact of life for many dental patients these days) or if your policy won’t pay for the particular procedure or whether you’ll need to shell out your own money because you either haven’t met your deductible or you've exceeded the plan’s maximum coverage.
Doctors often automatically charge patients without insurance more than what their insured patients pay since insurers negotiate lower rates for people they cover. So if you are uninsured, see if you’d be allowed to pay the insured-patient fee. “Many providers will give discounts, but you have to ask,” Rukavina says.
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3. Inquire about getting a lower fee for paying the entire bill up front. Prompt-pay discounts are often in the doctor’s interest because they reduce paperwork hassles and financial uncertainties. Some medical professionals offer 10 to 30 percent discounts for patients who ante up within 30 days, Rukavina says.
4. Ask about an extended payment plan. See if you can spread out payments over a year, interest-free. Many doctors and dentists are willing to do this and it’ll save you the interest you’d incur by putting the bill on your credit card.
5. Inquire about payment-assistance programs. Even though your income may be well above poverty level, don’t assume you won’t qualify for financial aid for your medical expenses.
Many programs — public, private and nonprofit — help families shoulder their doctor bills regardless of income, especially those facing high medical bills in a given year.
Ask your health insurer and doctor’s office if they can point you in the right direction. The federal government’s website, Healthcare.gov, and the nonprofit Needymeds.org offer useful guidance on patient assistance programs.
At Healthcare.gov, go to the "Get Help Using Insurance" section and click on "Free or Low-Cost Care." Needymeds.org is especially helpful for finding programs to reduce your medication costs.
6. If all else fails, contact a healthcare advocate. Sometimes it’s easier to have somebody on your side to do your negotiating, Veltri says.
Some states, including Connecticut, Rhode Island and California, have offices staffed by health care advocates. There are also nonprofit groups, like the Patient Advocate Foundation, that will negotiate on your behalf for free or a small fee.
Remember: Your health is too important to skimp on getting necessary care because of its cost. If you believe a medical fee is too high or simply unaffordable, make the effort to negotiate. There’s a good chance you’ll be successful.