How can consumers obtain a discount for paying a medical bill in full and on time? How much of a discount should they ask for?

First, patients should try to negotiate a lower price for non-emergency tests and procedures up front.  When dealing with bills post medical event, patients should request itemized bills from all healthcare providers and check them against the EOB (Explanation of Benefits) provided by the insurance company.  The patient can also request that the billing departments and the insurer do an internal audit or review of the bill for accuracy.  After this has occurred, the patient can try to negotiate a lower cost for each bill.

After the individual has completed an attempt at negotiation, he/she should ask what the cost would be if he/she paid the bill in full. The amount can be as much as 40% less or more. If they want to only discount it 10%, it might not be worth it to pay up front.

If the bills are far more than the individual can pay even after negotiation, you can always ask for a payment plan to spread the debt over time.

How likely is the provider to offer a discount? Does the amount and likelihood of a discount vary by provider type?

It all depends. If the bill is small, there’s not typically a lot of room for the provider to negotiate. Pharmacies, hospitals and doctors will negotiate. You’re always in better position if you negotiate prior to the test/procedure rather than after it. With that said, you will get no discount if you do not ask.

How common is it for a health care provider to leave a patient’s network without either the provider or the insurer notifying the patient?

Sadly, it is quite common, especially with patients who have individual or small business policies. The insurers are trying to make as much money as possible, and look to shrinking networks to improve their profit margins. Always call ahead and check to see that your provider is in your network prior to receiving any non-emergency test/procedure/exam.

Why do preferred providers leave or get dropped by insurance networks?

In a word, profit. If the insurer feels that dropping a provider will help them control costs, the insurer will do so.

What are the most common medical billing errors consumers experience and why? How can consumers spot these errors?

Unless you have expertise in medical bill coding, it is extremely difficult for the average person to find a medical bill error. The best way to protect yourself is to insist on an itemized bill. You can look at the bill and see that you received all of the elements that the provider claims you did. Coding errors, which are quite common, take an expertise to find and most people won’t know how to determine if those errors have occurred.

Why don’t providers send patients itemized bills?

Healthcare providers are supposed to send itemized bills, but many still don’t. Every patient should request itemized bills, and check them against the EOB (Explanation of Benefits) providd by the insurance company.