Consumers often feel like their medical bills are rigid, inflexible and set in stone. But that's not always true: A new study shows that patients can often gain financial benefits by disputing seemingly incorrect bills or negotiating for financial relief.
86% of consumers who do not contact their doctor to question a medical bill said they do not believe it would make a difference. – but “the experiences of those who have contacted us prove the opposite,” says a new study from the University of Southern California.
According to the study, published in August, about 26 percent of people who called because they disagreed with a charge or couldn't afford it received an adjustment to their medical bill after contacting them. About 15 percent received a price reduction, 8 percent received financial assistance and 7 percent had their bill canceled entirely.
“Most of those who came forward were able to get help through self-advocacy,” said report co-author Erin Duffy, a researcher at the USC Schaeffer Center for Health Policy and Economics.
The researchers surveyed 1,135 adults in the United States from August 14 to October 14, 2023.
About 1 in 5 respondents said they received a medical bill in the past 12 months that they did not agree with or could not afford, and about 62% of them contacted the billing office to resolve the issue.
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“If you can’t afford to pay anything, or [if a bill] If something doesn't seem right or doesn't match your experience of care, you should call and ask questions about it,” Duffy said.
The savings can amount to hundreds or even thousands of dollars, depending on factors such as the patient's health insurance and the type of doctor's visit or procedure, says Carolyn McClanahan, a physician and certified financial planner in Jacksonville, Florida.
Bills “go everywhere”
A 2023 Consumer Financial Protection Bureau analysis of medical bills for adults ages 65 and older found that patients “face a complex billing system where errors and inaccurate bills are highly likely.” Inaccurate bills often result from erroneous insurance claims and are more common among consumers with multiple sources of insurance, the CFPB said.
The most common errors included missing or invalid claim data, problems with authorization and preapproval, missing medical records, incorrect billing codes and failure to submit claims on time, the report said. Such errors contributed to the “denial of claims that would otherwise have been paid,” it said.
“[Bills] go everywhere,” said McClanahan, founder of Life Planning Partners and a member of CNBC's advisory board. “And there is no transparency or rhyme or reason as to how [providers] decide to attack.”
Doing nothing and avoiding paying medical bills is probably not a good course of action: According to a separate CFPB resource, it could have negative financial consequences, such as late fees and interest, collections, lawsuits, repossessions and a lower credit score.
“If something seems outrageous to you, ask questions,” McClanahan said.
How to manage medical bills
Consumers should ask in advance what a doctor's visit or treatment will cost or inquire about the estimated costs, she said.
Sometimes consumers pay “a hell of a lot less” when they pay cash rather than through insurance, McClanahan said. But writing a check can have other consequences, such as the amount not being counted toward the annual deductible, she added.
If you think you've been overcharged, according to PatientRightsAdvocate.org, request a detailed bill from the provider or hospital and look for errors or duplicate charges. Find out the fair market price for a service and use that information to guide negotiations, the nonprofit says.
If something seems outrageous to you, ask questions.
Carolyn McClanahan
Doctor and certified financial planner based in Jacksonville, Florida
The phone number for your healthcare provider's accounting or billing office can be found on your bill, the CFPB said.
According to the regulator, you should also ask the following three questions about your itemized bill:
- Do the fees reflect the services you receive?
- If you have insurance, do the bills reflect your insurance payment and what the provider believed was covered?
- Do some of the charges indicate that a service was “out of network” when it was not?
If you call a doctor about a medical bill, keep a journal of the communication, McClanahan advises. Write down the names of the people and what was discussed, and get assurances about when you'll receive a response.