How to Negotiate With Your Doctor and Reduce Your Medical Bill

For many patients, one of the biggest decisions when finding the best possible care for their situation comes down to affordability. But what many patients don’t know could dramatically reduce their healthcare costs the next time they visit the hospital. 


Insurance companies are known for haggling with the medical facility over the cost of care. And an increasing number of individuals are realizing that the ordinary patient can bargain with the billing office, too. 


Know Before You Go

Some research and price comparison before you go in for your appointment can win you a significant amount of savings when the bill comes later. Calling the doctor’s office beforehand and asking for a list of projected fees can help you compare options. Websites such as Healthcare Blue Book are free consumer guides to show fair prices in your area for differing medical services. 


Forbes Magazine reported on one financial planner from Minneapolis who researched several different hospitals before choosing where to schedule his orthopedic surgery. This resulted in thousands of dollars in savings. 


With a list of potential fees from the hospital, patients can then call their insurance provider and discover how much they will be required to pay. Equipped with this information, you can then contact the billing department and try to negotiate. 


Check an Itemized List

If you have already had your procedure and were readmitted to the hospital after passing out from the shock of an astronomical hospital bill, then there are also some effective ways to approach the billing office and still negotiate your actual payment. 


Requesting help rather than demanding in a panic is a good way to begin approaching the office. Author of Heatlthcare for Less, Michelle Katz writes that “People are always more likely to lend a hand when you acknowledge them as fellow human beings, rather than as bureaucrats.” 


Depending on the bill, your negotiating strategy will differ. Ask for a list of charges after a hospital stay and scrutinize the items for possible errors. Hospitals will occasionally charge for included items such as towels and cotton swabs which should come with the price of a room. Extra charges for services that never actually took place or for devices that were not used can also save a bit when brought to the attention of the billing department.


When visiting the doctor in his office, come prepared with cash to pay upfront. Medical facilities are often happy to reduce the bill in exchange for quick payment upfront. “You might win as much as 50 percent off full price,” advises Cindy Holtzman, a medical billing advocate from Georgia, “if you offer to pay quickly by cash or check.”


In addition to price comparison website, there is also a growing number of companies who will negotiate on your behalf in exchange for a percentage of the savings. One such negotiator from Maine, John Gillis, the president of Insnet, claims a 75 percent success rate by being prepared with data in order to discuss specifics with billing offices. 


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Three Ways to Save Money on Health Care

1. Hire a Personal Trainer

One way to save money on health care is investing in physical fitness. People who exercise daily are healthier than those who don’t. 

Find ways to stay active. Between work and friends people have difficulty finding time to exercise. If you need motivation and lack the knowledge about fitness, then hire a personal trainer. Like doctors who design wellness plan for you, personal trainers tailor a fitness plan specifically for your health goals and needs.

They force you to work out, push you beyond your limits, and offer fitness guidance. Some people become best friends with their trainers due to the connection they establish. 

If you can’t afford a personal trainer or don’t want to pay for one, then find a workout buddy. An exercise partner acts fills the role of a personal trainer, but lacks the professional training and knowledge. They keep you motivated and you do the same for them. People exercise more consistently when they have a friend involved.

You could also join a group fitness class. Spin, yoga, zumba, Pilates, and other fitness classes are extremely popular. This will not only keep you active, but there’s a chance to socialize with other people interested in staying healthy as well.

If you like playing sports, then maybe an adult sports league keeps you moving. Adult softball, basketball, soccer, and flag football keep working professionals physically active. The small things like sports force us to stay healthier. When healthier, we spend less money on health care.

2. Take Up Gardening

Nutrition is the other aspect of overall healthy living. You need to eat healthy in addition to exercising. Without one or the other, your personal wellness approach falters.  This failure costs you money.

Some people are deterred from eating healthy since everything "organic" costs more. Don’t let the higher costs affect your eating. Instead, start a garden. Gardeners are healthier since they spend more time outside. Gardening is a physical activity in itself.  

Also, gardeners invest time in growing good natural vegetation. Their acquired knowledge in gardening translates into nutritional awareness. People who garden tend to become more aware of what they eat and where it comes from.

Local produce is less likely to contain harmful chemicals needed to preserve it over long travel distances. Eat local from your backyard, a community garden, or the nearby farmers markets.

Joining a community garden might prove a great option for people who yearn for larger plots of land and a little social interaction. The gardeners you meet at community spots will encourage you to eat better.

Eating healthy decreases the chance of sickness, prevents such illnesses as diabetes and obesity, and saves you money on health care.

3. Use Your Resources

There are a multitude of valuable health resources that saves money. A personal trainer is a great resource. They might also have nutritional knowledge that you can benefit from. 

Community gardens are excellent resources as well. There you meet people who take an active interest in nutrition. They can give you advice, guidance, and improve your eating habits.

Doctors are the best resource for saving money on health care costs.  The best doctors provide you with comprehensive primary care with the creation of a wellness plan. They dedicate their knowledge to keeping you healthy in the long run. 

This includes talking to you about fitness, nutrition, and other preventative measures that improve your overall health. Doctors with a focus on preventative care will benefit you. Their participation in keeping you healthy will reduce hospital visits and save you money.

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Healthcare Reform and Your Wellness

Significant healthcare changes started this month with more rolling out during October 2013 and January 2014. The reforms are tied into the Patient Protection and Affordable Care Act -- PPACA, or simply ACA giving consumers higher quality care at lower cost. Who is affected by the reforms? Consumers like you -- who include patients, healthy people, care givers, wage earners, retired and disabled persons, and employers. If you haven't already, familiarize yourself with healthcare and Medicare-related tax reforms. You could be better equipped to maximize every dollar you allocate to your individual and family's wellness.

Healthcare overview

January 1, 2013 federal subsidies began to be phased in for brand name prescription drugs affecting Medicare Part D benefits. The Medicare Pilot Program, a nationwide approach, encourages healthcare providers to coordinate and improve patient care. Instead of each doctor, service or hospital receiving separate payments, services are bundled and paid at a flat rate.

Now Medicaid recipients receive preventative services at zero or minimal cost, and primary care physicians (PCPs) receive increased payment for these services. In October 2013, the Children's Health Insurance Program (CHIP) receives funding. CHIP covers children not qualified for Medicaid because their families' incomes are too high. Furthermore, in January 2014, the Medicaid eligibility guidelines (eg, income) change and extend coverage to qualifying individuals and families.

January 2014 ushers in several directives affecting consumers and health insurance providers. Some middle class individuals and families become eligible for tax credits, and premium and cost-sharing subsidies to make private health insurance more affordable. Insurance providers no longer can charge higher rates and/or discriminate against consumers because of gender or pre-existing conditions. And, annual or lifetime dollar limited on health benefits will be eliminated. Government certified Health Insurance Exchanges will be established in each state to provide affordable health insurance choices to individuals and small companies (less than 100 employees).

Medicare's surtaxes and taxpayers

There are two Medicare tax structures affecting many consumers in the 2013 tax year. The first is the Medicare surtax. It is a 0.9% additional payroll tax based on earning thresholds: $200,000 for individual taxpayers, $250,000 for married taxpayers who file joint returns, and $125,000 for married taxpayers who file separate returns. When the threshold is met, it is at that point the taxpayer's employer imposes the 0.9% withholding.

Not a wage earner? You still may be subject to an additional Medicare surtax -- the Net Investment Income Tax (NIIT). It is a 3.8% tax applicable to certain individuals, trusts and estates. The Internal Revenue Service (IRS) uses your Modified Adjusted Gross Income (MAGI) and thresholds similar to the Medicare surtax (above paragraph) to determine who is subject to NIIT. All this information is meant as an overview and certainly not provided as an advisement.

Planning ahead starts today

Each health care consumer's situation is different. Whether your health status is good today or becomes chronically challenged, it's difficult to plan for actual medical needs and costs. Some consumers use pre-tax earnings for a flexible spending, health reimbursement, or health savings account. Others find increasing withholding, making quarterly tax payments, and contributions to a 401K help ease tax liabilities.

Why not take immediate advantage of what you can easily control? For example, learn everything about your existing health coverage -- even if you expect coverage to change soon. Take advantage of preventive medical services -- often, these are covered100%. Always choose in-network providers to save money. Have a high-deductible plan? Ask the service provider for the insurance company's cost, and negotiate a discount.

Do you take brand name prescription medication? Talk with your doctor about generic drugs. Often, generics are as effective as the brand but cost you less. You could be saving a lot of money over months or a year -- especially on meds taken daily. If your health insurance provider offers mail-order pharmacy, use it -- or at least try the service. Depending on the provider and prescription, a three-month supply can cost as little as a one-month supply!

It's the start of a new year. What better time than now to learn about healthcare reform and the decisions you may need to make during 2013 and beyond. It's time -- your wellness, and that of your family depend on it!

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