Bargaining Down Medical Bills

Bargaining Down Doctor Bills

ByColumn By Elisabeth Leamy
September 14, 2010, 1:01 PM

Sept. 14, 2010— -- The economy continues to have a case of the flu, and if you have one too, you may be considering skipping a trip to the doctor. A recent poll by the Deloitte Center for Health Solutions found that one out of every five Americans surveyed decided not to get medical treatment when they were ill or injured. In some cases that could be a tragic decision, so I'm here to tell you that there is another way: negotiate with your doctor or hospital for a lower fee.

Another poll, this one by Harris Interactive, found 61 percent of people who negotiated with a doctor were successful in getting a lower fee, but only 12 percent had ever tried! And many hospitals offer deep discounts too, as much as 10 to 50 percent off.

So, where to begin? Problem is, if you're negotiating for a toaster at a garage sale you know what you're willing to pay for it. And if you're negotiating for a new car, there are dozens of websites that will tell you how much it should cost. Well, turns out there are sites that tell you how much different medical procedures should cost too. Once you have a feel for a fair price for a service, it's much easier to approach the doctor or hospital.

That's where comes in. The site lists what it deems the "fair price" for a medical service, which you can look up by key word. That price is based on the "contracted rate" or "allowed amount" that insurance companies are willing to pay for the same service. As you probably know, most doctors agree to accept a discounted price when they join an insurance company's Preferred Provider Organization or PPO. It can be two to five times less than the doctor's regular rate.

"Most patients would never expect that a common test or procedure might cost $500 at one office and over $3000 at another," said Dr. Jeff Rice of "Most patients have had insurance that limited the amount they had to pay regardless of the total price. You can literally save $1000s by simply asking about prices and checking around."

Now Healthcare Blue Book has gotten a huge boost, through a partnership with the giant service review website, Angie's List started by offering consumer reviews -- always non-anonymous -- of contractors and mechanics and is now applying the same grass roots principle to healthcare. So, you can go to the site and read unvarnished reviews of doctors or hospitals you are considering and then click through to find out how much you should offer them for the care you need.

Angie's List founder Angie Hicks was inspired to partner with Health Care Blue Book after finding a $1,000 overcharge on one of her own medical bills. By being vigilant and making a few phone calls, she saved a thousand bucks.

"It's not enough, though, to try to negotiate on medical costs if you don'tknow the going rate first," Hicks said. "That's why we got involved with the Health CareBlue Book. It empowers health care consumers with more information onacceptable medical rates going in, so they are able to bargain from aposition of strength and better their chances of successful negotiation."

If you want to double your chances of success, another tactic is to look up what Medicare pays for the medical procedure you need. Just ask the doctor's office or hospital for the "CPT Code" or Current Procedural Terminology Code. CPT codes are developed by the American Medical Association to describe every medical service. Type that code into the CPT search section of the AMA's website, here. You must search the correct code plus the city and state where your doctor is located to get an accurate price, as Medicare prices vary regionally. Between the insurance company rate Healthcare Blue Book provides and the Medicare rate you can learn from the American Medical Association, you have good numbers to make your approach. Now, here's more advice for a healthy success:

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