Consumers may feel like their medical bills are inflexible, unyielding, unmovable. But that's not always the case: A new study shows that patients can often gain financial benefits by disputing charges that seem erroneous or by negotiating financial relief.
Of consumers who don't reach out to dispute a medical bill, 86% said it's because they didn't think it would make a difference. — but “the experiences of those who did come close provide evidence to the contrary,” according to a new study from the University of Southern California.
According to the study, released in August, about 26% of people who called because they disagreed with a charge or couldn't pay it got a correction to their medical bill after the call. About 15% got a price reduction, 8% received financial assistance and 7% had their bills canceled entirely.
“Of the people who reached out, the majority obtained some recourse through self-advocacy,” said report co-author Erin Duffy, a research scientist at the USC Schaeffer Center for Health Policy and Economics.
Researchers surveyed 1,135 American adults between August 14 and October 14, 2023.
About 1 in 5 respondents reported receiving a medical bill they disagreed with or couldn't pay in the previous 12 months. About 62% of them contacted the billing office to address the issue.
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“If you can't pay for something, or [if a bill] “If something doesn't seem right or doesn't match your care experience, you should call and ask questions about it,” Duffy said.
Savings can reach hundreds or even thousands of dollars, depending on factors such as a patient's health insurance and the type of medical visit or procedure, said Carolyn McClanahan, a physician and certified financial planner based in Jacksonville, Florida.
Bills are “going everywhere”
A 2023 analysis by the Consumer Financial Protection Bureau of medical bills for adults 65 and older found that patients “face a complex billing system with a high likelihood of errors and inaccurate bills.” Inaccurate bills often result from erroneous insurance claims and occur more frequently among consumers with multiple sources of insurance, the CFPB said.
Common errors included missing or invalid claims data, authorization and precertification issues, missing medical documentation, incorrect billing codes and late claims submission, the report said. Such errors contributed to “denial of claims that otherwise would have been paid,” it said.
“[Bills] “Pricing is all over the place,” said McClanahan, founder of Life Planning Partners and a member of CNBC's Advisory Board. “And there's no transparency or logic or reason to how it's done.” [providers] decide to charge.”
Doing nothing and avoiding paying medical bills is probably not a good move — it could lead to negative financial consequences, such as late fees and interest, debt collections, lawsuits, garnishments and lower credit scores, according to a separate CFPB resource.
“If something seems outrageous to you, ask questions,” McClanahan said.
How to manage medical bills
Consumers should ask up front how much a medical visit or procedure will cost, or ask what the estimated cost will be, he said.
Consumers sometimes pay “a lot less” if they pay cash rather than through insurance, McClanahan said. But writing a check could have other consequences, such as the amount not being counted toward the annual deductible, she said.
If you think you were overcharged, request an itemized bill from the provider or hospital and look for errors or duplicate charges, according to PatientRightsAdvocate.org. Research the fair market price for a service and use that information to negotiate, the nonprofit group said.
If something seems outrageous to you, ask about it.
Carolyn McClanahan
Physician and Certified Financial Planner based in Jacksonville, Florida.
The phone number for your medical provider's accounting or billing office will appear on your statement, the CFPB said.
According to the regulator, here are three other questions you should consider asking about your itemized bill:
- Do the charges reflect the services you received?
- If you have insurance, do the bills reflect your insurance payment and reflect what the provider understood would be covered?
- Do any of the charges indicate that a service was “out of network” when it was not?
When you call a provider about a medical bill, keep a record of the communication, McClanahan said. Write down the names of the people and what was discussed, and get a commitment of when you'll hear back.
