Personal finance

Can you negotiate your COVID-19 hospital bills? | Smart Change: Personal Finances

Kate Ashford

Since health insurance companies have rolled back waivers for COVID-19-related hospital charges, a COVID-19 hospitalization could result in a surprisingly high bill from healthcare providers, according to a recent study by the University of Michigan and Boston University.

Among people who had private insurance from March 2020 to March 2021 and were billed for a COVID-19-related hospitalization, the average out-of-pocket expenses was nearly $4,000. Among people with Benefit of Medicare, the average bill was around $1,600. This included hospital care and medical services.

It can be stressful dealing with a high medical bill for something beyond your control, especially if a case of COVID-19 has kept you from working for a while or left you with lingering health issues. However, hospital bills can sometimes be adjusted or negotiated down. Here are some strategies you can try.

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Organize your COVID-19 hospital bills

Gather your documents, including all your bills, your insurance card, and any explanations of the benefits you received. Review your COVID-19 hospital bills and be sure to acknowledge all charges.

“Do you remember having that MRI?” says AnnMarie McIlwain, CEO of Patient Advocators in New Jersey. (Patient advocates help clients with medical issues, from finding the right treatment to dealing with billing and insurance issues.) “Have you actually talked to that gastroenterologist? There are often charges on bogus invoices, which shouldn’t be there.

Also check that each claim appears to have been handled correctly by your insurer. Typically, a processed claim will show a plan reduction and allowed claim amount, as well as any plan payouts if you have reached your deductible for the year.

“If you don’t see a payment or adjustment, there’s a chance they haven’t filed,” says Jennifer Kastner, owner of Patient Advocacy Solutions in Georgia. Your insurance may also have denied the claim, so follow up with your insurer before you start working for a bill adjustment.

To note: An Explanation of Benefits, or EOB, is a statement from your health insurance company that tells you how the company covers the medical care you received. It’s not an invoice.

Find out about financial aid

If you’re dealing with a larger medical bill than you can handle, call the hospital’s billing office and ask if you qualify for financial aid or financial assistance. This is sometimes called charitable aid.

“The worst they can say is ‘No,'” says Caitlin Donovan, spokeswoman for the Virginia-based Patient Advocate Foundation.

If you’re considering asking for help, you’ll need some basic financial numbers. “You’re going to generally want to know how much you make in a year, what you can afford to pay per year, and what you can afford to pay upfront,” Donovan says.

You can also inquire about a payment plan, which will allow you to pay your hospital bill over time. Typically, these don’t charge interest, so it’s a better option than putting large medical bills on your credit card or taking out a loan. “You won’t have to worry about medical bills showing up on a credit report, which isn’t what you want,” says Donovan.

Just make sure you can handle the monthly payment for the long term. “You don’t want to end up in a situation where you can’t afford to pay that bill and it ends up going into collection, or you end up cutting corners in other parts of your life where you don’t really shouldn’t,” Donovan said.

Offer money

If you are able to offer cash payment for a significant portion of the balance, give it a try.

“Cash is a word they like to hear in the billing office, and if you’re willing to pay something quickly and in cash, they’ll sometimes give you a percentage off,” McIlwain says. “I would say 20% [off] would be a good number to suggest.

That said, McIlwain says if you feel like the bill seems too much to handle, you probably aren’t able to make an 80% payment on the balance.

Call in person

If you’re dealing with a bill from a local hospital and need help, see if it’s possible to get to the billing office or billing counter.

“It’s a lot harder not to have compassion for someone when they’re standing in front of you,” McIlwain says.

If you can’t go in person, do your best to stay calm on the phone. Try to make the person on the other end of the phone your ally in your journey to solving this problem. Getting upset or angry is a natural reaction, but it won’t help. “They’re more likely to try to get you off the hook quickly when you let emotion get the better of you,” McIlwain says.

Keep good records

Once you start this process, keep track of each step. Write everything down in a notebook or keep a digital document or spreadsheet with a note about every phone call, every letter sent, and every person you talk to (and what they say). When you send a message through a patient portal, write it down. The better your records, the better you will be able to explain how diligently you worked to take care of your bill.

Another tip: when talking to the insurance company, always ask for a reference number.

“These people get tons of calls a day,” says Kastner. “You want to have reference numbers to refer to.”

Hire help if you need it

Sometimes, no matter how hard you try, you can’t pay a crippling medical bill, or find it too overwhelming. A patient advocate may be able to help. This is someone who can make phone calls on your behalf – to your medical providers, hospital, insurer and any other parties that may be involved. Typically, patient advocates are experienced in areas such as health care, insurance, and medical billing.

Prices may vary for this. Some organizations charge a flat fee, while others charge a percentage of what they save you. the Patient Advocate Foundation is free for patients suffering from a serious or chronic illness.

“One of the problems with the whole system is that we’re talking about people who are sick, tired, and struggling with new diagnoses,” Donovan says. “And we ask them to do a lot of work. So asking for help, whether it’s just having a family member on the phone or asking a professional to help you, is always a good idea.