Why is My Hospital Bill So High? Final Part: 5 Ways to Pay Your Bill

There is hope. You don't have to move to Mexico.

There is hope. You don't have to move to Mexico.

In this last installment of the series, we finally get to the question that many people need answered – “How do I pay my ridiculously high hospital bill?”

Seriously speaking, huge medical bills are one of the three most common reasons that drive people to bankruptcy and about 75% of those who did go on to bankruptcy had insurance at the time (2001)! With our current financial melt-down driving more people to be uninsured these figures are sure to be even more tragic.

To get a basic idea of what a typical hospital admission cost for an uninsured person, the Healthcare Cost and Utilization Project published their study in Feb 2009 that showed:  “Hospital charges for uninsured stays grew by 76%, from an average of $11,000 to $19,400 per stay (after adjusting for inflation), compared to 69% growth in hospital charges overall.” And this doesn’t typically include ambulance fees or things like ICU or emergency surgery.

So for the average person barely staying afloat in troubled financial waters, getting that $20,000 medical bill has led some to even consider suicide. But it doesn’t have to be that bad thankfully.

Just a few weeks ago, I met Margaret when contacted me after having to take her son to the ER. It was a traumatic and overwhelming event for her when she watched her 5 year old vomit and then his eyes rolled up into the back of his head and he became unconscious.  She immediately called 911 and EMS took the boy to the closest ER where he was intubated (was put on a breathing tube) and then flown out by helicopter to the Children’s Hospital downtown. There, he spent 3 days in the Pediatric ICU where he had a CT and MRI of his brain, a spinal tap as well as numerous blood tests. Thankfully, he was released in good condition 4 days later without any exact diagnosis for his episode.

The most important thing was that her son was ok, but since Margaret had no medical insurance, she knew even before getting the bill that it was going to be a bear – a really big, hungry and mean Grizzly bear. She didn’t exactly qualify for medicaid due to her income either. Worried and overwhelmed, she tried to get answers before the bills came which was the right thing to do. Her story thus had another good ending that she found some clever ways to lower her son’s bill (which incidentally was about $67,000) to something more manageable. Here are a few tips:

1. Remember that hospitals and doctor’s offices are HAPPY to work with someone who actually wants to pay. they spend enough time tracking down people who have ignored bills that they will gladly work with you. Even if you cannot reduce your bill, you can always pay monthly installments without interest. I personally know people who have arranged to pay as little as $50/month and less after a childbirth for example.

2. If you can pay a substantial downpayment – say for example 10-25% of the bill – this can make even the greediest hospital ready to negotiate a lower total bill. And again, the rest can be paid monthly. You will have more success with this step as with the first, if you contact them before the creditors come knocking on your door.

3. Always, always ask for an itemized bill and challenge what you see. Mistakes in this area are exceedingly common and you can always find something wrong. A medicine you were charged for that you never got, a box of tissue that you never used, a pregnancy test for your husband or a new set of spark plugs for your doctor’s Corvette. Ok, that last one you probably won’t find, but just wanted to be sure you were paying attention.

Authors at Bankrate.com report, “Estimates on hospital overcharges run up to $10 billion a year, with an average of $1,300 per hospital stay. Other experts say overcharges make up approximately 5% of hospital bills.” So don’t get fleeced on this easy step.

4. Consult with a medical billing advocate. Billing advocates basically work with hospitals and doctor’s offices on your behalf to get your bills reduced. A colleague recently spoke with Holly Wallack of Administrative Solutions Plus and was impressed by her services and dedication to helping patients control outrageous medical expenses.

Holly, who has been featured by Katie Couric, states on her website, “We review provider bills, hospital bills, and insurance documents for errors and overcharges. We negotiate with the party that has made the error, often reducing the charges to you and reducing your out of pocket cost. We can even help you recover money you’ve overpaid in the past. We believe that the majority of medical bills contain errors. Don’t pay more than you really owe.”

5. Check with your hospital to see if they offer any type of financial aid for overwhelmed patients.  Hospitals usually don’t publicize these programs or provide much guidance on how to apply unless asked and pursued with diligence.

Things to avoid:

a. Bankruptcy – yes it is an option, but most would recommend against it and it stains your record for 10 years. If you can arrange a monthly payment then why would you go for bankruptcy? And no, “So I can keep watching cable” isn’t a good excuse.

b. Getting a loan – also an option advocated by some, but not a good one. You are only trading one mess for another in most cases.

c. Running to Mexico – sure they have nice sandy beaches and great weather, but better to leave that as a vacation option rather than your only option. Plus those drug traffickers and their pesky little wars can really throw a wrench into things.

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41 Responses to Why is My Hospital Bill So High? Final Part: 5 Ways to Pay Your Bill

  1. TUNDE says:

    oh how i know about those bills. but when i got my bill I actually followed those steps…and guess what, it WORKS. ITEMIZED BILLING, THEY MAKE SO MUCH MISTAKES, THAT GETS YOU A FEW HUNDREDS OR EVEN A FEW THOUSANDS OFF YOU BILL. ONCE YOU CATCH THEM ON ANY MISTAKES YOU CAN START NEGOTIATING… THEY WILL BE VERY WILLING. TRUST ME ON THAT. NEVER GIVE UP REGARDLESS HOW MUCH YOU OWE, AND NEVER EVER GET A LOAN. HOSPITAL BILLS TAX DEDUCTIBLES AND NO INTEREST EITHER… WITH LOAN YOU GET STUCK WITH INTEREST SO CONSEQUENTLY YOU PAY MORE.

  2. maha says:

    Working in a Canadian ER, I feel lucky that of all the things my patients have to worry about during the course of their treatment, its not billing and affordability. (That’s not to say that the Canadian system doesn’t have its flaws.) Its really eye opening to see the kind of financial pressure that people have to face when seeking treatment. As great as the US is in some respects, sometimes I really feel my family and I escaped a major financial pitfall because my mom had an MI in Canada instead of Boston where we were planning on moving.

    • Debbie says:

      I have lived in both Canada and the US and I will take the US system any day! My husband had a quadruple bypass, and when I was honest about our ability to pay the bill, the hospital waived what I couldn’t pay. Great care and gracious people. Thank you to all who were involved in my husbands care!

  3. CrazyLady says:

    The payments thing doesn’t always work. I arranged and made payments faithfully and lo and behold, a year later they sued me. Drove me into bankruptcy. Whereas if they’d just been patient they’d have HAD their money, eventually.

  4. Gia says:

    After I had some surgery and a three day hospital stay, I received my portion of the bill after my insurance had paid their 80%. It came to a little under $8,000.00. I went to speak to the billing dept. and they cancelled my portion due to my insurance paying so fast! Boy was I surprised! The clerk said that because they were paid so fast it was like a cash payment and they would not ask me to pay the remaining! Boy was I happy I didn’t have an HMO ! Just good old fashion 80/20 !! Great blog! I came by way of Crass Pollination ! blog on!

  5. Bhatt,G. says:

    Going to the emergency of Good Samaritan Hospital Baltimore Was My Biggest Mistake
    Last year, I took my son to Good Samaritan Hospital for an emergency treatment. I filled the forms correctly and gave the medical insurance cards. However, after about one and half month, I started receiving phone calls from HRRG (a collection agency) for an amount of about $672. However, I never received the bill. After calling several numbers at Good Samaritan Hospital, I was told that Physician’s Emergency bills are processed at Pennsylvania (PA) and I was given a number to call. When I called the Billing Department, I was told that the bill was sent, but it was returned to them because of wrong address. When I verified the address, I knew that the billing department sent the bill to the old address that I left about 5 years ago. It shows how the billing department was so negligent in changing my address while I filed the correct address. However, when I asked them why the bill is not being sent to the insurance, I was told that it was not paid. When I tried to give the detail of my secondary insurance, the billing department refused to take information, which it appears it already had. I was told I should contact HRRG. As usual, I sent all the details of secondary insurance to HRRG through certified mail with return- address. However, HRRG did not stop calling. In the mean time, I received a letter from the Insurance that $622 has been paid. I again sent a copy of this payment to HRRG through certified mail with return-address. In the mean time, I also started getting the bill of $672 from Physician’s Emergency Services from PA on the correct address, as I initially corrected it when I first contacted the Billing Department. It was so frustrating that on the one side, the billing department would say I should deal with HRRG and on the other hand I was being billed from the Emergency Physician’s Billing. During this period, I also sent a money order of $50 to HRRG toward the balance of the money remained. When I called the Billing Department and told that I already paid $50 to HRRG and rest $622 was paid to you by the Insurance Company. The Billing Department wanted a proof via Fax. I told them I do not have a fax machine, then the billing department started saying, “do you want us to believe you?” Finally, I sent the proof to Billing Department by a letter. Thus the bill was paid and I did not receive the phone calls from HRRG anymore. But wrong, after 2 month gap, I started receiving phone calls from HRRG again in April 2009 for $622 payment. When I told that I already sent you the proof of $622 paid by the insurance via registered post with return receipt, HRRG people would not listen. The person on the other side would say “call your insurance company, and pay through the credit or debit card.” When I called after a few minutes, the other person on the HRRG side would–say it must have been paid to the hospital, we are affiliated with emergency billing. When I told that I already sent you the proof with registered post of this payment. HRRG would not listen; rather argue that I should pay this bill of $622, because it only received $50. I again called Emergency Physician’s Billing and I was told that the account is paid in full. However, when I told why is HRRG is still calling? I was told they would send the information to its billing investigative team. Should I believe that HRRG would not call me now onward? I do not think so, because it will call since it can receive some money from unsuspecting clients. On the other hand, I suspect that Good Samaritan Hospital is going to send me some more bills for the hospital charges; while it has also received some money from my insurance (beyond the emergency physician’s bill). A large chunk of it will be overinflated phony overcharges. I would be happy for a news media to investigate this matter in detail, including the phony overcharges that I am expecting to receive from Good Samaritan Hospital. I guess it was my biggest mistake to take my son Good Samaritan Hospital Baltimore. I could have taken him to some other place. If new developments occur on my story I will post it soon.
    Bhatt, G., April 24, 2009

  6. GB says:

    Last year, I took my son to Good Samaritan Hospital for an emergency treatment However, after about one and half month, I started receiving phone calls from HRRG (a collection agency) for an amount of about $672. However, I never received the bill. When I called the Billing Department, I was told that the bill was sent, but it was returned to them because of wrong address. When I verified the address, I knew that the billing department sent the bill to the old address that I left about 5 years ago. When I tried to give the detail of my secondary insurance, I was told I should contact HRRG. As usual, I sent all the details of secondary insurance to HRRG through certified mail with return- address. In the mean time, I received a letter from the Insurance that $622 has been paid. I again sent a copy of this payment to HRRG through certified mail with return-address. During this period, I also sent a money order of $50 to HRRG toward the balance of the money remained. However, I then received a bill of $50 from Emergency Physician’s Billing. When I called the Billing Department and told that I already paid $50 to HRRG and rest $622 was paid to you by the Insurance Company. The Billing Department wanted a proof. Finally, I sent the proof to Billing Department by a letter. Thus the bill was paid in full. But after 3- month gap, I started receiving phone calls from HRRG again in April 2009 for $622 payment. When I told that I already sent you the proof of $622 paid by the insurance via registered post with return receipt, HRRG people would not listen. I called Emergency Physician’s Billing to know why is HRRG is still calling? I was told they would send the information to its billing investigative team. Should I believe that HRRG would not call me now onward? I do not think so. On the other hand, I suspect that Good Samaritan Hospital is going to send me some more bills for the hospital charges; while it has also received some money from my insurance (beyond the emergency physician’s bill). I am certainly happy with the care and service that physicians provided, but my problem with billing issues has been quite frustrating to deal with. GB

  7. john says:

    I like tip #1, bascially just communicate and work with the hospital. Good to hear a positive story on options people have. I am soon expecting expenses from medical bills, and am concerned about the prices. What do you think of negotiating bills in with doctors in advance of surgery as you did not mention that one? This resource http://www.needhelppayingbills.com seems to say you can do this, but seems weird to negotiate a medical bill, like a new car, with the doctor. Thanks in advance.

    • ER Doc says:

      Hi John and thank you for your comment. Yes, negotiating directly with your doctor before a procedure can be a successful venture but make sure you get it in writing. Remember that if you are paying up front, that means they will get the money anywhere from 3-6 months sooner than with insurance and with a lot less hassle. Programs like Medicaid and Medicare themselves usually only pay physicians about 80% or so of what they charge and so you shouldn’t be paying “sticker” either and negotiate with them. I’m glad the article was of benefit.

  8. Reduce Your Hospital Bills…

    Anyone who has ever tried to work out a hospital bill knows that they can be next to impossible to understand. This conveniently makes it easy for hospitals to hide improper charges by using mysterious medical technology and codes. Whether through deli…

  9. tlj1 says:

    HRRG IS HORRIBLE, DO NOT HIRE THEM FOR YOUR COLLECTION SERVICES. I am working on resolving an outstanding balance on behalf of a person who has suffered a severe brain injury. She is receiving a small settlement and has several liens on the amount that she is scheduled to receive. She did not have insurance. In the interest of fairness to all of her providers, I submitted an offer to HRRG to ensure that they received some form of payment. I have sent information to their fax number (954)584-5604 repreated times. They have lost my information, then they act like its my fault that they do not maintain adequate records. Then, when asked to reduce the amount due to the circumstances surrounding the settlement of my brain damaged client, they say it is not their policy to reduce, though they never provide a copy of this policy for me to review. They have hung up on me twice saying that I “don’t know the law”, when I am trying to make sure that they are reimbursed out of this limited settlement. She called me a clerk, since I’m not the direct attorney. So instead of resolving like professionals, they act like children and call names. They are ignorant and inconsiderate, and cannot handle when someone is as knowledgeable about collection practices. These people are a joke.

  10. cyndy amos says:

    I took my daughter to the ER. After the insurance paid the part of payment, the hospital send the balance to me for payment. I called and negotiated for settlement of the payment. A settlement was agreed, and the hospital promised to write off the balance as bad debt. I paid off the settled amount. Few weeks later, i got a letter from a collection agency requesting for the balance. What can I do

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  15. Ummm says:

    i went to ER for because i was feeling lite headed, they kept me in the hospital for three days, they gave me all kinds of testing, i wanted to go home because i was feeling better after being in there just a few minutes, but they told me that they wanted to run more testing, i stayed like a dumbass, and i was billed for $35,000. i was dumbfounded, never in my life would i think that this doctor that i was recommended by the hospital was going to charge me all this money, i guess he want me to pay for his Doctor degree, i am a poor struggling women, they should have told me prices from the door, not after treatment, they could have told me to come back instead of having me spend the night so that they could charge me up, i am not happy, and i want answer, this Doctor had no right i told him i had no insurance from the door.

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  19. gladys coles says:

    hi i owe union memorial 8000.00 dollars and i only stay in their hospital for 15 hours and they charge me 4000.00 for that visit and another 4000.00 dollars for another visit and this time i was released at 5 a.m now i am begin suied now i have to go to court on mar 4th 2013 who do i talk to about this?

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