How to negotiate hospital bills.

When you want to save on and negotiate your hospital bills, the time to start the process is as early as when your doctor says you need to have a procedure, surgery, or some type of medical test.

The amount that hospitals need to charge, and the amount that patients have to pay for their hospital bills is not set in stone and is open to negotiation. While hospitals do have a master list of charges for various services that are based on that hospital's historical cost of delivering health care, the truth is that the medical bill can be negotiated in a variety of ways. Here are some ways to save on and negotiate a hospital bill:
 

1. Research the hospital costs
Your insurance company Web sites will probably be able to tell you what many area hospitals charge insurers, which can be the basis for your care, even if you do not have insurance.

How this works is if you have health insurance and if your policy determines that you need to pay a percentage of the bill, if you find the least expensive hospital that will lower the amount that you need to pay.

If you do not have health insurance you can get similar pricing data from for-profit companies and then you can use that pricing data to negotiate with a hospital. Some companies that do this will charge as little as $7.95 for a report that will give the average cost of what a health insurer is charged and what the average charge for a test, procedure, or surgery is from a hospital in a region. So when you get that pricing data, you should never pay more than that. Negotiate.

2. Communicate with your doctor
You should always ask to determine whether it is safe to delay the procedure or medical treatment. Consider also future health insurance needs. For example, a delay for a service, if of course approved by your doctor, is a very good idea if your spouse or you are in line for a job that will provide better health coverage, pay health benefits or a delay may be ideal if you have maxed out your flexible spending account for the year and want to carry over into the following year.

3. Receive your health insurer's approval
After you have settled on a hospital to use, if you have health insurance be sure to contact your insurer to get pre-approval for the care that you need, as if you do not do this the insurer will probably refuse to pay the bill. Find out how much your insurer will cover. Some billing experts and medical advocates will strongly recommend that you have your doctor detail both the procedure you need as well as any pre- and post-care follow up that you may need, in writing, so that you can present this to the insurer. You should always keep records for your file as well, along with bills and all other communication as an issue may arise at a later date.

4. Consider the hospital deductible and factor it in
Most stays in a hospital will usually have their own deductible, and some may be $1,000 or more. This is separate from the deductible you will need to pay for outpatient care or attention.

Most hospitals and medical providers will ask for the deductible and any other patient share of the hospital bill on or before service they provide to you. While you will not always need to pay the deductible or your share of the hospital bill immediately, you will need to come up with and agree upon a plan of action to pay it off.

A great option is to ask the hospital for a no-interest rate payment program, and many do offer this.

If you have limited income, the bill is too high, or are struggling, hospitals often times will be able to discount your deductible, coinsurance, or co-pay if you qualify for assistance under their criteria. But you need to ask about these discounts and programs. Find out how to settle medical debts.

5. Ensure you receive an itemized statement of your hospital bill
Unfortunately the health insurer usually gets more specific cost information and the itemized bill. Insured patients will usually just get a summarized billing statement. You can request, and are entitled to, an itemized bill. Numerous studies show that almost 90% hospital bills have errors on them. Errors vary widely and can include errant decimal points, care on days you weren't in the hospital, and charges for procedures not completed. Find how to discover billing errors. Learn more.

6. Look into assistance programs and charities
If you're are underinsured or have no insurance, you should meet with a financial counselor at the hospital as soon as possible to discuss your situation and talk about assistance programs. Discounts, charity care, and federal and state government programs may be able to help your situation. Many of the programs are generous and open to many people. For example, some hospitals even offer discounts to insured and uninsured patients that have incomes that are greater than 350 percent of the federal poverty level, so many people qualify for aid.

7. Do you need extensive service and is a hospital trip even necessary?
There are alternatives to a hospital visit. Consider having some procedures and tests, such as colonoscopies, CT scans, and MRIs done in independent centers or clinics, which can save hundreds or thousands of dollars on your bills.