228
u/Ok-Gur-349 7d ago
As someone that worked in billing, this post is nonsense. No one who works in billing would pause at you asking for an itemized statement, that's a completely standard ask they deal with all day, and they're not going to give you a "courtesy adjustment" because you asked for an itemized statement. Often they contractually can't.
But, yes, essentially everything in medicine is negotiable. You will get WAY further if you talk to your insurer about it, though. They're the ones that actually decide what you pay. The billers Do Not Give A Fuck and are just pushing paperwork through automated systems.
56
u/age_of_empires 7d ago
I called about a medical bill and they had accidentally swapped two digits so instead of $4200 I really owed $2400.
The woman on the phone said it was an oopsy
22
u/Ok-Gur-349 7d ago
Oh oopsies for sure happen.
You SHOULD ask for an I/s, to check for errors and also just to know what you're paying for. You should not expect it to be some magical money trick.
3
u/socalfuckup 3d ago
i brought my paychecks to the SSA to adjust my future benefits and they added up the YTD at the bottom of each one. girl, a large portion of your job is to know how to read and understand pay stubs
2
17
u/adirion123 7d ago
The real secret is that medical debt isnt real, and avoiding collections in most jurisdictions is very easy.
Not that they have mystery charge lines on the claim. Which is what the EOB would end up showing.
33
u/Ok-Gur-349 7d ago edited 7d ago
That's a bingo. If you'll humor me:
NEVER PAY A MEDICAL BILL WITH A CREDIT CARD. IT TURNS IT FROM MEDICAL DEBT INTO CREDIT CARD DEBT, INSTANTLY. DIFFERENT LAWS. BASICALLY ZERO SITUATION YOU WOULD EVER ACTUALLY WANT THIS unless you're points harvesting ig but I digress
P a y m e n t p l a n. 99% of the time it's interest free, and if you fall behind? 🤫 It'll be fine.
13
u/ekdocjeidkwjfh 7d ago
Yep and if you do pay a bill pay via check in the mail
Some places like trying to add a “pre auth” in their fine print and keep charging your card even if you only authorize the one payment.
3
u/adirion123 7d ago
This may well be the case for other forms of debts and bills but I can't imagine any general hospital in the US doing that. Despite the stereotype most hospitals are run by people terrified of legislation, so doing that would give their legal team an aneurism when self-pay is NOT where they make their money.
7
u/ekdocjeidkwjfh 7d ago
He owes 1/2 a million from a heart attack with a tripping bypass and he did not have insurance at the time and does not qualify for our state’s Medicaid
He paid once with a debit and they had a reoccurring pre authorization agreement in the fine print so now hes charged 500 a month
I keep telling him theres gotta be a way to revoke it but he claims there isnt. I think hes full of it
Say what you want but i have had this happen to me too, but with a much lesser amount also with the same hospital.
But that hospital keeps getting sued by the city for their unethical practices like preforming unnecessary surgeries wqs the most recent lawsuit (they lost)
1
u/adirion123 6d ago
That's insane, and I am not surprised by that last paragraph. I would suggest logging a complaint to the FTC they have been cracking down on that kind of thing.
2
u/sr_castic 7d ago
I've been using AI to help write letters and taking the proper steps to make it extremely difficult for them. Some of them I never hear from again and most give STEEP discounts if you do let it go deep into collections.
38
u/vLT_VeNoMz 7d ago
All procedures, meals, medications, etc that are administered at a US hospital have been priced by the hospital and the insurance companies that they accept or are covered by. Historically it was an actual book, I’m assuming it’s kept in a spreadsheet or billing program now.
Prices vary by hospital and insurance company, if you don’t have insurance, they will still try to charge you the insurance-agreed price (i.e. $50+ for a single Ibuprofen) so they can make more money. Their hope is you won’t call to check the prices. This isn’t always true at non-profit hospitals, but it is standard practice at most hospitals.
When you call the billing department they have reduced prices (still highly marked up) that are offered if you either cannot pay your bill or you are simply requesting an itemized receipt.
8
u/cowlinator 7d ago
If you don't have insurance, you will have to try to negotiate with the hospital.
If you do have insurance, you cannot negotiate with the hospital. They don't care. You have to negotiate with your insurance.
5
u/Plastyrhino8815 7d ago
Plus they can't offer you a realistic price (ex: cost of labor x2) because the insurance companies will throw a fit. The insurance company never pays $50 for ibuprofen. The insurance companies kept demanding discounts so the hospitals slowly raised their prices then give the insurance companies discounts from the inflated price.
18
u/pseudoportmanteau 7d ago
I know someone who tried to pull the "itemized bill" move and they provided the itemized bill and the price didn't change at all lol. This is not a magic get out of jail card you think it is.
11
u/Pup5432 7d ago
I used it when hospitalized in 2021 because my insurance was being difficult and an itemized bill might help. Yeah nope. Same price except now I find out they were charging very reasonable rates for meds (more or less same price I pay at the pharmacy) and an experimental pneumonia med that was $2000/day because standard meds weren’t working. Yes the number was bad and I have no reference for the experimental drug’s price since it ended up not going mass market but $2000/day to survive was a bargain.
Insurance did eventually end up negotiating and I had to pay $3k to finish my deductible up, would have sucked less if I didn’t get discharged on 12/28 lol.
31
u/LavenderRevive 7d ago
America's health "care" system is such a scam. I really don't know why nobody riots for stuff like that. It's so insane that there are people who don't profit from the system, that defend it.
8
8
u/Zumoshitekato 7d ago
Dude everything in America is a scam like this.
I was just in a car dealership and they offered me a 7 year extended warranty for "only 40 dollars a month". I responded with I didnt think it was worth nearly $3400 and he completely changed his tune and said he'd include it for $6 a month
3
u/Plastyrhino8815 7d ago
They profit from it. They get paid to look the other way, or talk about something else. Politicians all get free health care for life so once they get elected they are set for life.
1
u/Possible-Yak-9683 5d ago
I always find posts like this so ironic. You’re a body, you can riot. Yet you don’t.
1
u/PeakxPeak 5d ago
But are they American? Anyway, you can't just go out and start rioting. It needs to build up organically.
1
u/Possible-Yak-9683 5d ago
Actually, that’s a great point. Based on their comments they’re from Europe, so I don’t even know why they’re commenting on this. Likely a chronically online Redditor.
1
u/Smokin_belladonna 5d ago
they've been doing what Walmart and Mcdonalds are getting sued for without AI since before you were born! Artificial pricing to see what you will or can pay
6
u/Xavier_Orion 7d ago
I am also part of the uninsured thanks to the current administration and all the jackasses who voted them in. My insurance went from $600/month to over $1800. Anywho, went to Advent Health ER due to what seemed like a stroke. Thankfully, after 3 CT and one MRI and a lot of bloodwork, I was diagnosed with BPPV (crystals in the ear get all out of wack). Spent overnight in ER room as “hospital was full” of the insured I am guessing. Figured it would be $6-$8K got my bill $784.06. Apparently they have an 84% discount for the uninsured. Paid that shit off in two seconds. (I am very fortunate I can afford a $784 bill, I know). They can charge less, when they want to.
1
u/TheRealBobbyJones 4d ago
Medical services are almost always nonprofits. They can shift costs around. If they have a profit margin from what they bill insurance it isn't distributed as dividends. They can't do that even if they wanted to. So if they have extra lying around they can apply it as a discount. Especially if they set up their own endowment. Of course you also have other medical organizations that use it for expansion. My local hospital system has built a new building every 5 years it seems.
2
u/Angel_OfSolitude 7d ago
The short of it is, insurance. Insurance companies nickel and dime hospitals over every little thing, to the point of making them non operational. So they inflate everything at base with the expectation that your insurance will do its usual thing.
Tell them you don't have insurance and want an itemized bill and you'll get a real price.
2
u/Solid_Guy1983 7d ago
Yeah they DO send an itemized invoice and those items are insanely expensive $200 for an ibuprofen and so on. Hospitals have their own pricing system and it’s insane.
2
u/The-Yar 6d ago
Yeah but it's all insurance companies' fault. /s
1
u/Wjyosn 4d ago
Ok but why the /s…
1
u/The-Yar 3d ago
Because it's often the healthcare providers and not the insurance companies. Like here.
1
u/Wjyosn 3d ago
It’s a little more involved than that. There’s a reason the providers do this, and it’s almost entirely because of insurance
1
u/Late-Assignment8482 3d ago
Yes. Because in countries without this absolute batshittery, they don't have private insurance, and yet they do have doctors, hospitals, drugs, etc. and those do have a cost. A controlled cost.
So the part causing the problem is probably the unique part the other machines don't have?
1
u/ostrichxcat 7d ago
In the Us, hospitals also tend to try to charge more for people who have insurance to get more money from the insuranxe
1
1
u/SnarkyIguana 7d ago
I went to the ER last week. Been dreading the bill. Got a text yesterday saying it was ready for me to pay it and it was only 1300 so I was suspicious. The fact that it didn’t sound high enough to a point where I felt nervous is such a problem.
2
1
1
u/TheRealBobbyJones 4d ago
Or more likely the rep isn't a trained sales person and decided that since you are questioning the price you must be poor and gave you the poor person discount. It's honestly something I struggled with when I was doing sales. I assumed most customers were poor like me and I would pre-emptively try to lower the price before quoting. Eventually I realized many can indeed afford the standard price.
An immediate discount doesn't necessarily mean they are using nonsense charges. It means they deal with a lot of angry poor people.
1
u/Swimming-Finance6942 4d ago
This just happened to me for a mole removal. It was $510, I thought it was high but I paid. The woman gave me some lecture about deductibles.
I asked for a list of all participating doctors and staff and the codes. (I worry about padded consolidations) 5 minutes later she told me the bill came down to $97 because of a “small error”
She literally said “oh how did that get in there?”
1
-3
u/mercy_fulfate 7d ago
This absolutely did not happen. Every hospital gives an itemized receipt.
4
u/enbyBunn 6d ago
That's absolutely not true. I have never gotten an itemized hospital bill without asking.
I don't know why you would even claim this, it's just obviously untrue and most people know it because everyone has to go to the doctor.
Even a quick two seconds on google will confirm for you that most hospitals just give you broad categories, and you have to request an itimized list. Baffling
-1
u/mercy_fulfate 6d ago
How is me having a different experience baffling? So sorry I offended you by living a different life and having different life experiences.
4
u/bruhmoonchamp 6d ago
You’re being really dishonest here because you were the one that said “every hospital does this” now when you get called out you act like a pussy “just my experience”. Either it’s just your experience or you’re making a statement about every hospital you can’t have it both ways.
3
3
u/enbyBunn 6d ago
You said "Every hospital gives an itemized receipt."
I'm not "offended by your experience", moron. I'm correcting you on a stupidly wrong thing you said. Don't take the facts so personally.
1
1
1
-2
u/Tribe303 7d ago
Dont ask me! I wouldn't know, because I'm Canadian and have never seen a hospital bill. 🤷 I've had lung surgery and almost a dozen blood clots so I'm very familiar with our medical services too.
Sorry for the flex, but you need to fight tooth and nail for single payer healthcare.
My free lung surgeon btw, was the same lung specialist who assisted the heart surgeon who performed the first heart transplant in Canada. Luck of the draw for me!
0
u/Adept-Painting-543 7d ago
Can I have citizenship? I need to get our of this hell hole. I'll even pay taxes.
-1
u/zeke780 6d ago
Every historical system where I live would have most likely given you one already or would produce it.
Reddit has pushed the sovereign citizen minded idea that you can say certain words and suddenly you won't have to pay for medical care. It's not real and you still have to pay something.
-8
u/steeliewheelie68 7d ago
Who the fuck pays that much for an ER visit. At most $12 for parking if you drive, and $25 for the ambulance if you had to use emergency services.
3
u/DazB1ane 7d ago
If you live in the States, an ambulance ride can practically bankrupt you if you don’t have great insurance
2
u/Badwoman85 7d ago
Where do you live that this is the case? I am wildly envious.
1
1
1
u/gothiclg 7d ago
Literally every single American. That $25 ambulance bill you get is also $5,000 here, insurance will under no circumstances pay for the ambulance even if you can prove you’d die without an ambulance ride.
1
u/steeliewheelie68 7d ago
Damn. You guys are getting bent over. Not sure why I am getting down voted. Lmao.
1
u/gothiclg 7d ago
You’re being downvoted because a lot of people pay that much for an ER visit. Not everyone lives under a government that ensures there’s a taxpayer funded heath system.
1
u/crisantemo_bloom 1d ago
Sometimes I forget that there are countries where healthcare isn't free, and it seems crazy to me that it's still not a global thing yet
472
u/Available_Editor4383 7d ago
Am I crazy? Every hospital visit I’ve had provides an invoice.