How to negotiate for billing while in hospitalization without Insurance?

Commercialization of health care is a burning agenda today. Healthcare is becoming more commercial than noble these days. The study of medicine is becoming costlier so is the profession of medicine. Doctors are not leaving any stone unturned to charge patients whatever they can. There is no regulation on hospitals and hence we don’t have anything like MRP or say standard rates for hospitals’ procedures. Hospitalization is turning into a choking condition where avoidance of treatment creates threat on life or its quality and treatment of illness creates a threat of vicious circle of inflated bills and debts. Does this mean that one must never go to hospitals? Of course, this is inevitable. So, what one can do? Let’s look at the whole scenario with a view to manage this risk of inflated bills with the art of negotiation under an assumption that there is no medical insurance. 1. Ask questions: Firstly, one must ask questions. Ask questions to one’s doctor about the disease, process of procedure, risk involved, alternative treatments available. Ask question at bill desk about the cost of procedure to be carried. While asking the cost of procedure ask for all fees associated with the procedure e.g anesthesiologist, radiologist, laboratory costs, etc. Ask if the referred test is feasible to be done at other labs. When asking such questions one must try to get these details in writing. Though estimate in writing is not assurance as MRP but it makes the information giver conscious to give information eliminating the factor of confusion. Also, ask questions at pharmacy about the cost of medicines or injections one is asked to buy if any other alternative brand with same combination but lesser price is available. 2. Do the research – don’t be innocent victim: With the growing facility of research available through internet one must break this blind faith approach. Fortunately, the Internet has made it easier to research the cost of not only tests, medicines but also procedures and bed charges. Research if test to be done can be done from third party who is offering a discount. Example medplus or thyrocare offers some profiles at discounted rates as a part of package. Research if one’s doctor is offering the same service at other hospital (may be aided hospital) at lower rate. Research if the injections and medicines needed for the procedure are available at discounted rate at other pharmacy near the hospital. 3.Check for company tie ups with hospitals: Some of the hospitals are tying up with corporates, public and private both, to offer services at discounted rate to its employees. It’s a means of promoting the hospitals among its employees. Check with one’s company HR to know the list of hospitals with which company have tie ups, if any. 4. Audit (Review) the final bill: It’s very common for hospital bills to contain errors and overcharges, so make sure bill is appropriate and for services received.
  • Look for the codes in the bills and ask for detail description of the same.
  • Check services that should be packaged together are split and billed separately. This is common when multiple medical tests are ordered, but all relate to one medical diagnosis. Eg: CBP test includes Heamoglobin, so billing should be only for CBP.
  • Check for duplicate or excess billing. This happens when one is billed for a procedure which is carried out multiple times Eg: 4 dialysis charges applied instead of 2.
  • Check for room charges appropriately charged. Says if one is discharged in the morning (as most patients are) but socked with a full daily-room rate for the date you left the hospital. Seek appropriate correction for it.
  • Check you weren’t charged for the medicines brought by you. Also, check returns to pharmacy are appropriately deducted.
  • Check advance paid, if any is deducted.
  • In automated process of billing possibility of arithmetic error is rare but items included may be erroneous sometimes.
5. Negotiate: Never fear to negotiate. Apply the principle “catch more bees with honey” and be polite being persistent. Now, one must use all the research done so far to ask for discount on room rent, procedure cost or cash discount for huge sum payment in one time. Remember uninsured patients are charged more than insured patient as insurer negotiate lower rates with hospitals. One can also work on payment system with hospital business staff. Also, one must check if any discount or scheme is running currently for that department of hospitals. Say, on occasion of world heart day scheme on heart surgeries at 20% discount rate. Change in commercialized approach of health care will take time and need collective approach just as corruption but aforementioned steps will fetch some savings and informed decision as a relief from staggering hospital bill.
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