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How to Negotiate for Billing while in hospitalization without Insurance


Summary

The commercialisation of health care is a burning agenda today. There is no regulation on hospitals and hence we don't have anything like MRP or say standard rates for hospital procedures. Negotiating with the art of negotiation under the assumption that there is no medical insurance.

How to Negotiate for Billing without Insurance

The commercialization of health care is a burning agenda today. Healthcare is becoming more commercial than noble these days. The study of medicine, as well as the practice of medicine, is becoming more expensive.

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 hospital procedures.

Hospitalization is turning into a choking condition where avoidance of treatment creates a threat to life or its quality and treatment of illness creates a threat of a vicious circle of inflated bills and debts.

Does this mean that one must never go to the hospital? Of course, this is inevitable. So, what is one to do?

Let’s look at the whole scenario with a view to managing this risk of inflated bills with the art of negotiation under the assumption that there is no medical insurance.

5 Steps to Negotiate Hospital Bills Without Insurance

1. Ask questions:

Firstly, one must ask questions. Inquire with one’s doctor about the disease, the procedure, the risks involved, and the alternative treatments available. Ask a question at the bill desk about the hospital cost without insurance, which will help you understand the procedure to be carried out.

While asking about the hospital cost of the 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 a written estimate is not as certain as an MRP, it makes the information giver more conscious of providing information, eliminating the factor of confusion.

Also, ask questions at the pharmacy about the cost of the medicines or injections one is asked to buy and if any other alternative brand with the same combination but a lesser price is available.

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2. Do the research – don’t be an innocent victim:

With the increasing ease of research available through the internet, this “blind faith” approach must be abandoned. Fortunately, the Internet has made it easier to research the cost of not only tests, and medicines but also procedures and bed charges.

Research if a test to be done can be done by the third party who is offering discounts on hospital bills. For example, Med Plus or Thyroxine include some profiles at a reduced price as part of their package.

Research if one’s doctor is offering the same service at another hospital (maybe aided hospital) at a lower rate. Research if the injections and medicines needed for the procedure are available at a discounted rate at another 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 a discounted rate to their employees. It’s a means of promoting hospitals among its employees.

Check with one’s company HR to know the list of hospitals with which the company has tie-ups if any.

4. Audit (Review) the hospital’s final bill:

It’s very common for hospital bills to contain errors and overcharges, so make sure the bill is appropriate for the services received.

  • Look for the codes in the bills and ask for a detailed 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 Hemoglobin, so billing should be only for CBP.
  • Check for duplicate or excess billing. This happens when one is billed for a procedure that 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 the pharmacy charges on hospital bills are appropriately deducted.
  • Check advance paid if any is deducted.
  • In an automated process of billing the possibility of arithmetic error is rare but items included may be erroneous sometimes.

5. Negotiate Hospital Bill:

Never hesitate to negotiate hospital bills without insurance. Apply the principle “catch more bees with honey” and be polite while being persistent. Now, one must use all the research done so far to ask for a discount on room rent, procedure costs, or a cash discount for a huge sum payment at one time.

Remember uninsured patients are charged more than insured patients as insurers negotiate lower rates with hospitals. One can also work on a 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 the occasion of the world heart day scheme on heart surgeries at a 20% discount rate.

This change in the commercialized approach to health care will take time and require a collective approach, just as corruption requires.

I assure the aforementioned steps will yield some savings and an informed decision as relief from the staggering hospital bill without insurance.

Reach us at Ethika to get more support!

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Susheel Agarwal

Susheel is the CEO of Ethika Insurance Broking P Ltd. This company, which has a current value of 10 million dollars, was bootstrapped by him and two of his friends. He attributes his success to his ability to inspire others to seek happiness at work.