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How to negotiate for billing while in hospitalization without Insurance

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The 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 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 hospitals? Of course, this is inevitable. So, what one can 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.

1. Ask questions:

Firstly, one must ask questions. Ask questions to one’s doctor about the disease, process of the procedure, the risk involved, alternative treatments available. Ask a question at the bill desk about the cost of the procedure to be carried. While asking about the 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 estimate in writing is no assurance as MRP it makes the information giver conscious to give information eliminating the factor of confusion.

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

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

With the growing facility of research available through the 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 a test to be done can be done from the third party who is offering a discount. For example, med plus or thyroxine offers some profiles at discounted rates as a part of the 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 its 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 final bill:

It’s very common for hospital bills to contain errors and overcharges, so make sure the bill is appropriate and for 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 are appropriately deducted.
  • Check advance paid if any is deducted.
  • An automated process of billing the possibility of arithmetic error is rare but items included may be erroneous sometimes.

5. Negotiate:

Never hesitate 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 a discount on room rent, procedure cost, or 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.

Change in the commercialized approach of health care will take time and need a collective approach just as corruption but the aforementioned steps will fetch some savings and informed decision as relief from the staggering hospital bill.

Reach Us at Ethika to get more support!

Susheel Agarwal

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.

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.