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How 30 Minutes on the Phone Saved Us Over $50!

medical costs

Liza emailed in the following tip:

You and your readers have been so helpful to me in the past, I just wanted to share a discovery I made in the hopes it will help other families.

In the past, when I have received medical bills, I have always just paid them.

Last week, I got a bill from a medical lab for an $80 blood test my doctor ordered as part of my routine annual checkup. Routine checkups are supposed to be covered in full by my health insurance, so I called to ask what was going on. They told me that  the test wouldn’t be covered because I’m not 30 yet — even though I will be in 6 months!

I asked to appeal the insurance company’s decision, and it was surprisingly easy to do over the phone. When we finished my appeal, the health insurance person said, “Well, if we do cover this cost, we’ll only pay the lab $27.22, not $80. Why don’t you call them and offer to pay $27.22?”

I called the lab and offered to pay $27.22, rather than $80. They immediately agreed! Also, if the insurance company accepts my appeal, I’ll get my money back in about 60 days. If not, I’m only out $27.22, not $80.

Thirty minutes on the phone saved my family at least $52.78.

In the future, when I get a medical bill, I’m going to:

1. Call my insurance and ask them to cover it.
2. Appeal it if they don’t.
3. Ask how much they WOULD pay the provider, if they DID cover it.
4. Call the provider, and offer to pay them that (lower) amount.

I wish I had known this years ago! Health insurance and medical companies don’t play by the same rules as everyone else — prices seem to be VERY negotiable. The bottom line is, don’t pay your medical bills without calling to see if they’ll accept a lower payment.

photo source

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32 Comments

  • Jacki says:

    My doctor of 20 years recently suddenly passed away. He always included lab costs in our co-pay. Now, no other doctors in the city of doctors do this. I called around looking for a new doctor and found out from a secretary that if I asked our local lab to pay cash, it was much cheaper than billing insurance. Since this will come out of our deductible, we can submit the charge to apply to it. I compared prices between the university and our locally owned lab and the prices are so much different that it pays to drive to the local lab and pay cash.

  • Ashley P says:

    Yep. I worked in health care for 5 years. Always ask for the insurance rate.

    Also, especially when it comes to hospital bills, always ask for an itemized statement. They like to slip things into the bill that you either never got, or else bill items from a kit separately instead of as one kit (like a suture removal kit that contains gauze, scissors, iodine, etc.). When I went to the hospital for sciatica, they badgered me into getting a pregnancy test so I could have an X-ray, even though I knew I wasn’t pregnant. Ultimately, I never even got the X-ray. They charged me $600 for the pregnancy test. I was furious. I told them to remove it because, since the only reason I had to take it was for an X-ray I never got, it wasn’t medically necessary. Needless to say… they did.

    Spending 5 years working behind the scenes in the healthcare game taught me a lot of tips and tricks to save money. It’s an industry that I’m glad I left and would never work in again because of a lot of shady business dealings I witness, but I’m glad for the education I got.

    • Julie C says:

      Will you write a guest post(for MSM readers) on all of the tips that you learned ?

      • Ashley P says:

        I suppose I could try. I’ve been out of the industry over 3 years, and a lot has changed since then, so I’m not sure how much is still relevant.

    • Brooke says:

      I am a biller for a hospital. Not sure how your organization was run but we aren’t all bad. “They like to slip things into the bill” constitutes fraud and is completely unacceptable. Trust me, if there is a mistake on your bill it was not done intentionally.

      • Ashley P says:

        Oh, I know. Not everyone runs a shady operation. The operation I worked for was pretty decent. But we did a lot of business with organizations that weren’t so forthright. I live in South Florida, and Miami-Dade county alone has more Medicare and Medicaid fraud than the top 3 fraudulent states combined. It just runs rampant where we live, and there are so many people and offices that a lot of it goes unrecorded, unpunished, and even unnoticed. I tried reporting some of these entities, but nothing ever came of it.

        It’s a sad state of affairs. And a lot of people paid more than they should have because of it. It’s part of the reason I left.

  • Lora C says:

    Thank you for sharing this tip!! I just got health insurance through the affordable care act and I am finding that there is a great deal that I don’t know about navigating the health insurance maze. I am grateful to have health insurance for the first time in more than 15 years, but when I had it before it was so much easier. Thanks again for the tip!

  • M. says:

    I am without health insurance as of tomorrow thanks to the affordable health care act. My insurance didn’t have maternity care (which I do not need & do not want to pay for). The cheapest insurance that I can get for me & my husband is $500 per month with an $11,200 deductible. I had a $2,500 deductible before and only paid $297 per month. Even with insurance, I always ask how much tests will cost. Drs. act like you shouldn’t care because insurance will pay for it but trust me, with everyone’s deductibles as high as they are now – you NEED to ask!

  • Courtney Crane says:

    Medical costs can be so huge, but there are a lot of great ways to save significant amounts of money on them! Paying cash on the spot will often net you a discount (or paying it off early), asking to switch to a generic will sometimes save you and, though the reason for switching was care related, switching from a ‘regular’ OB to a midwife for the birth of my second child is saving us a significant amount. I am at a different facility and hospital for this child and I was pleasantly surprised to find out that we’re saving almost 25% by making the switch (and we’re in a much nicer, much more advanced hospital as an added bonus!)

    • Ashley P says:

      We are using a midwife for a home birth for our second child. It cost us over $10,000 in medical bills for a completely normal drug-free delivery.

      Having my second kid at home will only cost $4,000. And that covers all the prenatal visits and a week of post-natal care. If you have a perfectly healthy pregnancy, there’s no reason you can’t use a midwife! 🙂

      • Sissy Sweet says:

        When I was 4 months pregnant with my 2nd child, the company my husband worked for shutdown. That left us without insurance. I called all the hospitals within 30 miles. One of them covered everything, including the birth, and the care for the baby and the mother after the birth, for as long as you were in the hospital. You had to pay $4,000. before the 9th month. They told me how much money to bring for each prenatal visit. By the 8th month, everything was paid for. This gave my husband and I peace of mind, and saved us a lot of cash, as my son was born by c-section and had medical problems. He was in the hospital for 3 weeks. That baby is now 26!

        • Ashley P says:

          lol. Yeah. Times sure have changed. My father-in-law was talking to my husband about how insurance covered everything when all his kids were born, and how Barb had her own private room and everything. He was flabbergasted to discover that our insurance covered absolutely nothing! I had to share a room with a very loud woman who barely spoke English and took phone calls at all odd hours. And they charged an arm and a leg for the room and food.

          The payment plan you described is mostly how the midwives work down here. I’m hoping my second pregnancy is normal so I can have my baby at home and save a bundle. 🙂

  • Janet says:

    Liza, thanks for sharing this great tip! The healthcare business in this country is indeed shady. The affordable care act is indeed allowing me the option of having insurance for the first time in a long time, however the deductible is so high that I will be just paying out of pocket most of the time.
    Can’t anyone come up with a non-for-profit “insurance company” of sorts…something that works like a credit union where members are shareholders?

    • Tonya says:

      This may be something you would find interesting, it isn’t “insurance” but it is an alternative: https://moneysavingmom.com/2013/10/how-we-save-money-on-health-care-costs.html.

    • Ashley P says:

      Actually, there are a lot of “medical sharing” companies, especially for Christians who are worried about insurance funds paying for things that violate their conscience (like abortion).

      Just search for “Medical sharing” and you’ll find a lot of companies. This is one I’ve gotten information on previously:

      http://samaritanministries.org/how-it-works/faq/

      And Medical Sharing *does* count as insurance under the ACA, so you won’t be penalized.

    • Kate says:

      I belong to a nonprofit insurance co-op–offered to me by the ACA and our state exchange. Maineoptions.org.

      Thanks to Money Saving Mom, Dave Ramsey, and others, I’ve been able to save enough out of our small income to cover the deductible ($2350) and the out of pocket maximum ($12,700) if bad things happen. Cancer? $12,700. Car accident? $12,700. Not hundreds of thousands of dollars and years of debt.

      It’s not perfect–no one ever said it would be. But for my family and so many others, it means a much better life. I’m really happy with the nonprofit co-op model so far.

  • I’ve learned it never hurts to call! I had to get a super expensive blood test done a few months ago, and although my insurance paid half, our portion was still almost $1,400! So I called to inquire about their patient assistance program (mentioned on a paper that came with the bill) and turns out I only had to pay $200! Smartest phone call of my life 😉

  • Katie says:

    I’ve heard a lot of people say you can call the hospital and ask for a discount if you pay the bill in full. I’ve tried this twice and was turned down both times. They would rather have me pay the bill off slowly over a year or two than take cash up front in exchange for a small discount. Seems crazy to me. Does anyone have any suggestions for the next time I try this? I heard one time I may be talking to the wrong department or person.

    I have a bill on the way from the hospital for well over $2600 and I would be willing to pay it in full if they provided some sort of incentive to do so….otherwise we’ll just go on a payment plan for the next year or two.

    • kat says:

      I too have found that hospitals will not give discounts if it has been covered by insurance and already discounted. If it wasn’t covered by insurance, they usually do give a discount if paid in full immediately.

  • ann says:

    The insurance company recently paid $65 on a several hundred dollar bill for me. I called them to complain (nicely) that they hadn’t covered more. The customer service person resubmitted the bill and now all but $7 will be covered! It definitely pays to question insurance companies!!

  • Louise says:

    I agree about questioning insurance companies. I had to get a wellness exam for my insurance to keep getting a discount on my insurance plan. I got the exam and then got a bill from the doctors office. I called and asked why they didn’t bill my insurance, they said they didn’t know I had insurance even though they took a copy of it and billed my insurance for my lab work. They then billed my insurance for me, and then my insurance wouldn’t pay any of it. I called my insurance and they said it was out of network. I kept insisting that it was in network, plus they had paid for all of my lab work from the same doctors office. I got transferred a few times finally got someone who would listen. He actually called the billing office while I was on the line and found out that yes it was in network and had been submitted under the wrong code/ID number, and that they would pay it in full. Saved me $130!

  • Katrina says:

    I also saved a ton of money by having my blood work done by my primary care office that uses an outside lab like (lab corp). The prior year my Gynecologist prescribed 3 blood test that my insurance company requires be run thru the local hospital it cost $760. This year I found out I could take her orders to my primary care physician and have blood work done there. One of the test alone that cost me $300 last year cost me $12.10 this year. And all 7 test will total around $65. This 7 included the 3 from last year. CRAZY!! Make sure to ask where your blood work will be sent. Cost varies and insurance requires some places send it to more expensive labs.

  • SuperMoney says:

    Great tips! If you can question your cell phone company, or your mechanic, why not question your insurance company? Definitely sharing this!

  • Marlayna says:

    Our daughter went through cancer while my husband was going through his second master’s program, CRNA this time. He could not work for the whole program (28 months) and so I learned somethings as well. 1) they cannot send you to a collections agency if you are paying something, 2) consolidating is easier when you have many bills since every visit is a new account, and 3) many hospitals have a debt forgiveness program. We still owed on our hospital bill from our daughter’s birth when we found out about her Wilms tumor at 7 months old. We consolidated her birth and her surgery (our deductable, labs, anesthesia, etc.) The first time they forgave it all. We did it a year and a half later and they covered half of it. We had to give valid reasons and personal information but it was well worth it. They do not advertise it, you have to seek it out.

  • Tammy C says:

    Sadly we tried to get a discount on the anesthesiologist who did our son’s colonoscopy when he was in the hospital.Nope he wants all of his $800.00.I would have never known that just because you are in network hospital that not everyone who is part of the hospital takes your insurance.

  • Kerri says:

    I just wanted to add that you should check all medical bills you receive. I have received bills that were incorrect. The doctor’s office mistyped our insurance group number and of course the doctor was told we did not have coverage. All of this over one number incorrectly entered in a computer. Recently I received another bill that should have never even been sent to us. The doctor repeatedly sent in a code to the insurance which the insurance said they would not cover. After being turned down by the insurance company, the doctor just sent us the bill for the procedure thinking we would probably just send in the payment. I checked with the insurance company and they said we were to have never received any bill. It was between the doctor and the insurance company. Check all of your bills. That saved us 150.00!

    • Claire says:

      Check your bills by comparing the invoice from your doctor against the Explanation of Benefits (EOB) from your insurance company. Don’t just look at the doctor’s bill. I’ve had some doctors that put down the wrong amounts from insurance statement (i.e. my EOB stated I only owed the doctor $15 but the doctor’s bill stated I owed $30; once I pointed that out to the doctor’s office, they quickly corrected it).

  • christie says:

    Always always always ask for a discount. if they offer you 10%, ask for 20%. Most of the time you’ll only get the 10%, but the one time you get 20% it’s like a gift!
    Most hospitals in my area will provide a discount if paying in full. However, I’ve yet to find a provider (doctor, midwife, PA) who offers a discount. It’s worth the few minutes of a phone call to ask. So far this year I’ve saved over $80 just by asking for a discount, and that was with one ER visit.

  • Lisa says:

    Have tons of tips and suggestions but they won’t post in comments box. Maybe it’s too long. I’ll email to blog and hopefully they can be added and will help others.

  • Tara says:

    Very interesting!! I will definitely look into this in the future!

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