Life with MS

For the person with MS, medical bills can easily accumulate into considerable debt. However, getting healthcare needs met is a priority, even when insurance coverage and personal finances are inadequate. So what can you do? Negotiate, that’s what. Though your ability to pay may factor into how much of a discount you receive, savings of 10 to 30 percent are not uncommon. Whether you are trying to get the best price for an upcoming procedure, or trying to reduce a current bill, there are steps you can take to make your negotiation more successful.
 
Know the going rate
 
Rates for different procedures and treatments can vary widely from one provider to the next. Any hospital should be able to tell you its charges-to-cost ratio, but you will have to ask, as they will likely not volunteer the information. Find out what Medicare would pay for your condition or surgery, since that program tends to pay less than private insurers. You can learn that at the federal Department of Health and Human Services database, www.medicare.gov/hospitalcompare/search.html, by clicking on the gray button “find and compare hospitals.” Other sources include:
 
Healthcare Blue Book: Your Free Guide to Fair Healthcare Pricing is online at www.healthcarebluebook.com.
 
New Choice Health also offers free online medical costs comparisons at www.newchoicehealth.com.
 
Plead your case – respectfully
 
You won’t get very far in the negotiation process unless you bring the right attitude to the table. Though you don’t want to be shy or feel intimidated by your doctor, you should speak respectfully as you make your offer. If talking directly to your doctor is uncomfortable, then you may want to contact the office billing manager instead.
 
You may be offered a reduction that is not as high as you would like; don’t hesitate to make a counter offer. Proposing an immediate payment in cash has been known to take as much as 50 percent off the cost. Another option is to propose a plan in which you pay your balance in a few installments or on a monthly basis – typically at no interest.
 
Review your bill
 
Sometimes a careful inspection of your hospital bill will turn up mistakes or duplications which, when deducted, result in a significant savings. You may have to request an itemized bill and an explanation of some of the more difficult to interpret charges. A medical procedure or diagnosis that is not properly coded could be costing you, so be on the lookout for these. Even mistakes such as filing a claim under your maiden name instead of your married name could cause complications.
 
Explore financial assistance programs
 
The uninsured may be able to obtain the care they need through charity care. Most states have a government agency in charge of charity care, but the people who need it are often unaware that it exists. Your best bet for obtaining charity care is to contact your hospital. Hospitals typically have all the information you need to apply for and obtain charity care, including eligibility information and the appropriate forms. Charity care programs typically require that the applicant be ineligible for any type of health insurance coverage, including Medicaid. You may need to provide financial information demonstrating that they are unable to pay.
 
Understand your insurance policy
 
Not all coverage is black and white. If your treatment falls into a gray area that your insurance may not cover, you can improve your chances of approval by submitting letters from your doctors that explain why the treatment you received was necessary. Make sure that you get required referrals from your primary-care physician, and show proof of these. Be persistent and if you believe a certain item should have been covered but was not, file an official grievance. Official paperwork should be submitted whenever possible.
 
Things to avoid
 
When your medical debt mounts, you may be tempted to transfer the debt to a credit card. Don’t do it, say the financial experts. And don't convert your medical debt, which is unsecured, to a secured obligation by paying it off with your home-equity line of credit. The hospital may offer you a credit line from an outside lender at 0 percent interest. That’s not a good idea, either, because the 0 percent rate usually jumps into the 20 to 30 percent range if you miss a payment. Plus, once your balance is off the hospital's books, you lose any negotiating leverage you have.
 
Seek outside help
 
If your bills are exceptionally large or complicated you may want to seek help from a professional. Individual advocates usually run their own businesses and set their own fees, usually a percentage of the savings they negotiate on your behalf. Two sources of help are the Alliance of Claims Assistance Professionals at www.claims.org or the Medical Billing Advocates of America at www.billadvocates.com.
 
Follow through
 
Whatever course of action you choose, be aggressive about eliminating medical debt. Once your medical bills are reported to the credit bureau, they remain on your file for seven years – even after the debt is resolved.
 
(Last reviewed 7/2011)