Negotiating medical costs ahead of time could save you thousands

Medical debt is the number one reason for personal bankruptcy according to multiple sources. Whether you’re overwhelmed with medical debt, or have an upcoming procedure, the key is being informed.

Ben Hynden is 29 years old and experienced pain in his abdomen last year. His doctor suggested a CAT scan at an independent facility.

“When I got the bill it was around $268,” Hynden said.

SERIES: Erasing Medical Debt

The pain returned a few months later and Ben called his doctor’s office for advice.

The nurse practitioner was concerned he might have appendicitis and told him to go to the emergency room.
Hynden went to Gulf Coast Medical Center, owned by Lee Health.

After going through the triage process, Hynden was told it was very unlikely he had appendicitis and that he could get a CAT Scan while he was there.

He agreed.

Hynden knew the emergency room would be more expensive, but was shocked when he saw a bill exceeding $10,000.

According to his explanation of benefits, the CAT Scan at the hospital cost $8,897.

Thirty-three times the cost of the independent clinic.

He’s insured, but still has to pay more than $3,000 for the scan.

Lee Health spokeswoman Mary Briggs couldn’t comment on this specific case because of privacy rules, but told us there are several reasons the cost is so much higher at an ER. One is the readiness factor associated with emergency care and another is the charity care they provide.

“What happens is those costs have to be shifted to commercial insurance payers,” Briggs said.

Hynden admits next time, he’ll ask more questions.

“Never be afraid to ask the doctor or whoever how much is this scan, procedure going to cost.,” Hynden said.

Attorney Carmen Dellutri helps clients negotiate their medical debt.

He advises them to be proactive and head right to the billing department.

“Every doctors office is probably going to kill me right here, but we know that certain offices have set a standard up. If someone can’t pay, there may be an instant 10 or 15 percent off the bill if they can write a check for the difference,” Dellutri said.

In non-emergency situations, take the time to negotiate up front, before any test or procedure is done.

“Go in and being financials with you. Bring bank statement, bring your pay stub. I would even do a budget and say I’m offering you $100 a month toward this $5,000 bill because that’s what I can afford.”

Being armed with the best information is also important. Know what the Medicare rate is for procedures as a negotiating point. You can also use sites like healthcarebluebook.com for price ranges.

Lee Health’s prices can be found online at leehealth.org/price.

Dellutri says to keep it polite and professional. Don’t let emotions get in the way of a productive negotiation.

Hynden is better now and says he was diagnosed with an issue that would resolve itself.
As for the bill, he set up a payment plan.

How you can help erase medical debt

WINK News has teamed up with the charity RIP Medical Debt and has bought $1 million in medical debt for $12,500, and we’re asking you to help raise $10,000 to wipe out a second million dollars for people right here in Southwest Florida. $10 wipes out $1,000 in debt.

WINK News is accepting donations through our nonprofit partner, Southwest Florida Community Foundation. You too can be a WINK Hero for Hope and help erase medical local medical debt. Clicking here to donate now.