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May 13, 2008 -- Negotiating for non-emergency medical care

We often hear about how people are uninsured, but we don't hear about how they're underinsured. A lot of people have coverage, but it may only be minimal for some procedures. Figuring out what's covered and what's not is like reading hieroglyphics.

Smart Money magazine reports that consumers can really benefit by negotiating upfront for non-emergency care. The classic example of this is an uninsured pregnancy. The list price can be as much as 900% above what an insurance company can negotiate. The key is to negotiate beforehand; after the fact, you'll have no recourse.

Consumers need to know that the price difference from hospital to hospital is all over the map. So Clark's advice is negotiate, negotiate, negotiate. About two-thirds of people who haggle do get a lower price.

Whenever Clark gives this advice, medical professionals get hot under the collar. They often allege that he's turning medicine into Wal-Mart. But they need to understand that medicine is the only thing we buy that we don't know the cost of until after consumption. Doctors also need to know that a customer with a cash payment represents more money in their pocket than a negotiated insurance claim.

Clark recalls that before the "dot bomb" era, there were a lot of websites offering Internet price shopping and bidding services for medical care. They all went bust in the tech crash, but their time is coming again as consumers take on a larger portion of health costs. Having the ability to shop based on price makes perfect sense to Clark.


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What others are saying

  • negotiating medical costs
    My husband was recently diagnosed with cancer while uninsured. We informed each Doctor and his office manager on first visit we would need to negotiate payments. It worked. We were discounted anywhere from 25% to 50%. It is not cheap by any means but it does help.
  • Negotiating medical charges
    I always negotiate my medical procedures and appointments.. yes, beforehand.. Successful 100% of the time. Even if I have to prepay for something like a routine colonoscopy upfront. Try to get the Medicare-reimbursable rate for paying cash, that's as good as it gets, $800 for a colonoscopy prepaid, vs. $5,000 PLUS at the local hospital using their retail rate card. And the medical codes are available on the internet.
  • Free negotiating service?
    There is a company that will negotiate down medical bills before or after the procedure as long as the bill is $150 or more. They get paid 35% of what they save you, but only if they are successful. Anyone used them or heard of them? http://www.medicalcostadvocate.com
  • negotiating medical care
    I had a defibrillator implanted. I tried to find out the cost beforehand, in order to determine my co-pay. The doctor's office could not seem to tell me the 'codes', which the insurance company needed to get the 'costs'. So, I went ahead with the procedure and was SHOCKED to find out the list price (doctor, hospital, device, etc.) was $100K. My co-pay with good insurance fortunately was only $800. But, even though I was trying to do the right thing, I was not able to, because of not knowing the 'codes'.
  • Negotiating Medical Care
    Our office (and many other Primary Care MDs) have a list of services for cash-only patients, at very reasonable rates.
  • negotiating medical care costs
    Being in the profession I will say that many doctors are fine with negotiation. The problem is when you get to large groups or hospitals and there is no clearly defined path to someone who has the autority. As negotiation becomes more common this wil be less of an issue. It will actually work out well for the patient and the doctor. Early adopters always have to be persistent.
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