Be persistent with providers when negotiating medical bills

Paul D. Price, member  ·  May 29, 2018

I joined Samaritan about three years ago when I started working at Creation Ministries International as an events manager. Prior to this, I had been a licensed insurance producer in a variety of fields including health insurance. I was selling health insurance and Medicare plans in 2013 as Obamacare came into effect, and I saw firsthand how things began to go from bad to worse in health insurance. Finding Samaritan Ministries was a breath of fresh air! I had no idea things could be so much easier and more cost-efficient, and now I cannot see myself ever going back to insurance.

Overcoming billing challenges

Samaritan members often face the challenge of getting appropriate discounts and the proper documentation from providers. Some providers are simply not used to being asked about specific charges for specific services, but it’s important that we work to get fair and competitive prices.

Since my wife and I just had our first child, I have gained a lot of experience working with billing offices and procuring discounts. My general experience with providers has been good, and I have had no problems receiving the shares from members in a timely manner.

However, we did encounter major frustrations when we received bad information from health care billing representatives. In one instance, a hospital employee emphatically told me that they "no longer offer self-pay discounts." Later, upon discussing it with a billing representative, I found out that all self-pay patients automatically get 40 percent off! This, I fear, is all too common in our bureaucratic health care system, where the right hand does not even know what the left hand is doing.

The squeaky wheel gets the grease

Sometimes providers are not willing, at least initially, to offer any discount to uninsured patients. In particular, hospital doctors seem to generally work for far away, third-party billing organizations which may be harder to negotiate with than a local hospital or doctor’s office would be. My best advice is, above all, be persistent. To get what you need from a bureaucracy, you will have to be the ”squeaky wheel.” The functionaries will eventually give you what you are asking for.

This was the case for me recently as I dealt with a very stubborn third-party billing office. At first, I was told there were no discounts of any kind available, so I entered into a monthly payment plan and made minimum payments. The next time I spoke to a representative, however, I asked again, and was given a 15 percent discount.

That would not turn out to be the end of it. After a few weeks had passed, supervisors made the representative call me back and say they could not honor the discount because she had not had authorization to give any discount. I could not let this stand so I filed a complaint against the billing office through their local Better Business Bureau (BBB) online. I also sent a formal letter of complaint directly to their office, which included the following:

It is common industry practice to offer customers a discount who are willing to pay cash without going through an insurance company. This arrangement is mutually beneficial and refusing to do so represents an unethical double standard, since it is well-known that providers offer preferred/contracted rates to insurance companies as well as Medicare/Medicaid.

After I did this, suddenly they changed their tune once more! Now I have been given a 40 percent discount with this provider as well. Apparently, they contacted the hospital’s billing office themselves to see what discount they were giving self-pay patients. Stressing to them that they were violating a common industry practice by not offering discounts seems to have been the key here.

To fellow members dealing with difficult billing offices, I want to offer encouragement. If you are persistent and pursue all available avenues, including filing complaints if necessary, you can usually prevail and get significant reductions on your bill.

Paul D. Price is an events manager at Creation Ministries International. To read more articles by Paul, visit creation.com/paul-price.