'Hospital billed us $90,000; I wouldn’t settle until I got a $50,000 reduction'
Toby Meisenheimer · Oct 30, 2017
In college, I was the guy that bought all of the Halloween candy on November 8 for $25, and supplied our dorm floor with candy for the rest of the year. It was said that if a truck was giving away free manure, I would be interested.
Somehow that mentality allowed my wife and me to survive our first years together on a $25,000 income as a Christian high school math teacher. We watched pennies, used Quicken, and read personal finance stuff. This experience transitioned me nicely into a two-decade career as a financial planner, where I learned to apply my stewardship thought process to financial strategies for others.
But now my time is too valuable to cut coupons or send in for mail-in rebates. It hurts me to admit that, but I cannot major in the minors anymore. It’s a game of time vs. resource stewardship that we all are playing.
Part of good stewardship for our family was choosing Samaritan over Obamacare options, which included saving on the monthly expense, but also knowing that helping out the Body with our shares was a fulfillment of a Biblical health care model, and being the church for each other. It was a no-brainer.
We also view the Special Prayer Needs $25 per month suggested donation as what we would want if we ever ended up in that situation, and a way to give away some of the surplus we saved by paying way less with Samaritan than on an insurance plan with an expensive premium and $12,000 family deductible.
About a year ago, it was our turn to depend on the Samaritan community as my wife had an unexpected surgery that she has fully recovered from. But I got a taste of what health care is charging these days, and how they are using the “self-payers” like us to pay for their new hospital wing and landscaped courtyard.
Ninety days after the surgery, I thought I had received all the bills—hospital, surgeon, anesthesiologist, radiologist, even people we had no idea what they did for our 30-hour hospital stay: $23,000 in total. I put most of these on a $100 per month auto payment plan until all of the shares came in.
The hospital was politely giving us about a 25 percent off for being self-pay. I knew there was a lot of variance in pricing: “usual, reasonable, and customary rates,” preferred provider networks, Healthcare Bluebook, etc., so on a couple of them I was able to negotiate a further discount for a “cash payment in full.” I said I was having to prioritize who to pay, and that the percentage discount I was offered would determine who got paid first.
Then, about three months later, I got the sticker shock. The $12,000 bill from the hospital was just for the ER visit, tests, and pain meds. The REAL hospital bill showed up ... and it was $66,000. On top of everything else that brought the total to around $90,000!
This was the point where my feelings of injustice kicked in, How could all these providers do this? I called them and asked for a detailed billing of charges, where I found things three to five times what Healthcare Bluebook showed, and several times what Medicare paid for the same medical code. So I called them up and said I was going to politely stop paying them until they treated me a bit more fairly.
Their finance office said I could submit a financial aid application (that made refinancing look like a picnic) to get up to 90 percent off. I communicated that I wasn’t interested in that and wouldn’t qualify, but asked why, if they were willing to go up to 90 percent off, we couldn’t meet somewhere in the middle with less work for everyone.
Here's an actual conversation:
Me: If I were with Blue Cross, you would reimburse them much much less than what I’m having to pay.
Financial aid office: Yes, but you don’t have the contracts and the volume they do. So that’s why we give a generous 25 percent off the price.
Me: But you know and I know that nobody, I mean nobody, pays these full rates! They are made-up numbers! I’m willing to pay a little more than what is usual, reasonable, and customary, but not three times more.
Them: I’m sorry, we don’t discount for self-pay more than 25 percent off the rates.
Me: I’m sorry, I don’t usually pay three times what everyone else pays for the same product or service, so I guess we’re at an impasse here. Maybe you’ll just have to take me to collections and get even less, because this just isn’t right.
At this point in the story, my wife got a call from Tom, who was a nice man with collections, an “in-house, non-reporting” collection agency. She was worried I had pushed this too far, and risked damaging our credit. I loved the sound of “non-reporting.”
So I called him back right away and explained our frustrations, and heard empathy for the first time. And so the dance began. This was on the $12K bill, which was already down to around $9K. I offered him $4K. He took a day and came back with a no. I came back with “$5K today on my credit card for a paid in full.” And they took it!
I asked Tom what I should do about the $66K bill, which I had gotten down to $46K with conventional means. He said it wasn’t on his radar, but if I waited a little longer it might show up. So I did, and sure enough, got a collections statement from his office again. So I called him up and caught up with my new friend. I offered him $25K. He said no. So I said, “What’s it gonna take for me to put it on my credit card like I did last time? Just give me your bottom line.” He took a day and came back with $27,163.43. Sixty percent off the initial juggernaut.
What did I get from this? In one sense, very little. One percent cash back by running all this through my credit card and the satisfaction for whittling over $50K off the bill through a year of stubbornness. But the money saved is meeting others’ needs!
If we all did this when the big bills come, our shares have less of a chance of spiraling out of control like health insurance premiums are.
When Jesus was sending out the Twelve in Matthew 10:16, He told them to be as shrewd as snakes and as innocent as doves. They risked beating and death. We went shrewd and innocent and risked collections and bad credit—not even close! But I think we can take this approach in a God-honoring way, with kind but firm words, and stand firm for the sake of good stewardship.
All along, I kept coming back to this thought: Is it Christian to just pay what they are asking, and be nice, or to politely pick away and have our voice be heard, whether it is our own money or shares from fellow members?
At the end of the day, it’s all God’s, and I believe you have to feel led to either pay with gratitude, or roll up your sleeves and risk being a bit difficult. To my fellow Samaritan members who fight, win, and turn the discounts into more Samaritan needs being met and future increases postponed, my family thanks you.
Toby and Murphy Meisenheimer are members from Illinois. They have six children, including three adopted, and one in foster care. Toby founded Streamline Financial Services and for the past 19 years has been helping families and business steward their resources and set up donor advised funds. He also founded GoMissionTrip.com for overseas travel medical insurance, and TruColourBandages.com, a bandage company that believes everyone deserves a bandage to match their skin tone. Toby loves to run distances of 50 feet or less, and has read the first chapter of a lot of books. He manages his adult ADD not with medication but lots of kids and entrepreneurial activities, and listening to podcasts at 1.5 speed.