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Money Minute: Can I really negotiate my doctor's bills?

Mandi Woodruff

Employer-provided health plan deductibles have risen 47% since 2009, which means consumers are shelling out more before their insurance kicks in. The average deductible for a family in the U.S. was $4,522 in 2013, according to the Kaiser Family Foundation. Meanwhile, many copay-based plans have given way to plans that offer coinsurance — a percentage of costs that the individual must pay, even after they meet their deductible.

Learning when and how to negotiate your medical bills is a useful strategy if you’re in a high-deductible plan or need to go out of network.

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Figure out your medical billing code. Every procedure has a unique billing code (a unique five-number code you’d find on your doctor’s or hospital bill next to the service). Once you’ve got the right code, that makes it easier to call around to compare rates. Just be sure to describe exactly what you’re looking for; for example, an MRI of your lower back will have a different billing code than an MRI of your abdomen.  

Pay cash. Some doctors will give you a lower rate if you pay cash upfront for treatments. Be sure to ask for the cash-pay rate before you’re treated. Cost for services can be a touchy subject for some healthcare providers, so it might be best to start with your doctor’s office manager or billing department. 

Compare rates online. For common medical procedures, there are ways to compare prices without calling doctors one by one. Of course, many health plans cover 100% of the cost of routine treatments, but for people who don’t have insurance or who have a high-deductible health plan, shopping around makes sense. Check out Clearhealthcosts.com or Healthcarebluebook.com. You may not find exactly the same rates as listed on these sites, but by homing in on prices in your ZIP code, you can at least get an idea of what the range might be. Some major insurers also are pretty good about having medical cost calculators on their web sites.

Stay away from hospitals for routine treatments. Some hospitals charge 10 to 20 times more for a routine procedure than it would cost at a specialized facility. For outpatient treatments like an MRI or ultrasound, try comparing prices at standalone clinics first.

Ask for the cash rate for generic medications. Even if you have insurance, that $10 or $20 copay you’re paying for generic medications may, in fact, be higher than if you had paid in cash. Ask around different retail pharmacies to get an estimate of what a drug would cost if paid for in cash.

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