How to Help Get Medical Bills Reduced

For many of us, coping with the costs of a medical crisis adds emotional anguish during an emotionally taxing time. You may still be recovering or helping a family member recuperate when the healthcare bills start rolling in, making it difficult to focus on the task of sorting through and paying bills.

The numbers can be startling. The Kaiser Family Foundation, a nonprofit organization focusing on national health issues, estimated the average expense per inpatient day at a hospital in the U.S. to be $2,873^† in 2020. This estimated expense is also impacted by where you receive care with states like New York and California averaging higher expenses ranging from $3,676-$4,098^† .

As unsettling as numbers like that can be, it’s important to keep in mind that there may be ways to bring those balance due amounts down. Here are six steps you can take when unexpected bills hit.

Study your statements.

Medical bills can be complicated, especially if you're unsure about a particular charge. To help identify any problems, ask for an itemized statement from your healthcare provider. An itemized statement details the services you received and their associated expense. This can help you spot if there are any mistakes like listing the wrong procedure or diagnosis, billing you twice for a lab test, or other common medical billing errors.

Wrongly charged? Appeal your medical bill.

If the bill is due to denial of coverage by your insurer, you and your doctor may have to join forces to appeal that decision, with your physician submitting documentation on why you needed the treatment. For duplicate charges and other errors on your bill, appeal directly to your insurer to fix them.

Be prepared to negotiate.

If you’re stuck with a big bill, don’t give up. There may be ways to negotiate. With out-of-network bills, you can appeal directly to your insurance company or the healthcare provider and ask them to waive or reduce charges.

If you’re uninsured or meet income requirements, you may also qualify for a bill reduction. “Nonprofit hospitals are required to have financial assistance programs for patients who qualify based on income. Financial assistance can range from offering very deep discounts all the way to writing off a bill,” says Richard Gundling, senior vice president of healthcare financial practices for the Healthcare Financial Management Association^¶.

Ask for advocacy.

You can also request help from the state insurance commission or the consumer protection bureau in your state attorney general’s office.

“Many states have healthcare ombudsmen or consumer assistance programs that will negotiate on behalf of the consumer,” says Cheryl Fish-Parcham, director of access initiatives for Families USA^#. If you’re employed, your company’s human resources department or the U.S. Department of Labor may also be able to help^§.

Request a payment plan.

Hospitals often have payment plans available for patients unable to pay in full. But make sure the payment plan is one you can afford. “If you can’t keep up with the monthly payments, your debt may be sent to collections or you can have your wages garnished,” says Chuck Bell, program director for advocacy at Consumers Union^§.

Communicate with creditors immediately.

Throughout the negotiation process, which may be long, don’t panic or hide from creditors, advises Caitlin Donovan, director of outreach and public affairs for the National Patient Advocate Foundation^††.

“If you are contacted by a collection agency, let them know immediately that you’re disputing a bill; a collection agency can’t contact you again until they verify that the bill is a valid debt.”