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As
health-care consumers endure higher deductibles and reduced insurance benefits,
it is becoming more important to understand and even negotiate prices before receiving
medical treatment.
Dr. Kathryn Stewart, medical director of care management
at Mt. Sinai Hospital in Chicago, believes that patients can and
should be more proactive about seeking the best prices for their
services.
"Hospital costs are probably 40-50 percent of what
their (list price) charges are," she says. But when it comes to
billing, "most hospitals are happy to break even or have a little
bit of profit."
This means there is plenty of room to negotiate and
reduce your out-of-pocket expenses.
| Shop for hospital care as you would any other consumer
service, but with more effort since costs can run really high. You can save yourself
a bundle using these strategies. | | |  |
| 10 ways to reduce
your medical bills |
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1. Ask your doctor
to be your ally. If you're shopping around for medical services,
you probably have a primary physician who directed you to seek the
service in the first place. "You have to get diagnosed by somebody,"
says Stewart. "So let that person be your advocate."
She advises patients to ask their doctors where the
best hospitals are for the recommended procedures, which centers
will work with patients to lower out-of-pocket costs, and to even
ask for help communicating with that facility's finance department.
"If the hospital where a physician admits is approached
by that physician on behalf of the patient, I think (the patient)
might get somewhere with the hospital. Let's say I have a patient
in my practice who has one of these really high deductible (insurance)
plans, and they need to have a hysterectomy. (I could) approach
the finance department and say 'I've got this patient, but they
don't have (enough) insurance and they can't afford to pay full
price, but they can afford to pay something. Can you work with them?'"
2. Compare costs
by using the CPT code. Though your doctor might be willing
to initiate a conversation with the hospital finance department,
you can still expect to have several conversations with them on
your own. Before calling, make sure you have the "current procedural
terminology," or CPT, code for the procedure you are seeking.
"CPT is the industry term for the 'billing code.'
It's a five-digit number that is used to bill the procedure," says
Jane Cooper, president and CEO of Patient Care, a health advocacy
company based in Milwaukee. Cooper says that your physician or physician's
office can provide you with the code, and the number is the same
across hospitals. With this code, you can call multiple medical
centers to compare prices for the same procedure.
3. Find friends
in the billing department. When calling different medical
centers, ask for the billing department, and then ask what they
charge for the procedure you want. "
You should be able to get (the pricing information),
by being persistent, about 80 percent of the time," says Cooper.
"If the representative does not give you the answer you need, ask
for his or her manager. And keep asking for the manager." Your success
in this area can help determine whether you ultimately choose to
use this facility for your medical treatment.
"If the hospital or doctor won't tell you what they
charge, then my advice would be to go to a different doctor or hospital,"
says Cooper.
4. Negotiate
lower prices, payment arrangements. If you're fortunate enough
to get comparative information and an alternative hospital is cheaper,
go to the original hospital and see if it can match the lower price.
If all the hospitals you contact charge similar amounts, see if
you can negotiate a prompt payment discount with one of them.
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