This week’s question is from a reader who’s ticked off at a doctor. Literally.
On April 29, I went to a walk-in clinic to have a tick removed from my head (I could not remove it because I could not see it) and on Friday, May 31, I received a bill for $750 to be paid by May 28. Is this normal, and is there anyone who can help me? Am I to blame for not asking the cost of this before they helped me? I am in my 60s, and this has been so stressful. — Sara
If this story had been about any business other than health care, I would have thought this reader was pulling my leg, because the price is so out of line with the service received. But because it concerns medical costs, I find it not only believable, but likely.
Exactly what are these services worth?
A couple of years ago I had a high fever and couldn’t immediately get in to see my doctor. I was in such misery, I drove myself to a nearby hospital emergency room. After a few hours, a few tests and a shot of antibiotics, I was on my way.
Several days later I got the bill: $2,400.
My first call was to the hospital, and my first question was if they’d sent their bill through my health insurance company. They said no, their records reflected I was uninsured. I explained that I was insured and provided my health insurance information.
A few weeks later, I got a new bill: $600.
Despite having insurance, I had to pay the $600, because my deductible was $6,000. But where else in America does a vendor charge one customer $600 and another $2,400 for the exact same service? Imagine how you’d feel if you paid $50,000 for a new car, then found out I’d bought the same car from the same dealer on the same day for $12,500.
The services the hospital supplied were presumably profitable at $600; otherwise they wouldn’t have agreed to that rate with my insurance company. Yet they had no problem charging an uninsured person 300 percent more. And if that person was unwilling or unable to pay this inflated bill? The account would go to collections, the collection agency would sue and get a judgment and that person’s credit would be ruined.
Time magazine reporter Steven Brill made the talk show circuit in 2013 after writing a comprehensive story about this exact issue: hyper-inflated medical bills ostensibly created out of thin air and in no way related to the cost of the services provided. While Brill did a great job on his story, the subject is nothing new. We covered it in 2009: See “Killer Hospital Bills.”
Sara asks, “Am I to blame for not asking the cost of this before they helped me?” Answer: We should all ask the price of anything before agreeing to it.
When it comes to health care, however, that’s often easier said than done. Sure, Sara could have asked the cost for tick removal and, after being beaten up this way, it’s likely she’ll do so in the future. But how could I get an advance quote on fixing my fever when the services needed to be performed before the cause was known? Even if I hadn’t been practically delirious, there was no way for me to comparison shop.
What should Sara do?
The first thing Sara should do is what every consumer should do when confronted with any bill that feels unfair. Contact the person responsible, calmly explain the situation and, in the friendliest possible way, ask to have the bill reduced. Whether it’s a plumber, a restaurant or a doctor, you have every right to question a bill and ask for an adjustment if the cost is unreasonable in relation to the services provided.When Sara calls and asks for a break, she’ll probably get results. In a story called “Confessions of a Serial Haggler,” I quoted a Consumer Reports survey revealing how often people were successful when attempting to negotiate various expenses. The results:
- Furniture: 94 percent of those who asked got a better deal at least once.
- Medical bills: 93 percent of people who tried negotiating a lower bill were successful at least once.
- Home electronics: 92 percent were successful at least once.
- Appliances: 92 percent were successful at least once.
- Floor models/demos: 91 percent were successful at least once.
- Credit card/bank fees: 87 percent were successful at least once.
- Jewelry: 86 percent were successful at least once.
- Cellphone plans: 80 percent were successful at least once.
- Collectibles: 78 percent were successful at least once.
So Sara’s odds are good, and that’s something I can verify through my own experience. I’ve personally asked for, and received, discounts from doctors.
What Sara shouldn’t do
What many people do when confronted with bills they can’t pay or find unreasonable is decide they’re unfair, then do nothing. Result? The provider of the service rightfully decides the customer is a deadbeat and should be treated like one. So they send the bill to collections, ruin the customer’s credit, and do everything within their power to coerce payment.
Doing nothing is unfair to the service provider. They deserve to know the reason they’re not getting paid. More important, unless you’re indigent, doing nothing won’t work anyway.
If you don’t like the bill, don’t ignore it, contest it. If after stating your case you’re still not happy, take it up a notch. For example, Sara could talk to a medical billing advocate — a professional representing consumers with health care bills. She can find one by visiting Medical Billing Advocates of America. She could also talk to a consumer attorney.
But I’d be willing to bet that a simple phone call is going to leave Sara feeling a lot less bugged.
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I founded Money Talks News in 1991. I’ve earned a CPA (currently inactive), and have also earned licenses in stocks, commodities, options principal, mutual funds, life insurance, securities supervisor and real estate. Got some time to kill? You can learn more about me here.
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