Hospital billing negotiators can save patients big money

One of the most important things for self-pay patients to be able to do is to get real prices from hospitals and surgical facilities before they actually undergo treatment, by using tools such as the Healthcare Blue Book or Medi-Bid. Doing so can save the uninsured or a patient with high-deductible health insurance thousands or even tens of thousands of dollars.

But that isn’t always possible. It’s difficult to shop for a hospital that treats the self-pay patient fairly while you’re in the back of an ambulance and on your way to the emergency room, after all! In those cases, when you’ve already received care and are now looking at what is likely to be a grossly-inflated hospital bill, what are your options?

First, you can still try to negotiate the bill down to a more reasonable amount even after the treatment, again relying on the information provided by Healthcare Blue Book or a similar source. If you are lucky the hospital may have a policy that automatically reduces bills for the uninsured (these programs are often income-sensitive, however), or even have a specific person who works as a patient advocate for negotiating down hospital bills. 

For people without much experience negotiating their medical bills, it can be a long, drawn-out process however, and might still ultimately be unsuccessful.

Fortunately there is another option, a professional medical billing negotiator.

A medical billing negotiator does exactly they sound like they do – they will negotiate on your behalf for a reduction in your bill. The web site of one such company, Medical Cost Advocate, describes its services and process as follows:

Consumers have seen a dramatic increase in their share of out-of-pocket health care costs and medical bills. Insured and uninsured consumers are subject to ever increasing financial burdens in the form of direct physician/hospital bills, co-insurance, deductibles and out-of-network charges.

Consumers frequently over pay for health care because:

  • They do not have the knowledge required to reduce charges
  • They don’t have time to become an expert in all aspects of health care
  • They are reluctant to negotiate with their health care provider

…Medical Cost Advocate provides health care cost reduction solutions to benefit consumers. Medical Cost Advocate is the expert source to validate billing accuracy, negotiate medical bills and regain control over your health care costs. We can reduce your medical bills after services are performed…

Medical Cost Advocate’s bill entry process is simple. It takes only a few moments to complete. Any medical/dental procedure or health care service that results in a bill to a consumer becomes a savings opportunity through Medical Cost Advocate…

Medical Cost Advocate experts negotiate your charges directly with health care providers (hospitals, physiciansdentists, ambulatory surgical centers, labs, etc) to reduce your medical expenses. The savings are passed on to you.

Medical Cost Advocate can save you hundreds and even thousands of dollars by negotiating your health care costs…

Medical Cost Advocate also offers to negotiate prices in advance of treatment. Another company I found that performs similar services is My Medical Negotiator, and I’d assume that there are other services out there as well.

One thing to keep in mind with these services is that they are for-profit companies, and they do charge for helping to negotiate down medical bills. Medical Cost Advocate states that they can help with any bill of more than $300, while My Medical Negotiator can help with bills larger than $200.

Two free options do exist for some people. Members of Christian Healthcare Ministries, one of the three health care sharing ministries that are an alternative to traditional health insurance, offers a service that can help negotiate reduced medical bills. In addition, members of labor unions that are part of the AFL-CIO can benefit from a medical bill negotiation service provided by Health Advocate.

Self-pay patients shouldn’t have to pay outrageous hospital bills that are inflated well beyond what insurance companies pay. Prudent shopping beforehand can help to prevent this for those that know ahead of time they will be needing treatment, and using the services of a professional medical bill negotiator can save patients thousands or even tens of thousands of dollars when shopping ahead of time isn’t an option.

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10 Responses to Hospital billing negotiators can save patients big money

  1. Dave says:

    The Karis Group is a large org that provides similar services to both CHMs and insurance company. However, they do have an entity known as Kare360 that works directly with the consumer through a monthly membership fee arrangement with rates for married couples starting at about $17 and, for a separate fee, can help with pre-membership issues. And no, I am not a member, just aware of it as they are based here in Austin, Tx.

  2. This post definitely gives me something to think about. I just summarized a blog post the other day from a consultant who advises against patients trying to negotiate prices on their own: Seems like it’s in the same vein. I’d be interested to hear what you think of his viewpoint.

    • seandparnell says:

      Thanks for your comment, Helen. Based on your writeup (the link from your site to his blog didn’t work) I’d say Mr. Padgaonkar has bought into the idea that prices need to be negotiated to begin with, among other problems. The absurd markups are actually a result of the process he endorses, in which third-party payers negotiate for ‘better’ rates. It turns out that you can offer really large discounts to third-party payers if you jack the prices up an insane amount at the front end!

      And I have to say, I always get a kick out of experts who advise people not to do something that they’ve been doing successfully for a while. I’d agree that negotiating with a hospital can be a daunting chore, but in the specific Wall Street Journal article cited it’s not like there really was much negotiation – Hospital A said the prices would be $23,000, Hospital B said it would be considerably less, so the patient went with Hospital B. There was no negotiating, just someone comparing prices.

      There’s also the very simple fact that having a third-party negotiate discounts on your behalf only works if you are part of a third-party payer, something the uninsured generally are not.

      So, I think I’d have to say Mr. Padgaonkar probably missed the mark with his blog post!

      • Thad says:

        I agree with you completely. Third party payers are a leading cause of health care inflation. I learned this almost a year ago when I went for a physical and had blood work done while having BCBS insurance. The doctor visit was paid 100%, but the lab work? That cost me over $800. That was in December 2012.

        In January I joined The Health Co-Op, which is a wrap around service to Samaritan Ministries, and had to have follow up lab work done. With help from my advisor at The Health Co-Op I got lab work done (the same as the one in December) for $75.00. I was actually stunned at the difference.

        So many people are under the impression that having insurance is the only way to have access to healthcare. It isn’t. It is the way to ever higher prices.

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  7. Wyatt Hunter says:


    Thanks for sharing superb article about Hospital billing negotiators can save patients big money. This is very useful information for online blog review readers. Keep it up such a nice posting like this.

    Wyatt Hunter,
    Billing Gurus.

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