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8/26/2010

5 Reasons to Haggle over Health Care, 10 Ways to Save
By Angie's List Staff
The health care horror stories abound: people skipping necessary tests and treatment because they can’t afford them, senior citizens choosing between food or medicine; patients cutting pills in half to make prescriptions last;.

But consumers have better options that are not hazardous to their health, says Angie Hicks, founder of Angie’s List, the nation’s premier provider of consumer reviews on local doctors, dentists and other service companies.

“No one should make healthcare decisions based on price alone, but it’s clear that a lot of people are doing that,” Hicks said. “But consumers have more power than they realize, and there are tons of great doctors, dentists and other healthcare specialists out there who are willing and eager to give high quality, affordable care. Those that aren’t will have to adapt as this trend continues to grow.”

The key, Hicks says, is finding providers who are willing to work as hard to address their financial ills, as they are to cure their physical ailments.

Some doctors are offering virtual visits and email consultations to patients they’ve already established a relationship with. These visits save time because they don’t require an in-office visit, and patients are charged less than a face-to-face appointment. Some ailments require that in-office visit, of course, so you need to work with your doctor to know what can work for you.

With health care reform on the minds of so many decision makers in government and the healthcare industry, Hicks said there’s never been a better bargaining time for patients.

“We’ve heard some great success stories, like the New York member who saved $4,000 when she said she couldn’t pay the costs not covered by her insurer and her doctor agreed to collect just the insurance portion. Or the Washington D.C. member who saved $9,000 on his mother’s in-home care by bargaining ahead of her treatment,” Hicks said. “Just ask. You’ll be amazed at what you can save – and still get great care.”

5 Reasons to Haggle over Health Care:

  1. 74 percent success rate reported in a survey of Angie’s List members who asked for discounts from their doc.
  2. 80 percent of all medical bills contain errors, according to some patient advocates.
  3. Generic drugs cost, on average, 30 to 80 percent less than the comparable brand drug.
  4. Some hospitals and doctors’ offices will cut your healthcare bill if you pay in cash, on the day of service – some as much as 50 percent.
  5. Charges for the same health care treatment in the same city can vary by hundreds of dollars, according to Healthcare Blue Book research:
a.    In Washington, D.C., prices for an MRI of a knee at five imaging centers ranged from $400 to   $1504.  HcBB fair price: $912
b.    An abdominal MRI at three Atlanta imaging ranged from $1,190 to $2,543, if payment was cash. HcBB fair price: $836
c.    Cost for an MRI of the lumbar spine ranged from $500 to $2,661 at eight Chicago facilities. HcBB fair price: $522

Angie’s 10 Tips to Save on Health Care
  1. The man or woman behind the curtain: Find out what current or past patients are saying about the billing office and general bedside manner of doctors before you even go to the office. Doctors are just now starting to be open to price negotiation. If bargaining is important to you, find a doctor who’s willing to engage rather than one who isn’t.
  2. Forewarned is forearmed: Check the Angie’s List Healthcare Blue Book tool to determine what insurers in your home town are willing to pay doctors for the treatment you need. Knowing what you should be charged can help you negotiate.
  3. Cash in king: You may save up to 50 percent of the normal charges if you can pay your medical bill upfront and in cash. You may be charged more if you use a debit or rewards card. Ask about discounts and payment options. Don’t be afraid to bring up the idea of a discount; some doctors will do it if asked, but few are advertising that option. Be sure to follow all applicable health insurance rules.
  4. Never too late: Even if you didn’t bargain ahead of time, you can still bargain for a better deal once you’ve received treatment. Be honest and up front with the billing agents about what you can pay and when. They may offer you no-interest payment plans or discounts on the service you received.
  5. Virtual visits:  Some doctors offer virtual visits where they “see” their patients online, a convenience that generally cost less than $40.  Online medical services often allow patients to schedule appointments, refill prescriptions and even chat live with a doctor. Some insurance cover these visits, but they may be cheaper than an office call, even with insurance. Nearly 90 percent of polled Angie’s List members say they’d use the online services if they were offered.
  6. Get quotes in writing: If you are price shopping before you have a procedure done, get a signature, name and title to go along with the price quoted.
  7. Cover every doctor in the room and the facility cost where treatment is given: When getting prices, be sure you cover all fees associated with your procedure, rather than just the surgical costs. (i.e. anesthesiologist, radiologist, facility fee, lab costs, etc.)
  8. Be polite: Don’t be overly aggressive in seeking a discount. If you cannot afford what you need done, tell your provider. Some medical practices will alert you to payment options, but some may not be actively promoting them. Start with the office clerk you’d normally check out with, but don’t be afraid to ask for a billing manager if you don’t feel like you’re getting a full answer.
  9. Review all the paperwork:  If a bill seems out of line, ask about it. Check around to determine if the bill is in line with what other facilities charge. Call the billing department armed with your information and ask for the lower charge.
  10. Call in expert help: Medical billing is so complex that it’s spawned a new industry of professional bill reviewers, sometimes called medical billing advocates. These specialists are trained to look for incorrect billing codes and duplicate charges. Check credentials before you hire, though. Experts say advocates average recovery of 17 to 49 percent and charge an average contingency fee of about 30 percent. Some charge flat fees, as well.


1,237 Angie’s List members responded to the May online poll. 1,015 Angie’s List members responded to the July online poll.

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