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Many consumers complain about the high cost of health care, but few of them know they can negotiate price and payment with their doctors, dentists and hospitals.  Some of those who’ve done it have saved hundreds of dollars.

“This is one of the best kept secrets in the health care industry, and consumers need to know about it,” said Angie Hicks, founder of  Angie’s List, the nation’s premier provider of consumer reviews on local doctors, dentists and service companies.

While some medical practices have a set payment and billing schedule, others are prepared to offer discounts and payment plans and will help patients work through the process. Because this trend is in the early stages, those options don’t get marquee billing, Hicks said.

“Most of the time, you have to ask your medical provider for savings or payment options,” Hicks said, predicting that as consumers become more savvy, medical providers will be more aggressive about their price options. Among the options:

• Uninsured patients or patients paying without using their insurance benefits may save up to 50 percent on procedures by paying their bills in full immediately.
• Discounts and zero percent interest payment plans are available.
• Many offices offer senior citizen discounts.
• Patients who use their insurance benefits can negotiate costs either not covered or not fully covered by their insurance provider.
• Patients can maximize savings by paying with cash or check because some practices have begun passing to patients the surcharges they have to pay for transactions that involve credit and debit cards or cards that offer cash back or points. Those surcharges may negate any bonus earned through the card.

 “Medical bills are among the most complicated documents any us will ever read, and too many of us just look for the number at the bottom and pay it without trying to understand how the billing agent got to it,” Hicks said. “It would be great if the bills were easier to understand and price comparisons were easier to do, but that isn’t going to happen overnight,” she said. “With just a bit of research, though, you can find savings and still get great medical care.”

Consumers should also focus billing accuracy, Hicks said. Some patient advocates estimate that 80 percent of all medical bills contain errors.

“This isn’t a matter of trying to avoid paying a fair price for service. It’s making sure you’re paying the correct amount and accessing options that are available,” Hicks said. “Never just pay a bill – review it first, ask questions if you have them and be prepared to be persistent.”

It took one Angie’s List member six months and repeated conversations with her doctor and health insurance offices to resolve an issue caused by an incorrect code. Had she ignored it, she would have paid hundreds of dollars that she shouldn’t have been billed for to begin with.

In a May 2010 nationwide member poll, Angie’s List found that 57 percent of respondents have never negotiated a medical bill. Nearly 25 percent of them didn’t even know they had that option.

“One of our members saved hundreds of dollars off her hospital bill by paying it all at once with her credit card,” Hicks said. “In fact, 74 percent of our members who asked for discounts, got them – and some ended up paying less than half of the original charge.”

Physicians were more willing to negotiate bills than other health care providers, according to the survey. More than 40 percent of successful medical bill negotiations were conducted with doctors’ offices; 31 percent with hospitals and 18 percent with dentists. Other categories covered include alternative medicine and chiropractors.

Hicks cautioned consumers from putting too much emphasis on price when it comes to medical care. Finding health care providers who meet your specific needs and have all the necessary licensing and training is paramount, she said.

“The good news is that there are plenty of great doctors and dentists who are willing to negotiate,” she said. “Medical billing advocates can also help you navigate the medical billing structure, most of them on a contingency basis. So if you don’t save from their expertise, you don’t pay them.”

More than 40 percent of the respondents who haggled with their medical provider did so because their insurance didn’t cover as much of their bill as they had expected. Nearly 20 percent of the respondents just wondered if they could get a better deal.

“Many providers have discounts available to patients who can pay their bill the same day service is rendered,” Hicks said. “Just like any other service provider, doctors and dentists appreciate the cash flow and have standing rates for immediate payment that are available to anyone.”

“Be polite, be reasonable and just ask about the possibilities,” she said.  “The worst that can happen is you learn your provider doesn’t offer payment options. Yet.”

Angie’s Tips on Negotiating Your Medical Bill:

1. Ask: Cash (or immediate payment) is king in a medical facility, just as is it is with retailers and service companies. Ask if there’s a discount for upfront payment or a no-interest payment plan. Be sure to follow all applicable health insurance rules.
2. Get quotes in writing: If you’re price shopping before you have a procedure done, get a signature, name and title to go along with the price quoted.
3. Cover every doctor in the room: When getting prices, be sure you cover all fees associated with your procedure, rather than just the surgical costs. (i.e. anesthesiologist, radiologist, laboratory costs, etc…)
4. Be polite: Don’t be overly aggressive in seeking a discount. Some medical practices will alert you to payment options, but some may not be actively courting 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.
5. 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.
6. 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 poll.