If you need to pay a lot out of pocket, I would definitely try to negotiate. Hospitals, labs and doctors negotiate with insurance companies all the time. Take a look at this
http://www.nytimes.com/2009/03/14/health/14patient.html
Here's some excerpts that may be useful to you or others.
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And keep in mind that doctors, hospitals and medical labs are accustomed to negotiating. After all, they do it all the time with insurers. A hospital may have a dozen or more rates for one procedure, depending on whether Medicare, Medicaid or a private insurer is paying the bill, said Ruth Levin, ... Your request for a special arrangement will hardly confound their accounting department.
And it is usually in everyone’s interest to avoid dealing with a bill collector.
If you recently lost your insurance or have a plan with minimal benefits, here is what you need to know if you want to seek a price break from the doctor, hospital or lab.
Dealing With Doctors
DON’T BE SHY “Patients are often intimidated by their doctors ... “But if you need help, speak up. Most are likely to help out.”
Talk directly to your doctor about your financial situation. If that makes you uncomfortable, then go to the billing manager. The office may be able to offer you a discount of 10 to 30 percent depending on the practice (specialists may offer a bigger break), or propose a plan in which you pay your balance in a few installments or on a monthly basis — typically at no interest.
OFFER TO PAY CASH UPFRONT Doctors can lose thousands of dollars every year on unpaid bills and spend countless hours haggling with insurers over reimbursements. If you can make their life simpler by offering to pay right away, you’re likely to get a small discount — even if you don’t have financial hardship.
BE RESPECTFUL...
Talking to Hospitals
STRIKE A DEAL, THEN CHECK IN If you need shoulder surgery, for instance, but don’t have insurance — or are facing a high hospital co-payment — call the hospital’s billing department and explain that you would like to discuss getting a discount and why. Dr. Moritz suggests saying, “I’d like to pay the lowest rate you give an insurance company.”
MAKE A COUNTEROFFER Like doctors, hospitals would rather be paid something than nothing. They lost $34 billion in 2007 on uncompensated care, up 55 percent from 2002.
“Hospitals would rather set up a payment plan than turn it over to a collections agency and then expect to write it off,” Dr. Liu said.
If you end up with a bill you can’t pay — or at least can’t pay right away — don’t panic. Find out what Medicare would pay for your condition or surgery, since that program tends to pay less than private insurers. You can learn that at the federal Department of Health and Human Services database,
www.hospitalcompare.hhs.gov, by clicking on the gray button “find and compare hospitals.”
I learned on the Web site, for example, that if I were admitted to my local hospital for chest pain, the average Medicare payment would be $5,732. Use the Medicare numbers as the starting point for your negotiation.
The truth is, said Ms. Levin of Continuum Health Partners, “only a very small portion of consumers or insurers pay 100 percent of our hospital charges.”
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Bargaining With Labs
Charges for lab work can be exorbitant. But, as with hospital bills, the numbers you see on your statement may not reflect what most insurers actually pay, ....
Negotiate just as you would with your doctor or hospital. Quest Diagnostics, the largest clinical laboratory in the country, for instance, offers a six-month interest-free payment plan, as well as financial assistance for those with real hardship.
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