How to Negotiate Your Hospital Bill

Your hospital bill arrives in the mail and the panic sets in: Could this possibly be right? 

You try to decipher your bill, but it reads like a foreign language. Worse, you have no idea how you’re going to be able to pay it off.

Sound familiar? Don’t despair — and definitely don’t reach for your credit card just yet. You can negotiate your hospital bill, as long as you know what to look for.  For now, take a deep breath. Here are five pro tips we’ve learned from helping customers negotiate hospital bills every day. 

Hospital bills often contain errors or inflated charges. That’s how Goodbill has saved customers as much as 60% when negotiating hospital bills.

1. Resist the urge to pay your bill right away.

Perhaps you’re used to paying your bills on time, and the bolded “payment due date” on your bill is giving you anxiety. Or, maybe the hospital has already sent you a reminder. Whatever you do, don’t pay your bill right away — you often have much more time than you think to research, understand and negotiate a hospital bill before it can go to collections or affect your credit.

Generally, a hospital will take one to two months after your visit to send you your first bill, and even then your insurance may not have applied adjustments yet. If your hospital is a nonprofit, like nearly 60% of hospitals are, your bill cannot legally go to collections for 120 days from the statement date on the bill. Once it goes to collections, you have another 12 months before it can affect your credit score. 

As of July 1, 2022, hospital bills can’t affect your credit score until 12 months after they first go to collections, up from six months previously.

2. Make sure your insurance has kicked in.

Sometimes hospitals will send you a bill before your insurance provider has had a chance to apply their adjustments or payments. Check your hospital bill for line items like “insurance adjustments” or “billed to insurance” to confirm whether your insurance coverage has kicked in. 

Your insurance provider will tell you they’re processing your claim by sending you a separate “Explanation of Benefits” in the mail. You can also call your insurance provider or log into their portal to check on the status of a hospital claim.

3. Ask your hospital for your itemized bill (plus more).

Chances are the bill you got in the mail isn’t the kind you need to understand your charges and negotiate your hospital bill. Hospitals often only send you a consolidated summary that glosses over your charges. In order to negotiate your hospital bill, you’ll want an “itemized bill” to help you uncover errors or inflated charges.

What’s trickier is that hospitals sometimes send you what looks like an itemized bill — with line items and codes — but they’re misleading. The itemized bill you need will have standardized industry codes, such as CPT codes or HCPCS (pronounced: hick-picks) codes, that allow you to cross-check procedures and prices. 

As a patient, you’re legally entitled to receive your itemized bill within 30 days of requesting it. Call your hospital’s billing department and ask them to send one over to you. 

While you have the hospital billing department on the line, here are a few other things to ask:

Do I qualify for financial assistance?

Nonprofit hospitals are legally required to provide financial assistance, or “charity care,” to reduce balances for low-income patients. Income criteria is generally based on meeting a certain percentage threshold of federal poverty guidelines. There are also nonprofits that can help you apply for financial assistance, often for free or a small fee.

Can you extend my payment deadline?

It doesn’t hurt to ask the hospital to extend your payment deadline, or pause aging on your account, while you wait for your itemized bill. This gives you more time to do your research, without worrying about your hospital bill going to collections.

Do you offer discounts or payment plans?

Some hospitals will offer discounts if you’re uninsured (called “cash rates” or “self-pay rates”), or if you commit to paying your bill all at once. Be careful if you use this approach: While it’ll provide some immediate relief, you may still be overpaying if your charges are incorrect. The other option hospitals might offer are payment plans, so that you can pay off your bill in smaller chunks over time.

4. Research prices for your procedures.

Once you have your itemized bill with procedure codes in hand, you’re ready to research prices for your procedures to catch any errors or duplicate charges. Price transparency rules require hospitals to publish their prices, though many hospitals are lagging in compliance or don’t make them available in consumer-friendly formats. 

It’s labor intensive, but if you’ve signed up with Goodbill, we do this in seconds for free: Our software checks your entire bill and flags errors or pricing discrepancies. Plus, if a hospital hasn’t published their data, we look at nearby hospitals to find comparable prices. 

If you’d prefer to research on your own, however, you can generally find the site with your hospital’s published prices by searching for your hospital’s name and “price transparency” in Google.‍

As of January 2021, under the Hospital Price Transparency Final Rule, all hospitals are legally required to publish prices for their services. Not all hospitals are compliant.

5. Send a negotiation letter.

The best way to negotiate your hospital bill is to email or fax a written request to the hospital’s billing or settlements department. Keep it to one page, but make your case: It might be that you simply can’t afford to pay your balance but don’t qualify for financial assistance; or that you’ve found errors or inflated charges in your bill. Once you submit your request, call the hospital to make sure they received it, and get a time estimate for resolution.

Following these steps will take some time, but remember: You generally have more time than you think to do your research. 

Prefer not to deal with the hassle? Then let Goodbill do the heavy lifting. We’ll obtain your itemized bill and other important records for you, have our medical coding experts analyze it for errors, and negotiate your hospital bill. Plus, it’s 100% free unless we find you savings.