You haggle at the car dealership, at the farmers market, and at flea markets. But your doctor's office? That doesn't occur to most people. Yet there's a lot of room for negotiation over medical care costs, says John Santa, MD, a medical expert with Consumer Reports.
Simply speaking up about money can make a difference in what you'll ultimately pay, Santa says. "When people are stressed financially, that's helpful information [for a doctor] in terms of taking care of them medically," he says. "That communication to some degree ends up being a negotiation."
Most doctors will be responsive, Santa says, and may offer you less expensive alternatives. For example, a watch-and-wait approach, as opposed to rushing into costly tests and specialist visits, can save a lot of money without necessarily sacrificing quality. So can generic drugs.
Saving on Hospital Bills
Doctors can also use their relationship with local hospitals to help with big bills. "In most cases, if a physician gives the hospital a call and says my patient is struggling with a bill and asks them to help, they'll do that," Santa says.
Just thinking like a shopper when choosing medical care can save a bundle, he says. As all good shoppers know, cash is king. If you have it, use it to negotiate with your doctor or hospital for a better price. Look on web sites like www.healthcarebluebook.com for information about fair pricing in your area.
Saving on Surgery, Prescriptions
And it turns out the price of real estate isn't the only thing dictated by location. "You may be able to get elective surgery much less expensively in an ambulatory surgery center than in a full-service hospital," Santa says. Just do your homework: Treatment in a doctor's office if your procedure requires the sophistication of a hospital isn't worth the cheaper price tag.
Prescription prices vary widely from one pharmacy to another, so be sure to shop around for drugs, too. If you can't afford your medications, talk with your doctor about programs that help patients get the drugs they need for free.
Santa acknowledges that many people fear their doctors won't see them or suggest the care they need if they try to bargain. "If that's the case, you don't have a good doctor," Santa says. It's time to shop for a new one.
Saving on Hospital Stays
Hospital bills also can be whittled down, says Santa, if you follow some of these tips.
Insist on efficiency. If you're having surgery, ask to be admitted to the hospital the morning of your procedure rather than the night before. Also ask to be discharged as early as is safe and reasonable.
Demand focus. Be clear that you want your care to focus on the particular procedure for which you were hospitalized. "Let them know, I don't want anybody ordering another X-ray or set of blood tests. My doctor will take care of that when I'm discharged," Santa says.
Don't pay for mistakes. Billing errors are common. Insist on an itemized bill and a copy of your medical record after treatment, and make sure they're consistent. Don't pay for any service, device, or drug you didn't use. If hospitalization led to an infection, demand that any extra hospital days needed to treat it be removed from your bill.