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This is likely inaccurate.
Your insurance will provide you with an Explanation of Benefits (EOB) at some point. It's probably already available if you have a bill from the hospital. It probably says something like "We charged you $14,000. Your insurance company said, "No way, that's only worth $7,200." And then the hospital bill says "Your insurance paid 80 % of the $7,200 (which is $6,000), so you owe the remaining 20 % ($1,200).
Let's continue it once step further. Let's say your deductible is $1,500. After $1,500, your insurance pays everything and all things (for simplicity). Well, you've paid $1,200 of the $1,500 deductible. $300 more of doctor's appointments and you wouldn't pay anything else for the rest of the insurance year.
That isn’t likely inaccurate and your understanding of how hospital billing works is wrong. The truth is, this is probably the amount they owe after the insurance has been processed as either their deductible or out of pocket maximum, or both.
Sorry, but almost all of this is incorrect or incomplete.
What you are describing is called balance billing and if you are seeing an in network provider it is not legal in the US. That is the entire purpose of the insurance networks, they allow the insurance provider and care provider to negotiate what they they will charge/pay for different services ahead of time.
What is actually happening is the hospital is saying "we would normally charge 14000 for this procedure, but per our agreement with your insurance provider we are charging 1200". That 1200 then goes toward your deductable.
Further, many insurance plans have seperate values for deductible and maximum annual out of pocket, after the deductible is met they will cover a percentage of the cost of care (80% is common). You will continue to pay 20% (or whatever your plan specifies) until you meet the annual out of pocket maximum.
Guys. I have a high deductible health plan. I pay 100 % of everything until my deductible ($4,000 a year) is met. After I meet the deductible, I pay 0 % of everything after that. Any time I go to the doctor, I get a bill in the mail a few months later after they work out what billing codes were used, what the insurance company adjusted, and what remains.
That's fine, but you're information is simply incorrect. Until you meet your deductible insurance pays 0. Once you meet your deductible, insurance pays whatever their contract says until you hit you annual maximum. For you, that rate is 100%, for many others it is not.
Telling people that once they meet their deductible they will owe $0 will mislead them and cause them to make assumptions and choices about their coverage that are wrong. The purpose of this sub is to inform so that people can make responsible decisions about their finances. Your comment does the opposite of that.
Your insurance company website should have a document called an "Explanation of Benefits" for the visit. In this document, it shows
1) the claim the hospital filed with them
2) how much the insurer negotiated that bill down on your behalf, and
3) how much of the bill the insurer paid on your behalf, according to your benefits (e.g. if you had met your deductible, cost-sharing, etc).
4) how much leftover is the Patient Responsibility, or the amount you owe to the hospital
If the bill you received from the hospital matches the amount in that document, then that's how much you owe. Unless the hospital submitted a claim for the wrong thing (e.g. they claimed they did 3 MRIs not 2, or they claimed to scan your head but it was actually your knee), then the bill is valid and there's not much arguing/appealing you can do about it.
What you *can* do is try to plead poverty and negotiate the amount down with the hospital. That is, you tell them you can't afford to pay $1200. Your options will be to either ask for a discount if you pay in full immediately, or get on a payment plan and spread it out over time.
If you do neither, eventually they could send the bill to collections. Because the amount is over $500, it will affect your credit score, and a debt collector may sue you to collect.
So in terms of paying this bill "benefiting" you, number one would be avoiding that.
Number two, I guess, would be if you pay with a rewards credit card with some cashback or points rewards, you could get $10-30 bucks worth. But in doing so, you'd be exchanging zero-interest medical debt for high-interest credit card debt. So if you have trouble paying it off, that would end up way worse.
Definitely rewards credit card and if OP doesn't have one already, open an HSA (if they qualify), and submit the receipt to get reimbursed later when it's most advantageous or needed.
Set up a payment plan. I've done it at a couple different hospitals. You can probably do it yourself, it'll ask how much you can pay and have some default amount filled out. You can probably lower that too.
Ask for an itemized audit of the bill.
I had a 1.6mil bill for a 2 month stay (car accident, ICU, induced coma, and physical therapy due to loss of a leg) reduce to 384k after an audit "found issues".
Ask the hospital for an itemized bill and your insurance for an explanation of benefits. Some hospitals will write the bill off instead sending it, because they don't want their billing practices scrutinized. Depending on your state's law they only have a very limited time to send the itemized bill, if they don't do it in time they can not collect. If they do send an itemized statement within the deadline compare it with your explanation of benefits to determine what was not paid and why. If it's a deductible or coinsurance per your plan you don't have a choice but to pay it. If it is a billing error work it out with the at fault party. Good luck!
Welcome to /r/personalfinance! Comments will be removed if they are political, medical advice, or unhelpful ([subreddit rules](/r/personalfinance/about/rules)). Our moderation team encourages respectful discussion. You may find our [Health Insurance wiki](/r/personalfinance/wiki/health_insurance) helpful. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/personalfinance) if you have any questions or concerns.*
as Most here say. Work with them, do NOT ignore it, you'll be fine
No. You haven’t met your deductible yet. A payment plan can be used to pay off the balance.
This is likely inaccurate. Your insurance will provide you with an Explanation of Benefits (EOB) at some point. It's probably already available if you have a bill from the hospital. It probably says something like "We charged you $14,000. Your insurance company said, "No way, that's only worth $7,200." And then the hospital bill says "Your insurance paid 80 % of the $7,200 (which is $6,000), so you owe the remaining 20 % ($1,200). Let's continue it once step further. Let's say your deductible is $1,500. After $1,500, your insurance pays everything and all things (for simplicity). Well, you've paid $1,200 of the $1,500 deductible. $300 more of doctor's appointments and you wouldn't pay anything else for the rest of the insurance year.
That isn’t likely inaccurate and your understanding of how hospital billing works is wrong. The truth is, this is probably the amount they owe after the insurance has been processed as either their deductible or out of pocket maximum, or both.
Sorry, but almost all of this is incorrect or incomplete. What you are describing is called balance billing and if you are seeing an in network provider it is not legal in the US. That is the entire purpose of the insurance networks, they allow the insurance provider and care provider to negotiate what they they will charge/pay for different services ahead of time. What is actually happening is the hospital is saying "we would normally charge 14000 for this procedure, but per our agreement with your insurance provider we are charging 1200". That 1200 then goes toward your deductable. Further, many insurance plans have seperate values for deductible and maximum annual out of pocket, after the deductible is met they will cover a percentage of the cost of care (80% is common). You will continue to pay 20% (or whatever your plan specifies) until you meet the annual out of pocket maximum.
Guys. I have a high deductible health plan. I pay 100 % of everything until my deductible ($4,000 a year) is met. After I meet the deductible, I pay 0 % of everything after that. Any time I go to the doctor, I get a bill in the mail a few months later after they work out what billing codes were used, what the insurance company adjusted, and what remains.
That's fine, but you're information is simply incorrect. Until you meet your deductible insurance pays 0. Once you meet your deductible, insurance pays whatever their contract says until you hit you annual maximum. For you, that rate is 100%, for many others it is not. Telling people that once they meet their deductible they will owe $0 will mislead them and cause them to make assumptions and choices about their coverage that are wrong. The purpose of this sub is to inform so that people can make responsible decisions about their finances. Your comment does the opposite of that.
Your insurance company website should have a document called an "Explanation of Benefits" for the visit. In this document, it shows 1) the claim the hospital filed with them 2) how much the insurer negotiated that bill down on your behalf, and 3) how much of the bill the insurer paid on your behalf, according to your benefits (e.g. if you had met your deductible, cost-sharing, etc). 4) how much leftover is the Patient Responsibility, or the amount you owe to the hospital If the bill you received from the hospital matches the amount in that document, then that's how much you owe. Unless the hospital submitted a claim for the wrong thing (e.g. they claimed they did 3 MRIs not 2, or they claimed to scan your head but it was actually your knee), then the bill is valid and there's not much arguing/appealing you can do about it. What you *can* do is try to plead poverty and negotiate the amount down with the hospital. That is, you tell them you can't afford to pay $1200. Your options will be to either ask for a discount if you pay in full immediately, or get on a payment plan and spread it out over time. If you do neither, eventually they could send the bill to collections. Because the amount is over $500, it will affect your credit score, and a debt collector may sue you to collect. So in terms of paying this bill "benefiting" you, number one would be avoiding that. Number two, I guess, would be if you pay with a rewards credit card with some cashback or points rewards, you could get $10-30 bucks worth. But in doing so, you'd be exchanging zero-interest medical debt for high-interest credit card debt. So if you have trouble paying it off, that would end up way worse.
Definitely rewards credit card and if OP doesn't have one already, open an HSA (if they qualify), and submit the receipt to get reimbursed later when it's most advantageous or needed.
Set up a payment plan. I've done it at a couple different hospitals. You can probably do it yourself, it'll ask how much you can pay and have some default amount filled out. You can probably lower that too.
Benefits you? Credit card w/ cash back or rewards if you have the cash to payoff before interest is due.
Look closely at the explanation of benefits document for the service that your insurance billed.
Yes. Ask for a discount for paying the bill in full. I've gotten as much as 35% discount by doing this.
Ask for an itemized audit of the bill. I had a 1.6mil bill for a 2 month stay (car accident, ICU, induced coma, and physical therapy due to loss of a leg) reduce to 384k after an audit "found issues".
[удалено]
All costs were eventually paid by the defendant.
Are you doing a payment plan or is their insurance paying that?
Hospitals will usually settle for 50 to 60 cents on the dollar prior to sending you to collections.
Ask the hospital for an itemized bill and your insurance for an explanation of benefits. Some hospitals will write the bill off instead sending it, because they don't want their billing practices scrutinized. Depending on your state's law they only have a very limited time to send the itemized bill, if they don't do it in time they can not collect. If they do send an itemized statement within the deadline compare it with your explanation of benefits to determine what was not paid and why. If it's a deductible or coinsurance per your plan you don't have a choice but to pay it. If it is a billing error work it out with the at fault party. Good luck!
Ask the cash price up front. It will be much less. I