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tips for negotiating medical bills

I have about 6 different bills from my delivery and my insurance company is giving me grief over what they will pay. Turns out not a lot. Have any of you had success getting bills reduced from hospitals, doctors, testing companies etc. Would very much appreciate any help you can give.

Tue. Sep 25, 1:43pm

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Your insurance company shoud have a grievance process- find out what it is and use it. It might not be easy to find- I had an issue with my insuance company earlier this year and it took me quite a bit of digging to figure out how to challenge a denied claim. But, in the end they paid everything.

Usually, they'll deny a claim because you went to the wrong hospital or got a procedure that they don't cover. If these things were out of your control, you have some leverage- for example, I was taken by ambulance to a hospital that wasn't covered by my insurance, so they denied the claim. When I explained that I was unconsious at the time and had no say in where I was taken, they allowed the claim.

Ask your insurance provider to explain just what was denied and why- talk to an actual person rather than doing this by mail.

Good luck!

Tuesday, September 25, 2007, 1:53 PM

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Quick question, and sorry for being a little off topic...my sister is getting some medical care in the USA (her husband is American and lives there) We are Canadian so we have a different system.

Do you pay first, and then the insurance company reimburses you?

Tuesday, September 25, 2007, 2:11 PM

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many fctors determine how much you pay and when you are required to pay. check with the doctor's office AND the insurance company BEFORE the visit!!! sometimes you need "pre-authorization" in order to be reimbursed for costs...you can't gather too much information, but you can suffer the consequences of not gathering enough!!

Tuesday, September 25, 2007, 2:26 PM

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Typically, for routine things, the doctor bills the insurance company, and then bills you for whatever it cannot recover from the insurance company. This may be subject to a copay that you have to pay at the time of the appointment, which iis usually a very nominal amount (i.e. $15).

Tuesday, September 25, 2007, 3:32 PM

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I had an accountant-friend tell me that if you have a halfway decent argument for why you shouldn't pay a medical bill, file a small claims suit. Costs you $20 in court fees, and doctors/clinics would rather eat the loss than invest time and money in getting a couple of hundred out of you.

Tuesday, September 25, 2007, 3:36 PM

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