Author: Olivia Matenhouse

I was a first time mom, who was rather clueless when it came to knowing what to expect as far as the charges for having a baby. Let’s just say, when I started receiving bill after bill for my rather short hospital stay.. I was humbled yet unprepared for what it was going to do to us financially.

We were insured through my job.. but it barely even covered anything. I knew I had to get creative in many different ways to get us to the other side of this new debt. While negotiating a hospital birth bill can be daunting, it’s still often possible to reduce costs or arrange a payment plans. I know there are other mamas out there getting these very same eye widening bills in the mail. I hope this step-by-step guide, and conversation prompts will help you navigate the process a little easier.

Step 1: Gather Information

Before you start negotiations, collect all relevant information:

• Itemized Bill: Request a detailed, itemized bill to understand what you’re being charged for.
• Insurance Coverage: Review your insurance policy to know what should be covered and what your out-of-pocket expenses are.
• Ask For An EOB: Ask your insurance provider for an explanation of benefits. Compare that to your bill to make sure it’s all being covered.
• Keep Written Details: Write down the names of everyone you speak with, what department they are in, their direct phone number etc.

Step 2: Review the Bill

Carefully go through the itemized bill to check for:

• Errors: Look for duplicate charges, incorrect quantities, or services you didn’t receive.
• Overcharges: Compare the charges with what your insurance company or other hospitals typically charge for the same services.

Step 3: Contact the Hospital Billing Department

Once you’ve reviewed the bill, it’s time to initiate a conversation with the billing department.

As frustrating as the situation may be, it’s important to remain calm and remember that being firm doesn’t mean being harsh. Approaching the issue with kindness and respect can make all the difference. People are far more likely to assist you if you’re polite and understanding, even when you’re advocating for yourself or your needs. A firm but kind attitude encourages cooperation and helps resolve situations more smoothly.

Conversation Prompts:

• Starting the Conversation:
  “Hello, I’ve received the bill for my recent delivery and would like to discuss it. Could you please help me understand some the charges?”
• Inquire About Errors:
  “I noticed a charge for [specific service], but I don’t recall receiving this. Could you verify if this charge is correct?”
  “There seems to be a duplicate charge for [service]. Can you review this for me?”
• Request an Explanation:
  “Could you break down this particular charge for [specific service]? It seems higher than expected.”
  “Is this charge in line with what’s typical for this service in our area?”

Step 4: Negotiate the Charges

If you find errors or believe some charges are unreasonable, negotiate for a reduction. Often, if you offer a cash payment for a charge that insurance wasn’t covering anyway they will issue a much lower charge amount.

Conversation Prompts:

• Requesting a Discount:
  “After reviewing the bill, I’m concerned about the total cost. Is there any way to reduce the charges, especially given that [example reason, e.g., I was charged for a service I didn’t receive]?”
• Comparing Prices:
  “I’ve looked into the costs at other hospitals, and they seem lower for similar services. Is there any flexibility to adjust these charges to match the typical rate?”
• Uninsured or High Deductible:
  “We are currently facing financial difficulties, and this bill is a significant burden. Are there any discounts available for uninsured patients or those with high deductibles?” (Majority of hospitals offer financial assistance)
• Payment Plan Inquiry:
  “This bill is more than we can manage all at once. Could we arrange a payment plan that works with our budget?”

Step 5: Discuss Payment Options

Inquire about the threshold for their “Medical forgiveness” plans. These are debt forgiveness programs set up to help patients who are struggling with large medical bills. These programs can provide partial or full cancellation of medical debts, allowing individuals to manage or eliminate their financial burden. Medical debt forgiveness is often offered by hospitals, healthcare providers, or through charitable organizations and is designed to help those who are experiencing financial hardship due to medical expenses.

Eligibility for these programs usually depends on factors like income, household size, and the amount of debt. It’s important to reach out to your healthcare provider or hospital to inquire about forgiveness programs, payment plans, or financial assistance options if you’re facing unmanageable medical bills. Additionally, some states and non-profits offer assistance to individuals facing significant medical debt, and in certain cases, legislation has been enacted to protect patients from excessive medical costs.

If a medical forgiveness plans or full payment isn’t feasible, you will need to discuss alternative payment methods.

Conversation Prompts:

• Setting Up a Payment Plan:
  “What are the payment plan options? Could we set up a monthly payment that fits within our budget?”
• Interest-Free Payment Plan:
  “Could you offer an interest-free payment plan, considering the amount and our financial situation?”
• Lump-Sum Discount:
  “If we were to pay a lump sum today, would you be able to offer a discount?”

Step 6: Document the Agreement

Once an agreement is reached, make sure to get the details in writing, including the new payment terms, any discounts, and deadlines.

Step 7: Follow Up

Monitor your statements to ensure the adjustments are made and that your payments are being applied correctly.

Follow-Up Prompt:

• Confirmation:
  “Thank you for your help today. Could you please send me a written or emailed confirmation of the adjusted charges and the payment plan details?”

Negotiating a hospital bill can save you a significant amount of money, and most billing departments are used to these conversations. Stay calm, be polite, and persistent.