Everything Changes - The Guide to Young Adult Cancer

The first step to reducing your medical debt is asking your doc or hospital to reduce your bill. This takes time, chutzpah, and smarts and is worth the work.

Asking for a discounted bill can sound impossible but it’s not.  Here’s why:  The cost of medical procedures, doctor’s time, and hospital services are not set in stone. In fact, different patients are even billed different prices for the same services. Walking into a doc’s office or hospital is not like walking into McDonald’s where a Big Mac costs the same for everyone in line.  With medical care, different people get charged different rates and your rates can be negotiated.  After all, negotiating rates is exactly what insurance companies do and you can do it for yourself too!

The National Endowment for Financial Education has a great brochure ‘Avoiding and Managing Medical Debt’.  These tips on how to ask for a reduced medical bill  are based on their expert advice:

1.  Have a positive attitude. Your odds are good: 50% of people who ask for reduced costs get them, plus using these strategies give you an extra advantage.

2.  Talk to the right person, face-to-face: Don’t do it by phone or letter. Talk in-person to your doc, your doc’s or hospital’s office, business, or billing manager.

3. Honey goes farther than vinegar. Be polite. Kill’em with kindness.

4.  Be persistent. Don’t take no for an answer.  (I never do!) Many hospital staff don’t know the correct policies and will say ‘no’ when they should say ‘yes’.  Work your way up the ladder.

5.  Build your argument. Find a copy of the hospital’s free and discounted care policy.

The American Hospital Association has a Billing and Collections Practices Policy.  4,200 hospitals have signed on agreeing to: a.) assist patients who can’t pay for all or part of their care, b.) make these policies accessible and written in clear language. Visit this link, click on ‘more than 4,200′. If your hospital is on the list, present this info in defense of your request.

6.  Contact your State Attorney General. If you’re at a non-profit hospital, many state AG’s will help ensure they provide charity care.  Find your State AG here.

7.  Compare costs. Conduct research to find out what patients with insurance or Medicare are paying for your same procedure codes. Demand the same rate.

8. Offer to pay part upfront.  Billing departments need cash from patients who often can’t paying anything at all.  Bargain for a discount in exchange for paying something upfront.  Will they cut in half a $15,000 bill if you give them $800 upfront?  Maybe.

9.  Get it in writing. When they agree to your request, get it in writing!

Does haggling for reduced costs excite or intimidate you?  Have you ever done it?

For grants, financial assistance, and money saving tips download for free the first chapter of Everything Changes: The Insider’s Guide to Cancer in Your 20s and 30s.  Scroll down on the right side of this page for the yellow highlighted download link.

I have a horrible history of arguing with PETA (People for the Ethical Treatment of Animals) advocates, like the big Foie Gras debate in Central Park where the PETA volunteer almost clobbered me with her clipboard.

I now have another beef to pick with PETA. (Would you ever know that when I was diagnosed with cancer I had already been vegetarian for 14 years, vegan for seven? I do love cows and geese, it’s just these wactivists are absurd!)

According to the blog Disruptive Women in Healthcare, PETA is sending letters to the CEOs of major hospitals urging them to reduce their carbon footprint by eliminating meat as an option to patients, visitors and employees. I like the response of Glenna Crooks, the blogger who posted the story. She argued that transitions to meat free diets take time for our bodies and schedules to adjust to, and there is a learning curve for educating oneself about proper vegetarian nutrition.

I agree with Glenna. During and after a hospital stay is not the right time to throw another wrench into a patient’s already complex and life altering care plan. Hell, if some of us in cancer treatment or after surgery can manage to swallow a bite of boiled chicken or sip beef bullion, it is cause for a celebration not a PETA demonstration.

Hospitals should try to reduce their carbon footprint, but they should look to The University of Pittsburgh Medical Center as an example of how to do so through adopting energy efficiency standards.

Are you, were you, or would you ever be vegetarian or vegan? Do you think it is a good idea for hospitals to impose that dietary choice upon patients? What food worked best for you during cancer or other illnesses and could you have gotten by without a bowl of chicken soup?