10 ways to cut your medical bills

By Bankrate.com

As health care consumers endure higher deductibles and reduced insurance benefits, it is becoming more important to understand and even negotiate prices before receiving medical treatment.

Dr. Kathryn Stewart, the medical director of care management at Mount Sinai Hospital in Chicago, says patients can and should be more proactive about seeking the best prices for their services.

"Hospital costs are probably 40 to 50% of what their (list price) charges are," she says. But when it comes to billing, "most hospitals are happy to break even or have a little bit of profit."

This means there is plenty of room to negotiate and reduce your out-of-pocket expenses.

1. Ask your doctor to be your ally

If you're shopping around for medical services, you probably have a primary physician who directed you to seek the service in the first place.

"You have to get diagnosed by somebody," Stewart says. "So let that person be your advocate."

Stewart advises patients to ask their doctors where the best hospitals are for the recommended procedures and which centers will work with patients to lower out-of-pocket costs, and to even ask for help communicating with that facility's finance department.

"If the hospital where a physician admits is approached by that physician on behalf of the patient, I think (the patient) might get somewhere with the hospital. Let's say I have a patient in my practice who has one of these really high-deductible (insurance) plans, and they need to have a hysterectomy. (I could) approach the finance department and say: 'I've got this patient, but they don't have (enough) insurance, and they can't afford to pay full price, but they can afford to pay something. Can you work with them?'"

2. Compare costs by using the CPT code

Though your doctor might be willing to initiate a conversation with the hospital finance department, you can still expect to have several conversations with them on your own. Before calling, make sure you have the "current procedural terminology," or CPT, code for the procedure you are seeking.

"CPT is the industry term for the 'billing code.' It's a five-digit number that is used to bill the procedure," says Jane Cooper, the president and CEO of Patient Care, a health advocacy company in Milwaukee.

Cooper says your physician or physician's office can provide you with the code, and the number is the same across hospitals. With this code, you can call multiple medical centers to compare prices for the same procedure.

3. Find friends in the billing department

When calling different medical centers, ask for the billing department, and then ask what they charge for the procedure you want.

"You should be able to get (the pricing information), by being persistent, about 80% of the time," Cooper says. "If the representative does not give you the answer you need, ask for his or her manager. And keep asking for the manager."

Your success in this area can help determine whether you ultimately choose to use this facility for your medical treatment.

"If the hospital or doctor won't tell you what they charge, then my advice would be to go to a different doctor or hospital," Cooper says.

4. Negotiate lower prices and payment arrangements

If you're fortunate enough to get comparative information and an alternative hospital is cheaper, go to the original hospital to see whether it can match the lower price. If all the hospitals you contact charge similar amounts, see if you can negotiate a prompt-payment discount with one of them.

Don't forget that hospitals are willing to work with people who have severe financial problems. If you need to have a procedure performed but believe there is no way you can pay the bill, ask if the hospital is willing to work out a payment plan.

"Lots of hospitals have policies about (serving) underinsured people," Stewart says. "They have sliding fees scales and (are able to arrange) various payment arrangements."

5. Ask if recommended services are necessary

"One of the major pieces of advice I would give any patient is to not be afraid to ask questions," says Dr. Charles M. Cutler, the medical director of quality for Aetna, an insurance company, and a co-author of "Navigating Your Health Benefits for Dummies."

Ask about all the services your physician is recommending, including hospital stays, lab tests and medications.

"If you're concerned about the cost of a procedure and whether or not it is discretionary or could be done at a later time, you should ask your doctor," Cutler says. One factor in lowering costs may be postponing, or even eliminating, a needless test or procedure. That decision needs to happen in partnership with your doctor, but by asking, you could save money.

Continued: Explore state-sponsored hospital Web sites

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