Ok, just curious… do you generally get a positive response when calling doctors to ask about or negotiate prices? We’ve tried simply asking what the prices for different services are. Generally the receptionist transfers us to someone in the billing department, who either doesn’t respond, or gets belligerent, or says they have to look it up but never get back to you, or says it depends on your insurance, or the specifics of the case, or blah blah blah.
Ah, let me explain.
In order to negotiate prices, you must
pay for the services
yourself. If the insurance company pays, they have set fees – as a doctor once told me, “If I know the insurance company pays $100 for a procedure, why would I ever charge $95?”
It does you no good to negotiate if you’re depending on the insurance company!
I know of many instances where people who were paying out of pocket successfully negotiated prices – a friend whose son suffered a closed head injury received a bill for over $100,000 over and above what insurance paid – and negotiated it down to less than $10,000.
But when people have true MSAs, they routinely negotiate for services. And the more people who have MSAs, the easier it will be to negotiate – we will in effect be moving back to the good old days when people paid their own bills and the insurance companies (with their enormous overhead) are cut out of the picture.
There are some doctors and clinics and such that have a fixed price list for specific services. However my experience has been that, for many doctors’ offices, it is just not that transparent. Never mind getting to point of negotiating a price, because you can’t even figure out what the starting point it.
Does the door have a knob on both sides?
If it does, you turn around, use that knob to open the door and leave. Take your business elsewhere.
And if MSAs were common, such doctors as you describe would soon be begging for patients!
A surgery would be the type of thing too where, e.g. you might get a price for the surgeon for the knee replacement, but the anesthesiologist, the radiologist, and the doctor making the rounds in recovery all belong to separate practices that all bill separately from the surgeon. Perhaps you can negotiate with one… but you don’t necessarily get to choose them all.
I repeat – does the door have a knob on both sides?
If you don’t get a price to your liking, go elsewhere!
Other kinds of screwy things happen too. E.g. I know that my hospital runs blood work in their own lab, which is covered by my insurance and will charge xx amount. On Tuesday I get some blood drawn at the hospital. However, they’re short-handed that day, and send out my sample (without my knowledge or consent) to an outside lab, which happens to not participate in my plan, charges 3 times as much, and doesn’t apply toward my deductible. I’m left with a bill for much higher than I expected. I can stall up to a point, but they don’t respond without threat of legal action, insurance and the hospital both blame each other, and ultimately it’s my credit score that’s going to get dinged if I don’t pay, so I really have no recourse.
Does the door have a knob on both sides?
Tell the physician what happened, and tell him if it happens again, you’ll take your business elsewhere.
As for an Ob-Gyn - depending on where you live, these are in very short supply. Not an attractive field for young doctors to specialize in. 9 months isn’t necessarily a long time to find one. And if you actually want some prenatal care earlier in pregnancy… it’s not unusual to have to wait 3-4 months to get the next open appointment, never mind trying to find the doctor with the best cost structure, or one that will negotiate with you. And back to the first part of my post… my wife’s Ob practice was a classic case of having no idea what they actually charge. In fact they never even got around to billing us for prenatal services, and a different Ob ended up being on call for the delivery, so he billed us for that, which may have been totally different from what the original Ob would have charged.
Talk to the lawyers about OB – they are the ones who have made that specialty a target and driven out many OBs.
So if I may summarize, even the cost of routine medical care can be difficult to predict, let alone negotiate. At least in my experience. Even if you do have time between 9 and 5 to call around to different doctors’ offices and speak with unhelpful people in the billing department.
Take my advice – when you first come into the doctor’s office, check to see there is a knob on both sides of the door.
I don’t know if it would benefit my family…I mean, I don’t use our healthcare very much…except for annuals and physicals. Should I look into it? Our company shows us the menu of options, but doesn’t sway you into one direction or the other. So, I just don’t like change, and stick with what I have always used.
