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Reducing Healthcare Costs through Medical Negotiation

Posted Nov 02 2009 10:01pm
This year an estimated 1.5 million Americans will declare bankruptcy, and a study from the American Journal of Medicine suggests that more than 60 percent of people who go bankrupt are actually capsized by medical bills. Most of these medical debtors are well educated, own homes, and have middle-class occupations; three quarters have health insurance. >

However, medical negotiation, the practice of reviewing and negotiating payment of your medical bills and procedures, is providing individuals the opportunity to prevent medical bills from spiraling out of control.

“Many people don't think of medical negotiating as a practical option to reduce their medical costs; though they anticipate negotiating when purchasing a home or pricing a car,” says Derek Fitteron, CEO of Medical Cost Advocate (MCA), an expert medical cost reduction company.

MCA uses health care pricing information along with data showing the cost of typical medical and surgical procedures, and works with medical providers to negotiate costs on behalf of the consumer. MCA will negotiate any medical bills including those not fully covered by insurance like surgery, hospital and professional charges and those not covered at all including cosmetic, bariatric and dental. This can be done prior to the procedure (negotiating a set price) or after it occurs to help arrive at a reduced price for the consumer.

“While individuals can negotiate bills themselves, they often don’t have the skills, knowledge or time necessary to achieve success,” says Fitteron. “MCA negotiators include attorneys and former healthcare billing professionals that know how to negotiate bills and have industry data to leverage. All negotiations are conducted tactfully with utmost respect for the patient provider relationship.”

With an 80% success rate of reducing bills ranging from $250 - $250,000 by 20-50 percent, MCA follows a no-risk negotiation policy for consumers; if they don’t save the customer money, the customer doesn’t pay.

“Consumers should make a habit of medical bill negotiation,” says Fitteron. “Actively participating in the billing process both before and after a procedure or treatment provides consumers with an opportunity to get their debt under control. In todays increasingly consumer directed health care environment many families need a trusted cost advocate on their side.”

Fitteron also offers the following five money-saving tips to help consumers save money on their medical bills:

1. Be sure that you understand your insurance coverage. Review and understand your insurance summary/declaration sheet and know in-network and out-of-network provisions. Have a firm understanding of your co-payments, deductibles and co-insurance rates and when they apply.

2. Research before buying. If you plan to use or go out-of-network, do extensive research on a doctor’s capability and costs. A professional like Medical Cost Advocate can help you in this process and can help you negotiate a rate or payment plan before your procedure.

3. Take advantage of health savings accounts and other tax advantaged products to reimburse medical expenses like HSAs, HRAs, and FSAs which are frequently available from employers or directly.

4. Ask for details about your procedure charges including an itemized bill with procedure costs. Be sure to wait for an Explanation of Benefits (EOB) from your insurer, and always review both items to make sure you received what you thought you were getting.

5. Find a trusted medical cost negotiator, like Medical Cost Advocate, to help reduce bills. As most people lack the time, expertise or desire to negotiate their medical bills, they should hire an expert (that works on a pay-for-performance basis) to negotiate bills on their behalf.

About Medical Cost Advocate

Medical Cost Advocate (MCA) is a medical cost reduction company that lowers consumers’ medical bills before or after treatment through the power of professional negotiation. Serving consumers, their employers, benefits consultants and financial institutions, MCA leverages industry experience and proprietary data to regularly save consumers between twenty and fifty percent on their medical bills. MCA can negotiate any medical, surgical or dental bill for insured and underinsured consumers. With out-of-pocket healthcare costs steadily increasing, MCA provides the professional advocacy every consumer needs to realize savings without risk.

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