Are ER's and hospitals a wheelin' and dealin' kind of place?

Factual Questions
1

Recently I was riding my road bike up in the high country and unfortunately found a patch of ice to slip upon and bash my chin open. Upon picking myself up, I found that I was bleeding rather profusely and got myself into the local ER. Once there I was treated to six sutures. All in all, the PA that sewed me up did a wonderful job, the scar is already virtually invisible (three weeks!) and I can’t find any complaints about the care.

And then the bills come. Being a free-market kinda guy I’ve opted for a health plan with a $5,000 deductible. Needless to say, this ER visit doesn’t even approach that deductible. My health insurance was billed for $581.00, but the bill was reduced to $377.65 because, like most insurance companies, Humana has got a deal with the hospital.

Now, after the first round of the This Is Not A Bill statements have arrived, I presume that I’m soon going to be encountering an actual bill for $377.65 in the near future. $377.65 isn’t an impossible sum for me to raise, but it’s quite a lot. It’s not that I can’t pay it, but frankly I’d really rather not. Also, $377.65 for six sutures does seem a bit steep. Perhaps $250 would be a fairer figure? I certainly hope that I didn’t cost the hospital $377.65 in expenses.

Now, I know that a large number of medical bills ended up defaulted or whatnot, so if I were to call up the hospital’s billing department tomorrow and offer them $250, what would experienced or otherwise willing Dopers predict would happen? Are they going to laugh me off the phone, tell me to shut my trap, or possibly agree? After all, $250 in hand is better than $377.65 in the bush, right?

Thanks,
threemae

2

Last time I tried this, they claimed that they weren’t allowed to discount below the discount they gave me for my insurance, due to their agreement with my insurer.
I told them I’d gladly pay as soon as I saw a copy of that contract.
Never did see that contract, wound up paying anyway, albeit on a stretch pay program.
If you can’t raise $400 this month, most ER’s billing places would be willing to spread it out over 3 months, perhaps more.

3

You have nothing to loose by paying $250 and seeing what happens (except, maybe credit rating? Not sure how worried you are about that).

Plenty of places will not bother chasing the remainder $127.65 (in fact a place like a hospital would prolly write off the total charge as well, tho it may affect your credit rating?). A hospital would be going for the easy wins - thousands of dollars - but they will have a system in place to chase your money as well. I run a medium sized business, and would not both chasing a $377 debt that a client owes us, it’s just not worth the time and effort spent on it.

Many places that are owed money from people (or companies) will try for a few months to get their money with mail, and phone calls, but then sell the debt to a debt collection agency. The hospital might sell your debt of $377.65 to an agency for $150. The hospital gets $150 and calls it quits, and the agency chases you for the money. They hope they get more than $150 out of you and turn a profit.

Having been in this sitch myself (tho it was an insurance company chasing me for a car accident I was involved with, uninsured student and all), they’ll usually send a guy around to try to “sort something out”. In my experience, this was a regular guy in a suit, 35-ish, offering me some options.

I was too shit scared to do anything other than agree with him when he said I could pay back a $2500 debt at $50 a fortnight, but I have always wondered what’d happen if I’d refused. He did not make it clear he did not work for the insurance company, and I never asked (he opened with something like, “I’m here about the money you owe BigInsurance”, kinda ambiguous). It was only a few years later when I had paid it all off that I realised what had happened - he was not from BigInsurance at all.

However, In your case, you said you got good care in a timely fashion. While your stitches themselves would not have cost the hospital that amount, remember they have to pay malpractice insurance for the dr that helped you, as well as rent, power, equipment, and so on.

I reckon you should pay, but that’s just me.

4

So $377 is putting a crimp in your style. What will you do if your next fall results in the full $5000 being used? :confused:
You just joined the dumb tough club (Motto: If you are going to do dumb things, you gotta be tough)
You saved a pile on your premiums by going with the high deductible. Free market kind of guy my ass, you were cheap. :wink: Karma has now caught up with you.
Pay the money.

5

I would have thought credit rating was the big issue. The hospital won’t sue over the amount involved, but I don’t think they’ll accept a discount just because you ask. They may accept a compromise if you can’t or won’t pay, but the quid pro quo will be a black mark on your credit record. One day you’ll want credit and this may count against you. I doubt what you are hoping to save is worth the reputation for chiselling this may earn you.

6

I won’t pay any less than I’m eventually billed for, but I was hoping to be able to talk the hospital down a bit.

Out of curiosity, perhaps someone that understands medical billing better than me can suggest, what would this service probably have run at an urgent care clinic? I’m kicking myself not for having gone there instead under the presumption that it would have been cheaper, but I’m curious what this would have cost if I had been able to shop around a bit.

7

Call up the department that handles the billing and ask for a payment plan. I can all but guarantee they’ll let you make six payments of $62.94. No interest, No collections, no ding on the credit report.
And if you think $377 is expensive, hold your breath that you don’t get another bill. Some areas of the hospital (radiography comes to mind) bill you twice. Once for the hospital, once for the doctor/tech that did the actual work.

8

abby,

In the US, in-person visits from debt collectors seem to be pretty rare. Letters and phone calls seem to be the de facto methods of choice.
I’ve read some literature that leads me to believe that Australia’s customs are somewhat different, but nothing I could cite.
For legal reasons, I never discuss any past-due debts, real or imaginary, with any business except via postal mail. If someone knocked on my door, they’d get the same response telephone callers on those matters do: send me a letter, and no comment.

9

Hospitals will very often cut deals. If you don’t pay, it goes to collections. If you still don’t pay, eventually *they *will offer *you *a deal. (I’ve had this offered twice - even though I was making tiny payments, they offered me a substantial sum off if I made two lump sum payments instead.) Still, better to take the initiative and try to work a deal up front, so your credit report isn’t dinged.

There’s absolutely nothing to lose by trying. It’s not like they’ll add on a “tried to make a deal” fee if they say no.