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I left my old job in December 2015 - I was offered COBRA benefits that could be retroactively enabled up to 60 days after I left the payroll. My new job didn't start until mid-January (I wanted a long vacation) - I saw my doctor (a specialist) in the week before I started my new job. I didn't think anything of it because I thought I'd just enable COBRA and not bear any significant expense (beyond the cost of COBRA itself).

I received the bill from my doctor in late January. For $615 (!!) - this was because they billed my old insurer they had on-file who said I wasn't covered anymore - and proceeded to invoice me instead. Fair enough, as I hadn't retroactively enabled COBRA.

After I got the bill, I looked at the COBRA paperwork and saw it was approximately $500/month (plus an additional $50 for dental coverage). $500 is still less than $615 - but then I remembered my old insurance had a $1500 deductible that is reset every January. So I'd have to pay $500 plus the $615 bill anyway as that's under the annual deductible. Total out-of-pocket: $1115; so when mid-February came I decided to not retroactively enable COBRA and thought I'd pay the bill myself.

I know that you can negotiate medical bills down ( How can I negotiate a medical bill that seems excessive? ) so I called up my doctor's billing office and discussed options - without much persuation I got them down to 20% off and paying the balance over 6 months (they said the 20% discount is for all uninsured patients paying with cash). I said I'd call back the next day to confirm, but I neglected to. I thought I would find my old EOB paperwork to find out what discount my insurer used to get (because I'm certain it was for more than 20% - I'd get them to match that, then I'd pay them the smaller amount).

However, tonight I was paying a whole slew of bills off and I thoughtlessly paid-off my Doctor's bill using their online credit card service - I had completely forgot about the discount I was trying to get.

So I've inadvertently paid-off a medical bill for the full amount of $615 using their online collections service when I wouldn't have had to pay more than $492.

What's the best way (assuming it's possible) for me to ask my doctor for the 20% discount they mentioned to be applied to my account and get that amount put back on my credit card?

(I note that I'm paying with my "normal" credit card because my remaining HSA balance is insufficient to cover the bill)

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    I'd say you have about a 5% chance of retroactively receiving a refund. – quid Mar 9 '16 at 6:52
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    It kind of teaches you something about negotiation. "What if I paid in full right now?" Maybe you get a 25% discount. Also you did not pay in cash, you paid by Credit card. The doctor's office did not receive the full amount. – Pete B. Mar 9 '16 at 16:32
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    +1 for "credit card is not cash". Even checks aren't cash, though they are often accepted as qualifying for " cash" discounts. I'm afraid that the only person who has cheated Dai is Dai. – keshlam Mar 10 '16 at 13:28
  • @keshlam I think what Pete means is that people get charged for running credit cards, where as they normally don't for cashing checks (or get charged much less). So checks are closer to cash than credit cards. – barrycarter Mar 10 '16 at 17:59
  • In particular the doctor (or their payment processor -- IME it's often outsourced) has already paid a fee to process the charge, and most likely will have to pay another fee to process a refund. If you will be going back (unclear, you said this is a specialist) you might ask them for credit on their own books to be used next time you owe them a copay. – dave_thompson_085 Mar 11 '16 at 4:26
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Send your doctor a letter or email as follows (do not call, you want to get and send things in writing whenever possible).

Dear Doctor, 

Thank you for confirming that I was entitled to a 20% discount on my 
recent $615 bill, bringing the total amount down to $492. 

I went online to pay the bill, but, after paying, realized that I had 
paid the original amount of $615, instead of the correct discounted 
amount of $492. 

I was wondering if you could process a $123 refund to my credit card. 

If you prefer, I can make the $492 payment via check, and you can 
cancel the credit card transaction entirely. 

I appreciate your help. Sincerely, [...] 

Give your doctor a few days to respond. If he doesn't, write (do not call!) your credit card company (within the dispute period, which will be in small print somewhere, but is usually at least 60 days), and send them a similar message, again indicating that the $615 was a mischarge, and that the correct amount was $492.

While this won't guarantee a refund, I think it might improve you chances.

  • It wasn't a mischarge. He likely confirmed the amount and agreed to some set of terms and conditions that include penalties in the case of a charge back before authorizing the charge. He has no proof the discount was offered. I absolutely would not pursue this route. – quid Mar 10 '16 at 17:54

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