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I went to a local doctor's office that takes walk ins. The visit was normal, they took my vitals, doctor saw me, and prescribed some meds. A few weeks later I got a bill in the mail for $400. That's way above normal for a walk in visit around here (NYC area).

What are my options? Is there a way I can get the bill reduced without hurting my credit?

  • Why do you think you should be able to not pay the bill at all? – quid May 13 '16 at 0:23
  • @quid sorry I meant to say have the bill reduced – Ryan Stull May 13 '16 at 0:27
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    For whatever it's worth, negotiating the bill is in no way the same as settling a debt. I'm sure the doctor uses a billing vendor, just call the number on the invoice and ask. – quid May 13 '16 at 0:49
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    You got a service, why do you think you should not pay the price? If there are cheaper clinics - do your shopping and go to the cheapest one. I guess there was a reason you went to that specific one and no other, don't you think they should be compensated? – littleadv May 13 '16 at 6:39
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    I always leave that field blank. If they ask for it later, I start asking questions about what precautions they take to keep my private information secure. If I'm not applying for credit, I can usually get away with it by the time the conversation ends. Part of it is that I'm also usually willing to walk away. – Nathan L May 13 '16 at 16:50
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You should start by calling the clinic and asking them to tell you how the visit was coded. Some clinics have different billing codes based on the complexity of the visit. If you have one thing you are seeing the doctor about, that could be coded differently than if you have 4 things you are seeing the doctor about. In fact, even if you are there just for one ailment, but while you are there you happen to ask a few quick questions about other possible ailments, the doctor could decide to use the billing code for the higher complexity.

If when speaking to the billing department it is determined that the visit is using a higher complexity billing code (and a higher charge as a result), you could then request that it be re-coded with the lower complexity visit. Realize if you request that they will probably have to first get approval from the doctor that saw you.

Note: I am basing this answer on first hand experience about 6 months ago in Illinois, where the situation I described happened to me because I asked some unrelated questions about other possible ailments at the end of a visit to an after hours clinic. The billing department explained that my visit was coded for 4 issues. (3 of them were quick questions I asked about at the end of the visit, one of which she referred me to another doctor. My additional questions probably extended the visit by 3-4 minutes.) In my case I never got the bill reduced, mainly due to my own laziness and my knowing that I would hit my deductible anyway this year. Of course I can't say for sure if this is what happened in your case, or even if this practice is widespread. This was the first and only time in my life that I encountered it.

As a side note, your primary doctor would likely rarely ever bill you for a more complex visit, as it likely wouldn't lead to much repeat business.

As for your last question regarding your credit: if the provider decides to lower the price, and you pay the lower price, this in no way can affect your credit.

Surprising Update: When I called the billing office months ago, I had asked if they could confirm the code with the doctor, and I was told they would look into it. I never heard back, never followed up, and assumed that was the end of it. Well, today I got a call back (months later) and was informed that they had re-coded the visit which will result in a lower charge! It's still pending the insurance adjustment but at some point in the future I expect to receive either a credit on my next statement or a check in the mail. (The price difference pre-insurance in my case has gone from $359 to $235.)

Update: I did receive a check for the difference. The check was dated July 20, 2016, which is just over 2 months after the phone call informing me I would receive it.

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    Thanks, I followed your advice, and got the bill reduced about $200, just by calling the billing office! Now after insurance it looks like I'll only be paying around $100 – Ryan Stull May 20 '16 at 19:20
  • That's great news! Do you know if they ended up coding it differently or were they just being nice? – TTT May 20 '16 at 19:26
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    I'm not sure, they sounded kind of flustered when I spoke with them on the phone, so maybe they made a mistake. Idk. – Ryan Stull May 23 '16 at 21:56
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Some doctors will give folks who are not covered by insurance a price break. If that describes you, you could ask.

But if you didn't discuss the price in advance, that isn't the doctor's fault, any more than it would be the mechanic's fault if you asked for auto service without getting an estimate first.

Consider it a cheap lesson in not making assumptions.

  • Most healthcare providers will not give you a price ahead of time, even if you do ask. If you do manage to get an estimate, it rarely matches the bill when it comes. An auto mechanic would never dream of doing that. – Kat Aug 3 '16 at 21:58
  • In my experience, if you ask, they can give you an estimate of what they will bill. They can't always predict what the cost will be after the insurance company is done with the claim, unless there is a specific defined copay... and even that sometimes gets messed up by deductibles. Until we switch to true HMOs or single-payer, it isn't going to get much better.... despite the insurance companies' attempts to make us more price-conscious. – keshlam Aug 4 '16 at 0:45
  • You've had better experiences than me, then. I've always found it very difficult to even get a cash price, much less any sort of quote that takes insurance into account. Some "express care" clinics are transparent about prices, but I doubt a place that charged $400 for a simple visit is one of those. Asking is certainly a good idea, but there is no guarantee that it'll help. – Kat Aug 5 '16 at 23:32
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If you are disputing the size of the charge for specific services, like you think that they overcharged for lab work, you can try disputing it with the business office staff at the doctor's office. If, on the other hand, you just think that the overall bill is too expensive then you really only have one option.

You can ask if they will reduce the bill for you. Most hospitals and clinics I've dealt with have programs set up for this, but you usually access them by filling out paperwork demonstrating financial hardship (along with supporting documents). It never hurts to ask. But with the services already rendered the only person with an interest in reducing the bill is you.

The reduction, if any, will probably depend on what the clinic thinks your ability to pay is compared with the cost to them of pursuing you for payment, as well as the amount of funding they have for bill reduction. When I worked in the financial services office of a hospital a $400 bill would not even have been reviewed for discounting-- the balance would be too low to devote staff time to reviewing.

It's frustrating, and even asking in advance might not have given you accurate (or any!) information on what the cost of the visit would be, so your ability to shop around is limited. Unfortunately, that doesn't give you any additional options in this case.

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To answer the specific question of whether you can get the bill reduced without hurting your credit, yes, as long as the bill never goes to collections, there's no reason it should ever show up on your credit report.

Will they reduce your bill without sending it to collections first? Maybe. All you can do is ask.

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You will often receive a lower bill if you simply wait for a second or third billing statement.

I was once given the advice to never pay a medical bill until after they had sent three notices, because they will almost certainly reduce the amount due. Sounds crazy, right? I have excellent credit, so the idea of risking it by ignoring bills disturbed me greatly, and I scoffed at the advice.

I then had a similar experience to you, and decided to take the advice. By the third statement, the bill was reduced to less than half of the original, with zero intervention on my part. I then paid it without any impact to my credit whatsoever. I've since done that every time I receive healthcare services, and the bill is always reduced on subsequent statements, generally to less than half of the original bill. Sometimes it's because insurance finally got around to paying. Sometimes a credit is mysteriously added. Sometimes line items disappear without explanation. (Line items sometimes appear over time, too, but the overall balance generally goes down.) I don't know the reason for it, but it works.

This has happened with a variety of providers, so it's not just one company that does it. Granted, I never called to negotiate the price, so I can't say if I would've gotten a better deal by doing that. I like it because it requires no time or effort on my part, and it has greatly reduced my medical bills with zero impact to my credit. I only have personal anecdotes to back it up, but it's worked for me.

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