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I have a situation where my friend is cash poor from recently buying a house and just landed in the hospital for a few days. I would like to help him cover the medical bills when they start rolling in. How are large medical bills typically structured? Let's say the amount comes out to $10,000. Do the medical providers expect full repayment at the point of initial billing? Do they offer a loan option and monthly payments as well?

Forgive the ignorance of this question, I've been fortunate enough to never have large medical bills. I'd like to know so I can anticipate how my friend will need help.

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This really depends on the situation.

In general, medical bills will have a lot of leeway as to when they're paid. It's very common to be in your friend's situation; many large medical bills are unplanned and larger than a person is able to pay directly. So hospitals etc. are almost always willing to work with you, especially if you're up front about what you can afford. They often will reduce the total amount (especially if you're uninsured) and allow you to schedule payments over a period of time.

However, they do initially expect full payment up front. You have to ask to get into the other options.

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Most of the time you will not receive one bill, but many. Some from the specialist, some from different technicians, and of course one from the hospital. Because of this each will have to be dealt with differently. During one hospital stay, I received a small bill from a specialist, paid it no problem. But for weeks after that I got many past due notices. Once I finally got in touch with someone, they had to manually update their billing system. It was quite a poor system.

Some of the bills will wait until insurance is submitted, others will not. It all depends.

Just about every medical bill will not go to collections if you pay some amount, in most cases as little as $5, each month.

Overall you have to be prepared to deal with many different bills, and each with different policy.

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    In addition to this, I had a hospitalization last August. The bills from one specialist didn't show up until April of the following year. – Tangurena Jul 27 '17 at 19:10
  • @Pete Good answer, but I'll challenge you on the $5 amount keeping the bill out of collections. In my experience the biller will have a hard minimum (often a percentage of the total balance, but not necessarily) acceptable as a monthly payment. Paying less than that puts you at risk of going to collections, depending on the hospital. The hospital I used to work in would never approve a payment plan at $5 per month for an inpatient stay as brief as a single day. – Upper_Case Jul 27 '17 at 19:57
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It would be valuable to know if your friend has current health insurance, though any bills for which he would be responsible will follow a similar pattern.

It can vary from facility to facility, but in general an inpatient hospital will offer payment plans (particularly in the case of bills that are large and for services already rendered; your experience would likely be different if trying to schedule a surgery in the future, for example).

In all likelihood your friend's medical bills won't even be finalized at the time he is discharged. Medical coders and billers will review clinical documentation to determine which specific services were provided, and for what purpose, and then the cost of those services is set by:

(1) your friend's insurer's negotiated rate for that procedure code, or (if the provider is entirely out-of-network, the service is not covered by the insurance contract, or your friend is not currently carrying insurance),

(2) the hospital's charge master, or (if they allow such arrangements, which many do across a variety of circumstances),

(3) a reduced rate off of the charge master.

Any reductions in the total charges or minimum monthly payments are likely to be governed by strict policies internal to the hospital. So, for example, while the hospital will always take his money there may be a minimum monthly payment which, if it is not met, will shift the account into poor standing.

Your friend can expect a bill in the mail any time after his discharge, and when the first bill arrives it is important to contact the billing office to make whatever payment arrangements are appropriate. Additionally, it's possible (even likely, depending on what he is in the hospital for) that other medical providers external to the hospital will bill separately. These external providers will have their own policies for paying down a balance, but as with the hospital it is important that your friend contact them to receive any accommodations.

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