Ethical question

[Janna]

Let's say you had medical bills that you were making monthly payments on. One day, you came into some money - enough money to pay off those medical bills, but there would be none left over. If you knew that it is common practice for medical billing companies to negotiate down the amount owed if you are willing to pay it off in cash, would you call to negotiate the cost, allowing you to have some money left over? Or would you not bother to negotiate, but just pay the amount you know you owe?

 

Do you think both of these options are ethical, or only one? Why?

[swellmomma]

I would negotiate if a large portion of that bill was interest and not just the medical costs incurred. If it was the straight up costs and not interest I would just pay what I owe and know that I got it off my shoulders.

[Andie]

I don't think negotiating a lower amount is unethical, as long as one is honest about their circumstances. (Not claiming, for example, unemployment if it's not the case, or lying about income, or some such thing.)

[PariSarah]

Generally, "they" are more willing to negotiate if you're already behind. So if you're in good standing with them, they may not be willing to take any less than the full amount.

 

But to answer your question, I don't think negotiation is unethical at all. Dishonest negotiation is, but not run-of-the-mill negotiation.

 

Hey--but think about this: you pay off the medical bill. Then, for the next two or three months, pay yourself the monthly amount you had been paying them. Then, it'll be like you DID have some money left over!

[Mommyof4ks]

:iagree: with others. We got a really big bill from the hospital and simply asked and the bill was lowered substantially. If you go in and tell them that you would like to negotiate a smaller amount, then there is nothing wrong with that. It is kind of like asking for a lower price at the electronic store when you know that another store is selling the same item for less. It is just business.

[SonshineLearner]

Negotiate! They would have received less if they had to deal with insurance companies (did you have insurance?) and only received 1/3? if they had they had to take you to collections.... ("Hi There, We're trying to get all of our bills paid, and we'd be able to clear the bill with you if you could come down to a lower amount.) When you pay it off, be sure to write, "Paid in Full" on the front of the check. It'd be fun to hear if this works...

:-)

[Peek a Boo]

other.....

 

If the medical bill is not an interest-bearing note, I'd stick the money in a savings account and use it for other things....like sending in an extra payment on the car, credit card, or mortgage, or buying that higher-dollar item [tankless water heater? washer? vacuum? car repair?] that I would normally only be able to buy on credit.

 

now if you're paying interest on the bill, absolutely negotiate and pay the whole thing off and take PariSarah's advice!!

[Guest]

I don't think negotiating is at all unethical. The healthcare industry is so shady to begin with. When I was pregnant w/ dd and didn't have insurance part of the time, you wouldn't believe what doctors would tell me about how they charged more for people with insurance and how much they inflate stuff for people who are insured.

 

Also, a family from our church has a million dollar tab going with our local hospital b/c their daughter has cancer. It's ridiculous.

[teamturner]

I think it's pretty common practice for doctors and hospitals to charge you less if you are paying cash and not going through an insurance claim/company. I just asked a doctor last week about this. They have to go with the insurance rates for fees since the insurance company sets those. There's a lot of overhead to pay for the big insurance companies and all the steps it takes to collect and bill, etc. You take out all those little steps and pay cash and the fees are reduced.

[flyingmommy]

I can't see any way it would be unethical unless you lied or seriously exaggerated your circumstances. If you were honest and said, " We want to pay this bill off but it's more than we can comfortably afford. We are trying to avoid any possibility of being unable to pay due to the country's economic straits. Would it be possible to reduce this if we could pay the reduced amount in cash?" Something to that effect. I figure it can't hurt to throw in something about the economy....LOL

 

What I do think is unethical is a hospital charging you $25 for a Tylenol because they're trying to make up for all the folks who aren't paying their bill.

 

Good luck!

 

J

[CactusPair]

Negotiate. It's not unethical, it's fair business practice. It's strange how medical bill prices seem so arbitrary and open to change depending on who's paying and how. They're overcharging in many ways.

[JudyJudyJudy]

I would either negotiate or do what Peek suggested, depending on which way would benefit me most.

 

 

I think it's pretty common practice for doctors and hospitals to charge you less if you are paying cash and not going through an insurance claim/company.

That hasn't necessarily been my experience. When I didn't have insurance, I had a doctor who would work with me. However, I was paying far more (in some cases, almost 3 times as much) to the company that did blood work than my insurance company ever paid; the company did not have a discounted cash price. Also, when I had surgery, I got stuck with the entire bill, but if I had had insurance, the insurance company would have gotten a discount.

[CactusPair]

Our experience has been the same as JudyJudyJudy's. The insurance companies negotiate the prices way down. Private cash paying people are charged more than the insurance companies would be for the same exact procedure and treatment. That has been our individual experience.

 

I have heard other people say that they negotiated with the hospital and got a lower price for paying off debt in a lump cash sum.

 

The whole system is nuts!

[Harriet Vane]

I would negotiate. If both parties agree to the price there is nothing illegal or dishonest going on. Furthermore, given how inflated medical costs are I think it likely a lower price is still fair and will still cover the cost of the service just fine.

 

As an example, a friend of mine rents an apartment out. Her tenant paid full rent for some time (a year???) before tearfully telling my friend that while she loves the apartment, she just cannot afford it. My friend chose to lower the rent rather than lose a good tenant. My friend is getting less but she agreed to that and is fine with it.

[lionfamily1999]

Nothing wrong with negotiating. Get that monkey off your back, less stress, less bills.

 

You get charged for so many silly extras and the ins. companies have people negotiating for them.

[WTMindy]

It certainly can't hurt to ask. :001_smile:

[hillfarm]

Definitely negotiate.

 

When I had dd, our insurance was to pay 90% and we were to come up with the remaining 10%. We got the bill. I requested a copy of the detailed charges because it seemed unusually high to me. Several MONTHS later they provided me with a detailed bill. There were tens of thousands of dollars of mistakes including my being listed as occupying two delivery rooms at the same time (I was big, but not that big:D). I requested that the bill be corrected and called the insurance company right away to let them know that the bill was wrong. They didn't care. They had paid their 90% and didn't want to mess up their contracted price for services so they didn't want to question the bill. In the end, I ended up paying very little. Ninety percent of the wrong bill was more than 100% of the corrected bill and neither the hospital or insurance company was interested in making the correction. So definitely be sure that you have a copy of the detailed charges and peruse them carefully for duplicate charges--that was the main problem with my bill.

 

Oh well, you might think, anyone can make a mistake once. That's what I would have thought. But I incurred insurance billing at that hospital, a reputable, modern, city hospital, three separate times during the pregnancy. And three times the bill was wrong. That's right, wrong 100% of the time.

 

While I am totally diligent about paying what I owe, I am equally adamant about not paying that which I don't owe. So check that detail, you might not owe as much as you think you do.

[Tracey in TX]

Definitely negotiate. Worst thing that would happen is your request is rejected. Best thing possible owing half (or less) of what was initially charged.

[KristineinKS]

I work in medical billing and deal with patients every day to negotiate balances, so I would say, absolutely try to negotiate. Don't lie about the circumstance or claim hardship if it's not (though in most cases if it is, the doctors will give you a break), just tell them that you'd like to pay off your bill and are working with a limited amount, what can they do for you? We get this all the time, especially as people start getting tax refunds. The sooner a bill is paid in full, the more money the doctor earns, so if a timely payment can be negotiated, most doctors will jump on it. It costs a lot to have staff sending out bills, doing follow-up, calling patients, etc. Generally the only time doctors don't like to offer discounts is when there's a payment plan involved (meaning, you want a discount, but will have to make payments on the balance anyway) - they want that money upfront & the quicker the better. If you've been making payments & want to settle the account, they're usually fine with giving a discount, again, because the older a bill is, the more $$$ lost.

 

Also, it is technically illegal for doctors to charge cash pay patients any differently - however, there's a certain amount of "wiggle room" built into every bill. We expect to take discounts based on the contracts we've negotiated with insurance carriers and also expect that cash pay accounts will negotiate a deal.

[Janna]

I can't see any way it would be unethical unless you lied or seriously exaggerated your circumstances.

But wouldn't any kind of exaggeration, serious or not, be a lie and therefore unethical?

 

If you were honest and said, "We want to pay this bill off but it's more than we can comfortably afford. We are trying to avoid any possibility of being unable to pay due to the country's economic straits. Would it be possible to reduce this if we could pay the reduced amount in cash?" Something to that effect. I figure it can't hurt to throw in something about the economy....LOL

 

But what if the person received enough money to pay off the bill, and so therefore the bill isn't more than they could afford? They just wanted to have some money leftover for other things (savings or like Peek said - high ticket items). And if the money they received was enough to pay the bill, and only the bill, then there wouldn't be any possibility of being unable to pay because they already have the money, kwim? So even that kind of skewed thinking, albeit understandable to most, would be unethical, don't you think?

 

What I do think is unethical is a hospital charging you $25 for a Tylenol because they're trying to make up for all the folks who aren't paying their bill.

 

I find this interesting, because I compare it to a Dr. debating on helping someone who is a mass murderer or a rapist or a child predator. Is it unethical for him to deny this person service? Perhaps it's apples to oranges, but in my mind it's not, LOL. I guess I think that if you had services rendered and the bill is not a mistake, and they are charging interest, but you were aware of that when you couldn't pay the bill, then you owe, regardless of how they are charging for Tylenol or anything else, kwim?

 

Btw, I'm not directing these solely at you, flyingmommy. There were other responses similar to yours, but I happen to be using yours to respond to. These questions/comments are open to all.

 

And I find it amusing that you all assume this is about me. :D I know there are people who negotiate the cost even when they can pay the bill and for some reason it bothers me- even if they don't lie about their reasons. Even in the "couldn't hurt to ask" genre, it bothers me. I was curious who else thought this way. Apparently not very many.:lol:

[KatieJ]

No, I don't think it is unethical to ask at all.

I recently switched eye Drs because of some issues I was having. (Glaucoma suspect) and I didn't feel my previous Dr. was addressing my concerns adequately. He would ask me what my medical insuarnce was and then he would say, well, we don't want to upset them with a Glaucoma diagnosis just yet.

 

WHAT???

 

After hearing that twice, I switched Dr.s. My current Dr. sent my bills for exams and tests into my insurance and guess what...he received almost 50 percent less than the billed amount. It was what he settled for. If I had been a cash customer, I would have paid over 200.00 more those same tests.

 

Ask and don't feel guilty.