These costs all vary by hospital, and they’re all massively inflated. They’re part of complex negotiations between the hospital and the insurance company, and they’re a scam.
The hospital puts all these little charges together to “justify” a giant bill. Then they “lower” those costs to what they’ve already agreed on with your insurance company. The insurance company then tells you “look how much we reduced your bill by our negotiating!” and then pays some portion of that bill and passes the rest on to you, depending on your deductibles and so on.
If you have no insurance, you don’t get the benefit of the “negotiated” price - they keep the price that high as part of a deal with insurance companies who are trying to justify why you should pay them so much in premiums every month. If out of pocket patients paid less, nobody would get insurance.
We need price transparency where hospitals have to publish these costs and make them available to everyone. We need to be able to call people out when they charge $20 for a tissue and $30 for a band-aid. We also need to be able to compare prices and choose hospitals that give us the best balance of cost and quality.
We also need to stop acting like giving everyone health insurance is the solution to our broken healthcare system. The insurance companies are the ones who broke it.
If you are facing a big bill after a hospital stay, whether for giving birth or for anything else, here are some ways to reduce that bill.
1. If you have insurance, call them and ask for an explanation of what they didn’t cover. The person will probably not have one for you. Say you are not willing to pay a bill if they can’t explain why you owe it. The insurance company will sometimes re-submit the claim and cover more of your cost.
2. Call the hospital billing department and ask for an itemized bill. This alone may reduce the cost somewhat because they were overcharging you to begin with.
3. When you get the itemized bill, go through it. Highlight any items that seem exceptionally overpriced or even that don’t apply to your visit (a medication you didn’t receive, a procedure that wasn’t done, etc.)
4. Call the hospital billing department back and go through the itemized bill, asking for clarification on all the items you flagged. They may remove items or reduce the cost.
5. Explain that you are unable to pay your bill in full and ask about a settlement or payment options. Sometimes the hospital will be willing to take a significantly lower amount if you can pay all at once, or you can get a payment plan with no interest that is feasible for you.
This is based on how my husband has been fighting medical bills for the last couple of years. He has a chronic illness and has frequent appointments, procedures, tests, etc. He frequently gets large bills and then negotiates them down to much smaller ones, or in some cases has gotten bills dismissed completely.
He says that calling the billing department and the insurance company and simply asking them to explain the charges makes a huge difference every time, because the person on the phone almost never has an explanation for why the bill is so high.
You ARE being overcharged, and you don’t have to just deal with it. You can fight back!
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