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If you don't mind me asking, what kind of medical office/procedure were you able to get a cash price and discount on, in what setting, and which employee did yo

If you don't mind me asking, what kind of medical office/procedure were you able to get a cash price and discount on, in what setting, and which employee did you ask? I've never heard of that happening in the US before the fact; I have heard about negotiating down your medical bill with hospitals after the services have been rendered, though that seems like a crapshoot to me.

mgkimsal 10y ago
Can't reply for walter but... I've had a few experiences over the last decade with healthcare services. Had a consultation, some bloodwork and a other bits and bobs - nothing serious. Got a bill a month later for.. $430. This was done through insurance from my employer at the time, but my portion was still ~$430. I went to their office and said this was a little more than I'd be able to pay quickly (not a total lie - would have hurt at the time). Office manager there said "if you can pay cash we can call it $300 and be done with it". I paid the $300 cash and it was fine. This was a small private dr office in a professional office plaza place. Looking back... they could wait another few months for $430... and maybe have to take me to collections, or take $300 cash on the spot. Whatever averages they saw on collections, this was probably not a bad deal. Few years later, I have same insurance provider, but self-employed, so 'individual/family' plan. My wife got very sick, and we ended up in ER. X-rays, drips, sent home with medication, etc. Got a bill almost 3 months later for ~$3000. Called hospital and asked for some sort of discount. I got (same line from 3 different people on different tries) "this already is a discounted price, because you have insurance, these are the negotiated/discounted rates". Looking more closely at the paperwork, the 'retail' price was somewhere north of $5000, but the insurance company's 'negotiated' rate was ~$3000 ($2800 IIRC). It never hurts to ask, and maybe ask a lot, but it's not some magic "you'll always pay half price by just asking for a discount". And the point many others have made before - when you're having to go to ER, you don't have the luxury of shopping around, and generally the majority of folks you're seeing there are in no way cognizant of billing/pricing stuff (especially on a sunday when we went).
WalterBright 10y ago
One example was having a skin lesion removed, a surgical procedure. I asked the dermatologist/surgeon, it was a procedure she did in her facility. Another time I visited a neurologist, the woman behind the checkin front desk told me what it would cost. I said that sounded high, can I get a discount? She chirped sure, 30% off for cash on the spot. Doctors routinely offer discounts for cash on the spot, because then they don't have to deal with patients who are slow payers or don't pay at all. If they don't, find another doctor. They aren't rare. Heck, dentists are always advertising and offering discounts. They're businesses. You can get at least 3% off just by using a check, because then they don't have to pay 3% tribute to the credit card company. I don't recommend being an ass about it. Just be nice and ask for a discount.
- mgkimsal 10y ago
  "You can get at least 3% off just by using a check, because then they don't have to pay 3% tribute to the credit card company." Tried this by offering cash on some kitchen remodeling work we were doing. I was talking to the sales person and - we were already going to buy - but I asked if they offered cash discount. She got flustered - almost insulted - "these are our best prices!". I tried to explain running $4000 was going to cost them probably close to 4%, and I have more consumer rights re: chargebacks if I'm not happy. $100 off? $150 off? Nope... flat out refusal ("that's not the way we work!"), so we paid with the credit card. But they just lost that money anyway. :/
  - WalterBright 10y ago
    Negotiations don't always work, that's for sure. But it is a learned skill, and one can get better at it. There's a good book on it, "Getting To Yes".
  - coredog64 10y ago
    AIUI, if you take Visa, you aren't allowed to advertise a lower cash-only price. So maybe they were freaked out about losing the ability to take cards. Also, I'd be concerned about a personal check for that amount. The last car I bought I put $2K on my miles credit card (the max they would take) and a check for the rest. They made me fill out loan paperwork anyways so that they would have recourse if the check bounced.

mgkimsal 10y ago

Can't reply for walter but... I've had a few experiences over the last decade with healthcare services. Had a consultation, some bloodwork and a other bits and bobs - nothing serious. Got a bill a month later for.. $430. This was done through insurance from my employer at the time, but my portion was still ~$430. I went to their office and said this was a little more than I'd be able to pay quickly (not a total lie - would have hurt at the time). Office manager there said "if you can pay cash we can call it $300 and be done with it". I paid the $300 cash and it was fine. This was a small private dr office in a professional office plaza place. Looking back... they could wait another few months for $430... and maybe have to take me to collections, or take $300 cash on the spot. Whatever averages they saw on collections, this was probably not a bad deal. Few years later, I have same insurance provider, but self-employed, so 'individual/family' plan. My wife got very sick, and we ended up in ER. X-rays, drips, sent home with medication, etc. Got a bill almost 3 months later for ~$3000. Called hospital and asked for some sort of discount. I got (same line from 3 different people on different tries) "this already is a discounted price, because you have insurance, these are the negotiated/discounted rates". Looking more closely at the paperwork, the 'retail' price was somewhere north of $5000, but the insurance company's 'negotiated' rate was ~$3000 ($2800 IIRC). It never hurts to ask, and maybe ask a lot, but it's not some magic "you'll always pay half price by just asking for a discount". And the point many others have made before - when you're having to go to ER, you don't have the luxury of shopping around, and generally the majority of folks you're seeing there are in no way cognizant of billing/pricing stuff (especially on a sunday when we went).

WalterBright 10y ago

One example was having a skin lesion removed, a surgical procedure. I asked the dermatologist/surgeon, it was a procedure she did in her facility. Another time I visited a neurologist, the woman behind the checkin front desk told me what it would cost. I said that sounded high, can I get a discount? She chirped sure, 30% off for cash on the spot. Doctors routinely offer discounts for cash on the spot, because then they don't have to deal with patients who are slow payers or don't pay at all. If they don't, find another doctor. They aren't rare. Heck, dentists are always advertising and offering discounts. They're businesses. You can get at least 3% off just by using a check, because then they don't have to pay 3% tribute to the credit card company. I don't recommend being an ass about it. Just be nice and ask for a discount.

mgkimsal 10y ago
"You can get at least 3% off just by using a check, because then they don't have to pay 3% tribute to the credit card company." Tried this by offering cash on some kitchen remodeling work we were doing. I was talking to the sales person and - we were already going to buy - but I asked if they offered cash discount. She got flustered - almost insulted - "these are our best prices!". I tried to explain running $4000 was going to cost them probably close to 4%, and I have more consumer rights re: chargebacks if I'm not happy. $100 off? $150 off? Nope... flat out refusal ("that's not the way we work!"), so we paid with the credit card. But they just lost that money anyway. :/
- WalterBright 10y ago
  Negotiations don't always work, that's for sure. But it is a learned skill, and one can get better at it. There's a good book on it, "Getting To Yes".
- coredog64 10y ago
  AIUI, if you take Visa, you aren't allowed to advertise a lower cash-only price. So maybe they were freaked out about losing the ability to take cards. Also, I'd be concerned about a personal check for that amount. The last car I bought I put $2K on my miles credit card (the max they would take) and a check for the rest. They made me fill out loan paperwork anyways so that they would have recourse if the check bounced.