5 ms·

Good point, but makes me wonder how Medical Bill negotiation is on the list at all? How do you walk away from that? I could see some leverage if you're already

Good point, but makes me wonder how Medical Bill negotiation is on the list at all? How do you walk away from that? I could see some leverage if you're already in collections I suppose. Edit: The list posted by "MerelyMortal" above.

devilbunny 5y ago
Elective surgeries. Need a hip replaced? Having a child? These things can negotiated in advance at a substantial discount.
paxys 5y ago
The leverage is – "I will not pay you and take the credit score hit, which I am okay with. You will then have to sell my debt to collections for pennies on the dollar. Instead of that, let's work out a favorable monthly payment plan."
- _huayra_ 5y ago
  I've always wondered if you can buy your own debt from collections and pay it off there, as some sort of soaring medical cost hack albeit tanking one's credit score.
  - xapata 5y ago
    You can offer to settle, which is similar. A "settled in full" note goes on your credit report.
  - micromacrofoot 5y ago
    if you’re going to tank your credit score why bother paying at all
  - injb 5y ago
    Not sure, but you can definitely negotiate with debt collectors. They have been known to withdraw things from people's credit reports in exchange for payment. Especially if you play hardball and insist on seeing paperwork to prove they they have the right to collect.
  - axelsvensson 5y ago
    It appears you can. At least searching for "buy your own debt" gives results for entities who claim to help you do so, without tanking your credit score. "You're certainly not going to take legal action against yourself".
- charcircuit 5y ago
  Why can't they just sue you if you fail to pay? Surely if someone doesn't pay for your services there must be some legal means to get the money that you are owed.
  - samatman 5y ago
    They of course can, and through small claims it's monetarily inexpensive, but it's both time and effort, and for more than small claims will handle, it's expensive. Some businesses won't show up personally at small claims and will get counsel involved, which is expensive. Depending on the debt, getting most of the difference between the legal expenses and the debt itself is in reach, given a creditor who is a rational actor.
  - paxys 5y ago
    If someone doesn't have the money to pay a debt then suing them isn't going to magically produce it.
    - charcircuit 5y ago
      This submission is about getting a discount when you otherwise wouldn't have. If you can afford to pay in full. You have the money to pay.
  - hedora 5y ago
    Why do that, when they can sell the debt to a collections agency that's willing to pay: (probability of recovery) * (1 - profit margin) * (amount owed) today, for the right to sue on you behalf? Note: I think the current debt collection system in the US is terrible, especially for medical debt. I suggest looking at the charity "RIP Medical Debt" if you do too. At the very least, when selling a debt to a collections agency, the (re)seller of the debt should be obligated to first offer the same price to the person that owes money.
    - webmaven 5y ago
      > At the very least, when selling a debt to a collections agency, the (re)seller of the debt should be obligated to first offer the same price to the person that owes money. That seems reasonable at first glance, but it would lead to an explosion of people simply refusing to pay and waiting for the 'debt collector price' offer to arrive.
DiffEq 5y ago
My first son was by cesarian and we did not have insurance. The bill was $15,000. After some various payment plan discussions I asked if there was any other way to pay. The lady said yes, if you pay cash before you leave the hospital is is $2000. I since have used the pay cash method to pay a fraction of various medical bills.
- glandium 5y ago
  The more I read about the American healthcare system the less it makes sense.
beaunative 5y ago
I just read all three credit bureaus removed medical bills from their report.
- MerelyMortal 5y ago
  Where did you read it?
  - vyrotek 5y ago
    Check out my reply above
- vyrotek 5y ago
  I was curious and found these details. https://www.businesswire.com/news/home/20220318005244/en/Equifax-Experian-and-TransUnion-Support-U.S.-Consumers-With-Changes-to-Medical-Collection-Debt-Reporting https://www.businesswire.com/news/home/20220318005244/en/Equ... > Effective July 1, 2022, paid medical collection debt will no longer be included on consumer credit reports. In addition, the time period before unpaid medical collection debt would appear on a consumer’s report will be increased from 6 months to one year, giving consumers more time to work with insurance and/or healthcare providers to address their debt before it is reported on their credit file. In the first half of 2023, Equifax, Experian and TransUnion will also no longer include medical collection debt under at least $500 on credit reports.
hammock 5y ago
>leverage if you're already in collections I suppose. What about before you undergo the medical services? Why is it so damn uncommon to ask for a price before seeing the doctor?
- kube-system 5y ago
  > Why is it so damn uncommon to ask for a price before seeing the doctor? The main reason is that, often, the doctor is choosing the specific procedures after you show up, not before. There's not a price for "stomache ache". For the elective procedures where it is known what is involved up-front, there is some price shopping that does happen.
  - hammock 5y ago
    There is a price for office consult. And when the doctor says, "I'm going to order a blood test," or "I'm going to clean your ear out" or whatever, you can ask them to have it priced out before they do it. People ought to know that.
- projektfu 5y ago
  Insurance has driven a market where the pricing is opaque. The doctors are trained to req services without concern for money and the billing office reconciles it with the insurance bean counters. Imagine choosing doctors like plumbers. Do you go with the one with the low initial exam fee? How about the one your family member recommended? Or the one with good reviews on the internet? Then, when they tell you the plan, do you go to another one and pay their exam fee to find out their plan? I have some experience at this from the veterinary side. Some people do treat us like plumbers. They know there are several points of leverage in the pricing. However, it is a two edged sword. If you decline the plan and renegotiate it, the vet is liable to stop recommending the expensive options because you are more focused on money than health. This happens unconsciously. If you decline a $20 diagnostic after a half hour of haggling I won't have time or energy to try to convince you to spring for a $100 monthly treatment when an inferior but acceptable treatment is available for less. I'll present both options and you will probably choose the inferior one as part of your haggling strategy. Haggling makes lots of sense when the quality of the commodity is not under control of the salesperson, it is easy to determine, and the salesperson pads your price with lots of margin. In medicine, everything is opaque and haggling is rarely able to take a broad cut on price without sacrificing quality.

devilbunny 5y ago

Elective surgeries. Need a hip replaced? Having a child? These things can negotiated in advance at a substantial discount.

paxys 5y ago

The leverage is – "I will not pay you and take the credit score hit, which I am okay with. You will then have to sell my debt to collections for pennies on the dollar. Instead of that, let's work out a favorable monthly payment plan."

_huayra_ 5y ago
I've always wondered if you can buy your own debt from collections and pay it off there, as some sort of soaring medical cost hack albeit tanking one's credit score.
- xapata 5y ago
  You can offer to settle, which is similar. A "settled in full" note goes on your credit report.
- micromacrofoot 5y ago
  if you’re going to tank your credit score why bother paying at all
- injb 5y ago
  Not sure, but you can definitely negotiate with debt collectors. They have been known to withdraw things from people's credit reports in exchange for payment. Especially if you play hardball and insist on seeing paperwork to prove they they have the right to collect.
- axelsvensson 5y ago
  It appears you can. At least searching for "buy your own debt" gives results for entities who claim to help you do so, without tanking your credit score. "You're certainly not going to take legal action against yourself".
charcircuit 5y ago
Why can't they just sue you if you fail to pay? Surely if someone doesn't pay for your services there must be some legal means to get the money that you are owed.
- samatman 5y ago
  They of course can, and through small claims it's monetarily inexpensive, but it's both time and effort, and for more than small claims will handle, it's expensive. Some businesses won't show up personally at small claims and will get counsel involved, which is expensive. Depending on the debt, getting most of the difference between the legal expenses and the debt itself is in reach, given a creditor who is a rational actor.
- paxys 5y ago
  If someone doesn't have the money to pay a debt then suing them isn't going to magically produce it.
  - charcircuit 5y ago
    This submission is about getting a discount when you otherwise wouldn't have. If you can afford to pay in full. You have the money to pay.
- hedora 5y ago
  Why do that, when they can sell the debt to a collections agency that's willing to pay: (probability of recovery) * (1 - profit margin) * (amount owed) today, for the right to sue on you behalf? Note: I think the current debt collection system in the US is terrible, especially for medical debt. I suggest looking at the charity "RIP Medical Debt" if you do too. At the very least, when selling a debt to a collections agency, the (re)seller of the debt should be obligated to first offer the same price to the person that owes money.
  - webmaven 5y ago
    > At the very least, when selling a debt to a collections agency, the (re)seller of the debt should be obligated to first offer the same price to the person that owes money. That seems reasonable at first glance, but it would lead to an explosion of people simply refusing to pay and waiting for the 'debt collector price' offer to arrive.

DiffEq 5y ago

My first son was by cesarian and we did not have insurance. The bill was $15,000. After some various payment plan discussions I asked if there was any other way to pay. The lady said yes, if you pay cash before you leave the hospital is is $2000. I since have used the pay cash method to pay a fraction of various medical bills.

glandium 5y ago
The more I read about the American healthcare system the less it makes sense.

beaunative 5y ago

I just read all three credit bureaus removed medical bills from their report.

MerelyMortal 5y ago
Where did you read it?
- vyrotek 5y ago
  Check out my reply above
vyrotek 5y ago
I was curious and found these details. https://www.businesswire.com/news/home/20220318005244/en/Equifax-Experian-and-TransUnion-Support-U.S.-Consumers-With-Changes-to-Medical-Collection-Debt-Reporting https://www.businesswire.com/news/home/20220318005244/en/Equ... > Effective July 1, 2022, paid medical collection debt will no longer be included on consumer credit reports. In addition, the time period before unpaid medical collection debt would appear on a consumer’s report will be increased from 6 months to one year, giving consumers more time to work with insurance and/or healthcare providers to address their debt before it is reported on their credit file. In the first half of 2023, Equifax, Experian and TransUnion will also no longer include medical collection debt under at least $500 on credit reports.

hammock 5y ago

>leverage if you're already in collections I suppose. What about before you undergo the medical services? Why is it so damn uncommon to ask for a price before seeing the doctor?

kube-system 5y ago
> Why is it so damn uncommon to ask for a price before seeing the doctor? The main reason is that, often, the doctor is choosing the specific procedures after you show up, not before. There's not a price for "stomache ache". For the elective procedures where it is known what is involved up-front, there is some price shopping that does happen.
- hammock 5y ago
  There is a price for office consult. And when the doctor says, "I'm going to order a blood test," or "I'm going to clean your ear out" or whatever, you can ask them to have it priced out before they do it. People ought to know that.
projektfu 5y ago
Insurance has driven a market where the pricing is opaque. The doctors are trained to req services without concern for money and the billing office reconciles it with the insurance bean counters. Imagine choosing doctors like plumbers. Do you go with the one with the low initial exam fee? How about the one your family member recommended? Or the one with good reviews on the internet? Then, when they tell you the plan, do you go to another one and pay their exam fee to find out their plan? I have some experience at this from the veterinary side. Some people do treat us like plumbers. They know there are several points of leverage in the pricing. However, it is a two edged sword. If you decline the plan and renegotiate it, the vet is liable to stop recommending the expensive options because you are more focused on money than health. This happens unconsciously. If you decline a $20 diagnostic after a half hour of haggling I won't have time or energy to try to convince you to spring for a $100 monthly treatment when an inferior but acceptable treatment is available for less. I'll present both options and you will probably choose the inferior one as part of your haggling strategy. Haggling makes lots of sense when the quality of the commodity is not under control of the salesperson, it is easy to determine, and the salesperson pads your price with lots of margin. In medicine, everything is opaque and haggling is rarely able to take a broad cut on price without sacrificing quality.