An anecdote about hospital negotiation: I just got a bill for $7,000 for a two-hour visit to a San Francisco hospital emergency room. The bill arrived with a l

An anecdote about hospital negotiation: I just got a bill for $7,000 for a two-hour visit to a San Francisco hospital emergency room. The bill arrived with a letter offering me a 20% discount if I paid directly (and claimed it back from my insurance or not, either way) versus if I asked them to submit an insurance claim, and another 20% discount for payment within 30 days. So the opening offer on the bill was to pay 40% less. This is probably in the neighborhood of what an insuror would pay, but the hospital saves a fortune in claims processing.