Complex healthcare bills give patients little leeway to negotiate

Patients no longer just face confusion over complicated hospital billing practices. In some cases, if they object to the charges, the bills may end up with collection agencies and later damage their credit, the New York Times reported.

In one instance, the Times reported that a hospital charged New Mexico resident Gene Cavallo $110,000 to excise a melanoma from his shin. Although his insurance company paid $70,000, he was on the hook for the remaining $40,000, an amount he negotiated down to $25,000 and ultimately paid. However, Cavallo's request that the hospital provide him with itemized bills and later the time he spent negotiating lower prices for some of the charges--such as $85 for a pair of tweezers and $20 for a box of tissues--led to payment delays that damaged his credit.

Patients are also often unaware that some hospitals or other medical facilties will refer the unpaid charges to the collections process, according to the Times.

The reports of patients blindsided by bills comes as hospitals and other providers try to collect owed revenue without appearing overtly aggressive. Meanwhile, the entire healthcare finance industry is under fire for failure to offer patients price transparency. 

However, it's difficult to obtain such a balance. Carolinas Health System, for example, sued thousands of patients for nominal amounts. And Accretive Health agreed to abandon the Minnesota market for several years after accusations of aggressively extracting money from patients in advance of undergoing procedures at hospitals operated by Fairview Health Services.

The Times noted that the process is more difficult due to insurance companies shifting costs to their patients, a rise in charges and even hospitals' purchase of medical practices.

"While doctors' practices traditionally worked out deals for patients who had trouble paying, today many doctors work for large professionally managed groups and hospital systems whose bills are generated far away, by computer," the Times reported.

To learn more:
- read the New York Times article