Challenging Your Medical Bill Cost Can Be Beneficial, According to a New Study

Notice something odd on a medical bill? Don’t let it slide. More often than not, disputing it can reveal errors and potentially lead to a more affordable bill, according to a study published Friday in JAMA Health Forum. “If there’s a bill that you receive that doesn’t look quite right or that you can’t afford, pick up the phone and call the billing office,” said lead study author Erin Duffy, director of research training at the USC Schaeffer Center for Health Policy and Economics. “When people do, most get positive results.” According to the survey’s results, about 1 in 5 people said they got a medical bill they disagreed with or couldn’t afford over the past year, 61.5% of whom said they contacted billing offices to address their concerns. Most people who didn’t call billing offices said they thought it wouldn’t make a difference, Duffy said. “Most of the time, the bill was corrected,” she said. “And even people who just felt it was unfair, even if they could afford it, a lot of them were able to negotiate a lower price.” Among those who reached out about a billing error, almost three-quarters reported that the mistake was corrected, the study found. About 62% of people who reached out about an unaffordable bill said they got a payment plan or price drop; about 76% who wanted to negotiate said they got financial help or had their bill canceled. The survey’s findings come as more than half of adults in the United States say they’ve had medical debt in the past five years, according to a 2022 survey from KFF, a nonprofit group that researches health policy issues. Another report from KFF finds that people in the U.S. owe at least $220 billion in medical debt. Dr. Adam Gaffney, a critical care physician at the Cambridge Health Alliance in Massachusetts, said medical debt can “ruin people’s financial futures,” including hurting their ability to get a loan or a mortgage. People have also had their wages garnished, he said, or have been sued by hospitals over unpaid medical bills. Duffy notes that certain individuals in the survey were more inclined to dispute a medical bill: extroverts and people tend to be more skeptical, competitive and upfront about their opinions. People without a college degree, those with low financial literacy and the uninsured were the least likely to dispute a bill, she added. The study was based on survey responses from more than 1,100 adults in the U.S. between Aug. 14 and Oct. 14 of last year. How to dispute a medical bill The first thing you should do if something looks wrong on a medical bill is make sure the bill is yours, said Michele Johnson, executive director of the Tennessee Justice Center, a law firm and nonprofit advocacy group. That’s especially important if you have a common last name, she added. “I’ve gotten bills before that aren’t even mine,” she said. “My husband’s name is Hill, my name is Johnson, and it’s happened repeatedly. So is it your bill? That’s the first thing to ask.” Johnson also suggested asking the hospital for an itemized bill, which will provide a detailed list of all the services, treatments and procedures a patient got during the visit. Hospitals are required to send an itemized bill within 30 days of a request. “We have seen situations where an infant baby boy is charged for a pregnancy test,” she said. “When they give you the itemized statement, look to see if those are services that you actually used or could have used.” And then call the billing office if something looks wrong. The No Surprises Act, which was signed into law in 2020, protects people from getting surprise medical bills when they get medical services from an out-of-network provider at an in-network facility, Johnson said. (In-network means the health care provider signed an agreement with your health insurance to accept a discounted rate; out-of-network means no agreement is in place.) “If you’re in an insured hospital and see a doctor who is in-network for you, they can’t then have an anesthesiologist that is out-of-network,” Johnson said. People without insurance and those not using their insurance for a service can get a “good faith” estimate of the cost of care before their visit, she added. Then, if someone gets a bill that is at least $400 more than the estimate, they can dispute it. Many hospitals also offer financial assistance, also known as charity care, she said. Nonprofit hospitals are required to have a charity care policy and make it available to read on their website. If eligible, Johnson said, people can get the cost of their care reduced or even for free — even if they’ve already been billed. Johnson also advised against using credit cards to pay off a bill, if at all possible. That’s because a proposed rule from the Consumer Financial Protection Bureau that’s expected to take effect next year will remove medical debt from credit reports. Johnson recommended requesting a payment plan instead. “Medical bills are treated differently than credit card debt,” she said. “You don’t want to pay that over the top of essentials like housing or food, which often our elderly clients will do even for bills they don’t actually owe.” Johnson said patients should remember that they can and should dispute a bill if they feel something is wrong. “We think of health care bills as this whole other thing, like a black box that we don’t have any access to, because the American health care system is very much, there’s a power dynamic that really makes patients feel vulnerable and helpless,” she said. “But the truth is, if they’re charging you money, there are certain rules that protect you as a consumer and that enable you to push back.”