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Comment by golover721 | Hacker News Reader

What perhaps makes it crazier is that they never expect to get the whole $2900. They bill that and the insurance company will always reduce it by a huge amount. Individuals without insurance are expected to also "negotiate".

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I keep hearing this "negotiate" thing, but I tried it when I was billed $254 for a strep test (after being quoted $25 at the walk-in clinic), and the provider refused to negotiate. I appealed with my insurance, the appeal sort of disappeared (I received a letter saying it had failed the first round of review, and they were sending it elsewhere, and then I never heard back again) - and after fighting it for four months, I gave up and paid. Should I not have?

It sounds like their system is working as intended. closes ticket

It’s like the PayPal and EBay dispute process. Lots of unnecessary manual lookups, waiting periods and then an arbitrary deadline, and my favourite: waiting for them to make an automated decision. Like, why not stall when they already have my money.

Nope this was my experience too. I also heard that they'll knock 50% off or more if you offer to pay cash on the day of. This was also not true (at least in Alaska).

In Utah I've gotten further, but usually if they knock off 20% I've had a good day. It's insanity. The market is completely messed up.

50% cash discount is almost unheard of. 10% is a norm, 20% if you are lucky.

How often have you tried in non-emergency situations? I got 50% of at UCSF seeing a specialist there.

My dentists always gave me 10% off for paying cash. Collection agencies often gave me 10 to 20% for paying the whole balance by credit card on the phone. Hospital sometimes gave me 25% for paying a year old balance within 1 month. These were all insurance repriced bills, except of the dental. Many bills were over 1 year old, because of billing errors and numerous back and forth between me, service provider and insurance company.

Same deal. Strep test, $250 plus a $50 "outside of business hours" clinic charge. I visited at 9am on a Monday morning. The billing dept claimed it was a standard charge they charged everyone. I fought them for months about it. Only after it reached collections did I pay it. The extra fee was missing, but $250 for a strep test is a rip off regardless!

There is no real negotiation or defined process. . You have to be willing to play hardball and outright refuse to pay. Also be willing to call every day or get a lawyer that writes nasty letters. Also be willing to deal with collection agencies.

It’s a stupid game about who is the biggest bully. Not many people have the nerves for this.

Negotiate with whom? I don’t think there’s anyone at the hospital you’ll have access to that can guarantee you a lower price (or can probably even tell you what the price will be). After you’ve had the treatment and finally given the bill you don’t have any negotiating power; you can only beg at that point.

You might have to just refuse to pay until someone calls you about it. Then you could offer to pay a portion. It may very well be a collections agency calling, and late payment could reflect poorly on your credit rating.

This actually can work, but you have to remember to check up art the right time before they send to collections. Don't forget about it or a collector will be calling you.

That's actually my point. Eventually someone will call you and want to negotiate to get partial payment.

Yes, and you can negotiate with the collector, but at that point your credit report is damaged so probably not worth it.

The funny thing though, it is so common for medical bills to get to collections that it doesn't effect your credit rating like other bills would.

I heard that too. I have 2 bill in collections from 6 years ago, still negatively impacting my credit score. The 7 year mark is coming up in two months so I will see how it affects my credit.

Can you negotiate with the collector to get the bad credit entry deleted and pay and a discounted percentage of the bill ?

I read somewhere that’s how to fix your credit rating, wonder if it’s also good for s discount ;)

Yeah, that's called "pay for delete."

You have a much better negotiating position at that point. They can't reposess your treatment!

That's actually backwards. You are in a better negotiating position, when you've had the treatment and been given the bill. You can simply say, I can't afford that bill and I can't pay it. Don't beg or ask. Tell them. The people trying to collect money from you are paid a commission based upon how much they collect.

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