You thought that medical procedure hurt? Just wait ’til you see the bill.
The average cost of a one-day hospital stay in the US topped $3,200 in 2024, with California recording the highest costs ($4,700) and Mississippi the lowest ($1,400).
It’s no wonder that about 36% of American households carry medical debt, with the average total debt in collections between $2,400 and $8,000.
The good news is that an estimated 80% of hospital bills contain errors — you just have to know how to identify them and address them to save your wallet a lot of pain.
Rick Gundling, chief mission impact officer for the Healthcare Financial Management Association, shared the secrets of negotiating a hospital bill — and steps to take if you don’t have health insurance.
Ask for an itemized bill
Having a line-by-line breakdown of procedures, services and medications — instead of a total sum — helps highlight errors like duplicate charges, services not rendered or incorrect billing codes.
“Detailed documentation also provides information in price discussions and is important if you need to appeal insurance denials or apply for financial assistance,” Gundling told The Post.
Make sure you got a good price
It can be difficult to know how much you’ll need to shell out for a service.
The CMS Procedure Price Lookup tool provides national average costs for procedures in hospitals and ambulatory surgery centers, while the Valenz Bluebook displays “fair price” information.
“Though rates differ based on your particular care requirements, it could be a starting point in your discussions,” Gundling said.
Be determined — and get everything in writing
Gundling recommends being “persistent but polite” as you explain your financial situation to the hospital.
“If the first representative says no,” he added, “call back to speak with a supervisor or the patient financial advocate office.”
If you reach an agreement or you’re given a discount on the bill, be sure to get written confirmation of the deal.
“Document everything, including names, dates and reference numbers of all conversations,” Gundling advised.
A 2023 survey of 1,100 people revealed that about 74% of respondents who contacted a billing office about a suspected billing mistake had the error corrected, and 62% successfully negotiated a price drop.
Try to pay immediately
Gundling advises paying the bill ASAP if you can afford it without depleting emergency savings. Otherwise, go for a payment plan to avoid credit card debt or financial instability.
“Immediate payment often yields better discounts since providers prefer quick resolution and avoiding administrative costs of payment plans,” Gundling explained.
“However, many medical providers offer interest-free payment plans that allow you to preserve emergency funds and cash flow without penalties.”
Look for hardship programs
Non-profit hospitals — which represent roughly 58% of community hospitals — are required by federal law to have a charity care policy.
Free or discounted care is generally provided to patients with household incomes below a certain threshold.
“Many hospitals, which are investor-owned, also offer hardship programs, particularly for patients who are uninsured, unemployed or facing medical bills exceeding a certain percentage of annual income,” Gundling said.
“Even middle-income families often qualify, especially for catastrophic medical expenses or when experiencing temporary financial hardship like job loss.”
Seek help if you need it
“Hospital financial counselors are often the best first resource and can help identify discounts, assistance programs and payment options,” Gundling said.
“The Healthcare Financial Management Association has developed a guide to help consumers understand where to get answers to their questions about healthcare prices, compare prices among providers and manage their out-of-pocket costs.”
Don’t ignore the bill
Gundling recommends responding to a medical bill within 30 days to preserve your rights to appeal and prevent immediate action by a collections agency.
Fortunately, the three major US credit bureaus (Equifax, Experian and TransUnion) removed medical collection debts under $500 from consumer credit reports.
They also removed all fully paid medical collections from credit reports and extended the waiting period for unpaid debt to appear on reports from six months to one year.
“Unpaid medical bills only affect credit after being in collections for at least one year, giving you significant time to negotiate or arrange payment,” Gundling said.
“VantageScore 4.0 and newer FICO models reduce the impact of medical debt on scores, recognizing that medical debt is often involuntary and not predictive of creditworthiness.”
What to do if you don’t have health insurance
Health insurance is the primary and most effective way to manage high hospital bills.
Unfortunately, an estimated 8% of the US population, roughly 26 million Americans, don’t have health insurance.
If you’ve lost your job, you should consider COBRA continuation coverage, which allows you to keep your employer-sponsored health insurance for 18 to 36 months after a major event like divorce or job loss.
Choosing this option means paying the full premium plus an administrative fee.
There may be other alternatives as well.
“The ACA Healthcare.gov marketplace plans may offer substantial subsidies based on your reduced income, potentially making coverage very affordable or even free,” Gundling said.
“Medicaid eligibility expands significantly with job loss, and many states now offer expedited enrollment for those who recently lost employment.”
It may not seem like it, but Gundling assured that uninsured patients “often have strong negotiating power.”
He suggests requesting a cash price for the procedure, which may be significantly lower than the billed price.
Plus, most hospitals offer “self-pay discounts.”
“They prefer receiving partial payment over sending bills to collections,” Gundling said.
