Tammy Taylor was overwhelmed after an unexpected surgical complication landed her in the hospital's intensive care unit for 11 days. Her bill added up to $500,000.
During her recovery, Tammy received a steady stream of insurance paperwork to find out what was covered and what she actually owed.
"I really had a mound of paper like this. It was literally a full-time job. You call, you have to talk to this person, you're on hold. You need a supervisor, they're not a supervisor, and it goes on and on," Taylor said.
But wait, there's more. Taylor said both of her sons need new hearing aids this year. Each pair costs $5,000.
"I've always paid out of pocket for those," Taylor said.
So Taylor turned to Copay Solutions. The San Mateo-based company assigned a case manager to audit all of her bills, and to deal directly with her insurer to make sure she was billed correctly and not overcharged for her care. Taylor said all she had to do was fill out some forms to release her medical information to the company, and they took care of the rest.
"It's like a concierge service. All your out of pocket expenses are tracked and your total financial picture for health care is captured and then audited and reviewed in great detail," said company CEO John Fowler.
He says if there are discrepancies or if the case manager finds out you have been charged out of pocket for something your insurance is supposed to cover, they will use "polite persistence" to call and follow up until your claim is settled.
"It's not easy and there's money to be saved if you can do it right and watch the angles," said Fowler.
For a $50 monthly fee, and 25 percent of any savings they find you, the company creates a digital record of all your health-care bills. They say they successfully overturn 70 perfect of denied claims.
For Taylor, that meant a savings of $10,000 on her sons' hearing aids.
"It's the first time in 11 years that insurance covered them. Copay Solutions found a different way to code the expense and made sure the insurance company accepted the code. It's a huge stress off me," Taylor said.
You can do some of these things yourself. Angieslist.com founder Angie Hicks says people can save "meaningful dollars" if they take the time to read their insurance policies and to make calls when they run into problems. Hicks says a poll of her site's members found 75 percent of people who negotiated their own bills, cut the cost. Some ended up paying just half of what they owed. She says in one case, a woman avoided paying her portion of the bill completely, just by calling her surgeon's billing office.
"The surgery was $22,000. Her insurance covered $18,000, so she went to the surgeon and asked, 'Will you take $18,000 for this?' and the surgeon did. So in that scenario, it saved the person $4,000," Hicks said.
She offers these tips for people who want to negotiate their own medical bills:
- Research and compare costs for your procedure beforehand if possible. Check the cost, not just for the doctor, but the anesthesiologist and the operating room. Use a site like healthcarebluebook.com to help you compare prices.
- Request your "superbill." Look it over carefully to make sure all the charges are correct. If not, call your insurance provider or doctor's billing office to make the necessary corrections.
- When calling your insurance company, be sure to write down the name of the person you speak with and his/her extension so that you can create a record and establish one point of contact to handle your case.
- Don't be afraid to request a supervisor if you feel your questions aren't being answered. Be polite, but firm.
- If you've done everything and you still have a portion of the bill you have to pay out of pocket: ask for a deal. Many times the biller is willing to work out a payment plan without interest, or offer discounts for advance payments or cash payments. The same goes if you're uninsured. Be upfront about your situation and try to work out a deal so you're not weighed down by the stress of ongoing medical bills.
Whether you do it yourself or hire someone else, make time to do it. Taylor says she didn't pay a penny of her $500,000 surgery and ICU bill. Something she credits to her case manager who looked over the entire bill and made sure her insurance didn't bill her for anything out of pocket.
"It was well worth the investment," Taylor says.