Want To Pay Less At The Doctor? Negotiate

Patients May Be Able To Save Money By Using Cash And Paying Upfront

(CBS)  Shirley Brown likes the clinic she goes to and the doctors just fine, but she doesn't just go there for the medical care. She goes there for the discounts, CBS News correspondent Wyatt Andrews reports.

And it's not a blue light, end-of-the-month-clearance kind of discount. At the Columbia Park Medical Group near Minneapolis, anyone paying cash automatically gets 10 percent off the bill. The discount makes a difference to Brown, who makes $10 an hour as a housekeeper.

"I'd rather go to a clinic where they're going to give me a 10 percent discount versus one that's not. Makes good sense to me," Brown says.

It makes sense for the doctors to cut this deal, because tens of millions of patients in America are now paying doctors out of pocket. That includes the 47 million people without insurance, plus the millions with insurance who have high-copayment or high-deductible policies.

Dr. Deborah Demarais, who helps manage the Columbia practice, says for the clinic, upfront cash is king.

"Because if they pay on the day of service, we don't have to spend the administrative cost to send them bills, follow up, etc.," Demarais says.

The truth is, doctors accept discounted fees every single day – but from insurance companies. They don't usually advertise this, but more doctors than you might imagine will also negotiate their bill directly with patients.

"Yes, you can negotiate with your doctor," says Michelle Katz.

Katz says 10 percent is just where you start. After Katz was injured in an auto accident, she negotiated a $28,000 medical bill down to less than half. That inspired her to become a medical consultant — and today, she rarely pays full price. Most doctors, she says — especially ones who know you — will give big discounts for upfront payment.

"I say 'Yes, I am paying cash' and they will give me the cash price, which is usually 50 percent of what they usually charge in the office," Katz explains.

Brown will pay in cash today because she's uninsured and has no choice. She'll need many visits to the clinic as she recovers from pneumonia, and she'll save 10 percent every time. She says it means big savings for her.

"Every little bit helps," Brown adds.

In the end, she saves on the visit, the clinic has money in the bank. And it's a glimpse of what you might you save because of the growing cash economy in medicine.

[kevzgrl]

The hospital system in our town gives you a 15% discount if you pay within 30 days - that sure helps when you have larger bills like I have had in 2006 due to 2 medical emergencies. Pity this isn't a mandatory thing, or at least some kind of cap on what they can charge for certain things.
The cost of medical care in this country is ridiculously high, compared to the quality we sometimes receive.

[bellal-2009]

docpeter, that's a good idea when you're young but still risky. A health plan for major medical along with HSA (health savings account), would take away a lot of the risk. We've had many illnesses in my family and have always purchased our own health plans. I used to get barebones plans but after three major health events and tens of thousands our of pocket went to an expensive overinsured type plan. For us it's worth the peace of mind and complete choice in care.

[bellal-2009]

The President's health insurance plan that he highlighted in his speech would help bring transparency to costs. Many people I know don't even know what health insurance cost because they rely on their employer. Many times they are underinsured or overinsured and don't even know it. For people who have been layed off and tried to buy it on their own they find, depending on the state they live in, that there isn't much to choose from. Opening up the market to more health plans will give us all more choice. The Democrats plan for universal health care will limit our choices and also stunt research progress.

[drjortman]

This act is illegal! All info I have says you must charge all patients and insurances equally- I think a retraction is due

[docpeter-2009]

Some docs are offering this PATOS (Payment At Time Of Service) with discounts routinely at 10%.

Insurance is really not such a good deal anymore, especially if you are healthy. Figure you pay $600 per month and have a $1,500 per year deductable. You will have to pay $8,700 this year before your insurance even kicks in. This is about average. If you don't go to the doctor the insurance co. gets to keep the $7,200 premium and it goes into the pockets of the execs, not all to paying for the medical bills of other clients of the ins co.

Insurance is nation wide legal gambling. You are betting you will get sick, the insurance co is betting you will stay healthy, or not reach your $8,700 OOPE (Out Of Pocket Expense). They don't like to call it OOPE since the $8,700 never reaches your pocket because it is taken out of your pay check, but you earned it and it could have been in your pocket.

Medical expense accounts make better sense. Take your $600 per month put it in an interest bearing account along with your $1,500 deductable and after a few years you will have $20K - $30K for unexpected medical bills if you and yours are healthy.

[tamijoe14]

Discounts are also given to patients through Fee for Service programs where members pay a monthly fee to have the "discounting" done for them by major companies. Generally members are able to get discounts from 20% to 80% on not only physician fees but also Dental, Vision, Prescription and Chiropractic. This way the patient doesn't have to do the bargaining. Consumer Driven Healthcare Plans are a great asset to our healthcare problems. You can view one such example at http://www.healthanddentaltoday.com