We have many clients who are uninsured and incur substantial hospital/medical debt. All is not lost. There are several avenues to explore, which we can effectively do so on your behalf. In certain circumstances, financial aid packages are available which can greatly reduce or even eliminate medical debt. We will explore your eligibility for these programs and assist with the application process.
We thoroughly review each hospital’s billing, collections and financial assistance policies. Most hospitals offer a fixed percentage deduction for the uninsured patient(often referred to as the “self-pay discounted rate). Technical issues sometimes interfere, and they are also subject to differing definitions of “uninsured.”
In addition to the standard discounts applied, it has been our experience that discounts are often obtainable through active price comparison and negotiation. Price transparency has become law and hospitals must post standard charges online or face stiff penalties. We extract pricing information ,compare to other providers and assess the differences.
The No Surprises Act provides much-needed protection in certain types of medical billing where one would not otherwise have coverage. (For example, out-of-network provider balance billing.) However, the protections for the uninsured are limited to mandatory provisions of a written estimate before SCHEDULED surgery or procedure. If the final invoice price exceeds the estimate amount by more than $400, one might be able to obtain federal review. ALWAYS ask for a written estimate at least 3 days before your procedure whenever possible.
However, what happens to the person who goes to the hospital for a scheduled surgical procedure whose insurance denies the claim after the surgery?
PRICE MIGRATION HAPPENS. Most hospitals then “migrate the price” from whatever the insurance rate would have been to its charge master rate (full price ). The hospital has provided no additional services. It has no ethical basis to double or triple your rate rather than offer a self-pay uninsured discounted rate. Simply, if this has happened to you where you are uninsured and have received a substantial medical bill or, alternatively, lost your insurance due to anything from a pre-existing condition on a non – Affordable Care Act policy, to a flat denial that we or others are unable to reverse on appeal, let us help address your situation. There are answers. They may not be optimal in all cases, nor are they as dire as one would suspect. However, it would not be fair for the hospital to get a windfall after surgery was denied. It performed no additional services. And essentially is imposing a substantial windfall tax on. Monies that otherwise would have been predominantly written off by the insurance company by contractual agreement.
However, isn’t the point that this patient, whose insurance has denied all services after the fact, equally uninsured as the patient who comes in the door seeking self-pay discounted pricing? Of course, they are both uninsured and one might argue entitled to take advantage of the preferential pricing. Hospitals often look at anything involving the uninsured as an opportunity to increase profits. They are widely used and traditionally have been considered a profit center for hospitals.(and done in a patently unethical manner without any genuine agreed basis).
Human Health Advocates has handled multiple cases with similar issues present. We would be pleased to assist you if you are similarly situated. We are here to help.