I have worked in healthcare for 12 years in the southeastern US. I will say that there is room to negotiate just about every doctor visit, lab test and procedure. The key is to know the medical language to ask. If they know you have any kind of insurance the business (or billing person on the other end of the phone) is going to tell you they do not negotiate. This is usually false. What they really mean is if you are a “cash pay, uninsured” then they will negotiate. It is true that there are some private doctors who won’t accept cash pay patients, but not for the reason you think. The reason is the patient will usually not do the necessary testing being prescribed and that actually makes them a liability. If anyone wants to try to get an estimate and they are cash pay, get the CPT codes associated with the test, procedure, or doctor/specialist visit being recommended. Then call the billing departments for all the facilities that may provide that service and explain very politely, your situation. Ask if they can “help you out”. As a referral coordinator I performed this service for all my cash pay, uninsured clients. Was I a little “pushy” sometimes, sure. If I didn’t get a reasonable price, I would just say (insert name of local doctor/facility) quoted me 200.00 less than you.Just a random example of course,but you get the point. Nine times out of ten one of them would extend a nice discount. Be assertive, play on the “sick role” and always be nice. This seems to work well with the cost sharing ministries. But never, ever tell them you participate in the cost sharing ministries because they will assume it is health insurance. If it doesn’t work in your individual case at least you know you have tried.
