Cash Pay Negotiaions Guide Appeal Letter Free Download


Cash Pay Negotiaions Guide

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Health Symphony Appeal Letter

Cash Pay Negotiations Guide

If you would like to reduce the amount you owe to your physician, ask about or request the following:

  1. Charity Care Applications – This Application is completed by the patient or guarantor and documents his/her financial status, and must usually provide copies or recent pay stubs, bank statements, copies of tax forms, to provide financial hardship. Therefore, if you can prove financial hardship, request a Charity Care Application and ask for their determination criteria.
  1. Cash Pay Patients – The only individual or entity that is asked to pay the full price of what the physician charges is a Cash Pay Patient. Medicare, Medicaid and most health insurance plans will pay their contracted fee schedule with the physician or will determine what is Usual and Customary. This being the case, if you are paying Cash, request a substantial discount and never pay full price. A commonly requested discount for Cash Pay Patients is 50% because in comparison, the majority of health plans would wind up paying only between 40 and 50% of what the physician charged.
  1. Negotiate a Pre-Determined Amount – Physician’s offices are similar to retail establishments in that you receive a product/service and must pay what is asked. However, the difference is that Physician’s office do not post what their product/service costs. Knowing that a medical visit is expensive and a medical procedure/equipment or medication is even more expensive, it would behoove any patient to ask what the upfront and total costs would be and then negotiate a set price. Patients have more leverage to negotiate their fee prior to the service being performed. Afterwards, the physician has no motivation or incentive to negotiate.
  1. Ask for a Payment Plan – In combination with requesting a discount or negotiating a pre-determined amount, ask if you could pay that amount over time. A standard and acceptable time frame would be to make monthly payments not to exceed 6 to 9 months. If a bill is eventually not paid, a physician may have the right to send the balance to a collection’s agency, which would negatively impact your credit score. However, if you pay a set amount each month, it would be harder for the physician’s office to send you to collections because you are making steady payments to pay off your bill.
  1. If you have Health Insurance, ask for a Discount Anyway – If you have a plan where the physician is contracted, it would be difficult for you to receive any additional discounts. Seeing a contracted physician has already provided you with a benefit because the physician has agreed to accept payment at a previously agreed upon amount. However, if you are finding that it is difficult for you to pay your deductible, co-insurance or copayment, it does not hurt to ask for a discount or payment plan to pay your bill. If you have a good relationship with your physician, your physician may be more inclined to assist you.

Health Symphony provides information as a general resource and does not guarantee any results, expressed or implied, obtained from its use.