How to Negotiate Hospital Bills and Avoid Medical Bankruptcy

The high price of health care affects everyone. In fact, one recent study found that medical bills are the leading cause of personal bankruptcy. Insured Americans struggle with high deductibles, relentless monthly premiums and unforeseen out-of-pocket costs that can add up to thousands of dollars each year. Meanwhile, millions of Americans are uninsured, underinsured or simply between jobs and temporarily uninsured.

Whether you are insured or not, follow this approach to negotiate your bills and reduce your medical costs.

1. Find a less expensive hospital.

Hospital prices vary widely. For patients seeking knee surgery in Dallas, Baylor University Medical Center charges $43,852 while nearby Dallas Regional Medical Center - a 17 minute drive away - charges more than three times this price, a whopping $142,064.

You may find that the quickest way to reduce your medical bill is to simply choose a hospital offering the treatment for less. Search free hospital price transparency tools online to learn about costs in your region. Then contact your preferred hospital to ask for an estimate for your care.

2. Calculate what the government thinks your treatment is worth.

Medicare negotiates discounted payment rates with hospitals across the country. A recent NerdWallet Health study found that Medicare receives an average discount of 73 percent on medical bills. While hospital billing rates can vary dramatically, Medicare rates are fairly consistent and indicate what value the U.S. government places on hospital services.

Therefore, you can take your projected medical bill, and multiply it by 27 percent to know what the government would likely pay for your treatment.

3. Ask for a lower rate.

Call the medical billing office at your hospital and propose a lower rate for your care. Your negotiation might take dozens of calls, lots of unreturned voice mails and yield several "no's," but it's worth the time and effort if the hospital is willing to negotiate.

When negotiating, consider how much you can afford to pay. Offer this amount to the hospital billing office, and if you can, try to pay it all in one lump sum.

If a lump sum payment is not possible, offer to pay a modest amount every month - but if you do take this approach, make sure to finalize it in writing. It's important to agree on how much is owed each month and when your debt will be paid off. Once you agree to this type of deal, you will be responsible for making your payments in a timely manner. If you miss even one small payment, you may find a collections agent knocking on your door.

4. Get help from a professional.

To lower expenses, patients are turning to a growing number of medical bill advocates. These advocates are often experienced medical billing professionals who offer their expertise to interpret your bill, look for errors and overcharges, and ultimately negotiate a lower rate.

Many families have saved tens of thousands of dollars through these services, and often there is no upfront cost. Instead, these negotiators typically earn a fee as a percent of the dollars they save you. A service called My Medical Negotiator advertises that any bill more than $200 is eligible for its services. Other companies like CoPatient offer a free medical bill audit that helps you to identify billing errors and potential savings opportunities.

Christina LaMontagne is the vice president at NerdWallet Health, a website that helps patients choose better and more affordable health care. The site features tools to estimate medical costs and compare treatment prices among hospitals.