The reality is, healthcare is expensive, and hospitals and insurance companies are multi-million-dollar businesses that surround themselves with highly skilled people to protect their interests and bottom line.
Meanwhile, individual patients can get stuck with exorbitant medical bills, making it difficult to carry on with normal life.
The purpose of this guide is to change that reality. We hope this information can help level the playing field and ensure that patients can adjust their medical bills to pay fair prices.
This guide has 4 parts:
Part 1: Medical Bills 101
First, we will pinpoint the primary factors that lead to costly medical bills and then walk through typical medical documents from hospitals and insurance providers to help you understand exactly what you’re being charged for — and why.
Part 2: DYI - Negotiating Your Own Medical Bills
We’ll discuss the process of negotiating your medical bills. That process starts with gathering ALL of the right information, then recognizing problems that might be relevant to your specific case. Finally, we’ll guide you through what you can do to help reduce those bills.
Part 3: Getting Help with Your Medical Bills
While we hope to arm everyone with enough information to negotiate their medical bills, the truth is no guide can be 100% comprehensive. The medical billing system is incredibly nuanced and Byzantine, sometimes people run into a brick wall, and some still need help financing their medical bills. Here we share ways you can get help, from hiring a professional negotiator to seeking out medical charities and personal loan companies to help you pay your bills.
Part 4: About Resolve
Part 1: Medical Bills 101
The Medical Debt Crisis in the US: A Growing Burden
The United States faces a significant medical debt crisis, with millions of individuals and families burdened by exorbitant healthcare bills. This crisis has far-reaching consequences, impacting people from all walks of life and across various socioeconomic backgrounds. Understanding the scope of the problem is crucial to finding effective solutions and providing relief to those affected.
Recent statistics highlight the severity of the medical debt crisis in the US. According to a survey conducted by the Commonwealth Fund, approximately 79 million Americans struggled to pay their medical bills or had accrued medical debt in 2020. This represents a staggering 24% of all adults in the country. Additionally, among adults under the age of 65, nearly one in four reported problems paying medical bills or having medical debt.
Furthermore, a study conducted by the Kaiser Family Foundation revealed that even individuals with health insurance coverage face financial challenges related to medical expenses. In 2020, around 32% of insured adults reported difficulty paying their medical bills. This indicates that insurance coverage alone does not provide adequate protection against the financial burdens associated with healthcare.
Polling conducted the by Kaiser Family Foundation in March 2022 found four in ten adults (43%) report that they or a family member in their household put off or postponed needed health care due to cost.
If you have a large medical bill that you’re struggling to pay (or even one that you can pay but seems excessive), you’re not alone! As noted by the National Health Expenditure Report, we as Americans spend over $433.2 billion a year out of our own pockets paying for care (on top of insurance payments and co-pays). 18 million of us will struggle to pay for food and our housing this year due to excessive healthcare bills.
3 Main Contributors to Expensive Medical Bills
While there are several factors contributing to these expensive medical bills, three primary contributors stand out: hospital price gouging, incorrectly denied insurance claims and billing errors. Understanding these issues is crucial for patients to advocate for fair and accurate billing practices.
Hospital Price Gouging ($149 billion):
Hospital price gouging refers to the practice of hospitals charging inflated prices for medical services and procedures. The lack of price transparency in the healthcare system allows hospitals to set arbitrary prices, often significantly higher than the actual cost of providing care. This leads to outrageous medical bills that patients find difficult, if not impossible, to afford.
Using data provided by the Center for Medicare and Medicaid Services (CMS), we performed a study comparing hospital costs and the amount that they charge consumers, and we found that, on average, hospitals charge more than four times (4x) their costs for care services. Think of it like being sold a brand-new, base-model Honda Civic for over $70,000.
Meanwhile, behind closed doors, insurance companies and hospitals are busy negotiating discounts on those set prices. On average, consumers are charged 3.5 times more than what an insurance company pays. So, that Honda Civic you bought for $70,000, the insurance company is getting for around $20,000.
Incorrectly Denied Insurance Claims ($63 billion):
Say you have great health insurance and go to the hospital expecting your treatment to be covered by your plan. But six months later, you receive an enormous medical bill from the hospital, claiming that your insurance company denied coverage.
If this sounds familiar, it’s because it happens all too often in America — nearly 20% of in-network insurance claims end up being denied, and almost none of them are appealed.
Even worse, while hospitals tend to be good about appealing insurance-denied claims (with a 63% success rate), insurance companies are far more likely to say no to consumers (only a 14% success rate).
How to explain the huge discrepancy? Insurance companies are experts at using confusing jargon and setting up just enough roadblocks (i.e. forms and other paperwork) to make you want to throw your hands in the air and give up. Unfortunately, the average consumer does just give up. To provide some clarity, we have written up 10 Key Health Insurance Terms To Know.
Billing Errors ($46 billion)
Some estimates claim that 80% of all hospital bills contain errors. Oddly enough, these errors are almost always in favor of the hospital rather than the patient.
These errors can come from tricks that hospitals use to charge for the same thing multiple times, such as “mistakenly” charging for a service not provided, or the hospital trying to collect once from your insurance company and again from you (a practice known as balance billing). To learn more about balance billing check out Understanding the 3 Types of Balance Billing, Surprise Medical Billing and Balance Billing: Learn How to Fight Back, and Balance Billing State and Federal Laws and Protections (What You Should Know).
Understanding Your Medical Bills
Medical bills, Explanation of Benefits, and other medical-related documents are confusing — so much so that it seems as if hospitals and insurance companies are intentionally making things as difficult to decipher as possible. It is common, after a trip to the hospital, to receive multiple bills — from your doctor, the ER, the lab that ran blood tests, and the ambulance, all of which may technically be separate companies billing you a separate amount for their services.
The important thing is not to be overwhelmed by all of this. Take each bill, one at a time, and break it down to understand each part.
3 Buckets of Healthcare Pricing
We’ll simplify the medical bill pricing structure as much as we can by looking at three individual buckets and the role they play in setting a price for healthcare, hospital chargemaster, health insurance negotiated rates, and Medicare.
Hospital Chargemaster serves as a starting point for pricing, providing a comprehensive list of medical services and their respective charges.
Health Insurance Negotiated Rates when insurance companies negotiate discounted rates with healthcare providers, enabling them to reduce costs for policyholders. By focusing on these negotiated rates, we can identify potential cost-saving opportunities and ensure fair pricing.
Medicare is a federal program providing healthcare coverage for eligible individuals, establishes standardized rates for medical procedures. By leveraging Medicare rates, we can establish a benchmark for pricing, promoting consistency and affordability.
To learn more about how we simplify the medical bill pricing structure and the role of Hospital Chargemaster, Health Insurance Negotiated Rates, and Medicare, please visit our blog post The 3 Buckets of Healthcare Pricing.
Hospital Bill Anatomy
- Billed Charges (Gross Charges or Chargemaster Rate) - These are the “full-rack” rates that the hospital charges only to uninsured patients. The prices listed often have little bearing on reality (averaging around 4.5 times the hospital’s costs) and are never the prices that insurance companies end up paying — or prices that you should ever pay.
We call this the “sucker” price. Hospitals charge this amount just to see if they can get away with it. But you should never pay it.
- Insurance Adjustments (Contractual Amount or Contractual Discount) - The discount that the insurance company has pre-negotiated with the hospital.
- Insurance Payment (Allowed Amount) - The amount that the insurance company actually pays the hospital (per their pre-negotiated rate).
Note: sometimes the insurance payment (Allowed Amount) and insurance adjustment (Contractual Discount) will be wrapped into one number on a hospital bill. This can make things extremely confusing – which is why we recommend comparing the hospital bill to your insurance company's “Explanation of Benefits”
- Balance (Patient Portion) - This is everything that’s left over after the insurance adjustments and insurance payments have been taken out of the billed charges. It is the bottom-line amount that the hospital is saying you owe.
Here’s the formula that your hospital bill should follow: Balance = Billed Charges - Insurance Adjustments - Insurance Payment
If the above equation doesn’t work with the numbers that the hospital presented on your bill, something may be off.
You are not being asked to pay the itemized amounts listed above. The amount you owe after all insurance payments and adjustments will be on your hospital bill.
Insurance Explanation of Benefits
The Insurance Explanation of Benefits (EOB) is a document from the insurance company that is supposed to make costs and coverage clear. However, like hospital bills, the EOB can initially seem designed more to confuse than to explain. But with a little work, it becomes easier to understand.
An EOB is NOT A BILL
- Phone Numbers - You can call your health plan if you have questions about finding a provider or what your coverage includes.
- Date of Service (DOS) - The date care was received.
- Service/Product - The line item shows the type of medical service being considered in this instance. This can be a description and/or include a code that allows the insurance company to match a service provided with a set price.
- Allowed Charges - The amount your provider will be paid; this may not be the same as the Provider Charges.
- Copay - A set rate you pay for prescriptions, doctor visits, and other types of care. Think of this like a “shared” payment for services provided.
- Deductible - The amount you need to pay each year for covered services before your plan starts paying benefits.
- Coinsurance - The percentage of costs you pay after you've met your deductible.
- Paid by Insurer - The amount your health plan will pay to your provider.
- What You Owe - The amount you owe after your insurer has paid everything else. You may have already paid part of this amount. Payments made directly to your provider may not be subtracted from this amount.
A useful exercise is to match all of this information with the information on your hospital bill to make sure everything lines up properly.
Still having trouble understanding your medical bills, EOBs, or itemized bills? Don't worry, our friendly team of medical billing advisors is here to help! We'll untangle the confusion and make sure you're not paying a penny more than necessary. Reach out to us today and put your worries to rest!
Part 2: Lowering Your Medical Bills
How to Negotiate Your Medical Bill
Step 1: Gather the RIGHT Information
The first step to negotiating your hospital bill is to make sure you have in your possession — and that you understand — all of the relevant documents for your case.
- Hospital Bill - Your hospital bill is typically sent to you in the mail and/or via your patient portal. It comes from the hospital and lists total charges along with any discounts offered, insurance company coverage, and what you as the patient owe.
- Itemized Hospital Bill - The itemized bill won’t be sent automatically; you have to call the number on your hospital bill and ask specifically for the Itemized Hospital Bill. Hospitals aren’t inclined to provide this information, but they are required by law to do so if you ask. Make sure to be clear and direct, and say something along the lines of “I would like an itemized bill.”
- Explanation of Benefits (if you carry insurance) - If you have insurance, your insurance company would either have posted this to your online member portal and/or mailed it to you. Additionally, you can call your insurance company and ask them to send an EOB to you. *If you don’t have insurance, don’t worry about this document.
If it feels frustrating and diﬃcult to gather even these three simple documents, don’t worry — this is a very time-consuming process, even for us. It’s upsetting that something that seems so simple ends up being so complex and time-consuming but remember: be patient, and persistent, and do not accept “no” for an answer.
Step 2: Analyze and Identify
Most billing issues that we encounter fall into 2 different buckets price gouging and billing errors.
Price gouging is the hospital charging you far more than the fair market price for services provided. Hospitals charge consumers, on average, 4.2 times their actual costs and 3.5 times the price that insurance companies pay for the same service (the price insurance companies pay is negotiated behind closed doors).
Medical Billing Errors to Watch Out For
- Mistake: Someone entered a brand name drug code when you took a generic, cheaper drug. Or your sprained wrist was coded as a break.
- Duplicate charges or inflated quantities: Multiple charges for the same service. Or a coder adds an extra zero, and you end up being charged for 50 pills instead of 5.
- Treatments you didn’t receive: You were scheduled for an MRI while in the hospital, but your doctor decided it wasn’t necessary. The test might still end up on your bill if no one removed it from your chart.
- Incorrect surgery times: Operating room time is charged by the minute. A coder may mark down your surgery time incorrectly, causing you to pay more than you should. You can check your medical record to see when your surgery started and ended if the time on the bill seems off.
- Wrong room fee charges: For hospital stays, it's not uncommon for someone staying in a shared room to be charged for a private room. Bills can also be inflated when coders mark down the wrong number of days.
Tips to identifying billing issues
- If you don’t have insurance, the price that you’re being charged by the hospital is almost certainly inflated. Research a fair price for the service. These will be your starting point for what you’ll offer to pay to settle.
- Look up the Medicare rate for the service you received using the Medicare code lookup. Enter the code on your bill, select “All Modifiers,” and hit submit for an explanation of the code.
- Or you can use the Healthcare Bluebook.
- Look through your itemized bill line-by-line to make sure you remember being provided all of the services listed. If you’re unsure of any of those services, you may want to consult your Electronic Medical Record (EMR). You can call the hospital to request this (specifically state that you want them to send you your Electronic Medical Record. They are required by law to do so when asked directly).
- Start with the largest charges first. The descriptions can be confusing, so Healthcare Blue Book and Google searches are your ally. Take the HCPCS/CPT code (there should be an identified column) and run a Google search to get a description of the code.
- Check for coding errors using Find-A-Code. Use the NCCI Edits Validator (under the Tools menu) and enter all of the codes on your itemized bill. Find-A-Code pulls from government-published CMS guidelines to detect code pairs that should not go together (because that would be unbundling). Make sure that your entire hospital bill comes back clean.
- Check HCPCS or CPT codes using the Medicare code lookup to get an explanation of the code and to ensure you're being billed for the care you received. Input the code on your bill, select "All Modifiers," and hit submit.
Step 3: Write and Send Your Settlement Offer
Let the negotiations begin - Now it’s time to write and send your settlement offer! While many people may shy away from negotiating based on price, this is exactly what you should do.
Build a Case
Simply asking for a discount often isn’t enough. We want to not just make the request but also give the hospital a strong reason to accept a lower amount, which we do in three ways:
- Arguing that the amount billed creates a financial hardship.
- Arguing that the amount billed creates a hardship gets easier and more believable as the bill gets larger. Simply state that you have multiple bills related to the procedure (as long as this is true) and that everything together makes it very difficult to pay, then explain what you can afford and why.
- Arguing that the prices being charged are far out of the ordinary (and comparing to what ordinary or reasonable prices might be).
- Insurance companies generally pay 1.5 to 3 times the Medicare reimbursable, so it’s best to use that range as your initial offer.
- Arguing that the billing errors that you have identified be removed.
Now that you’ve built a case, it’s time to write and submit a settlement request.
Write a Settlement Request Letter
This letter gives the hospital something to respond to, and, more importantly, it forces them to start talking about price and not just payment plans or applying for financial assistance.
Your settlement offer letter should include the following information:
- Your account number
- Your full name, date of birth, and address
- Dollar amount owed on bill
- Argument for why you believe your bill should be lowered
- Dollar amount you’re offering to pay and why that much (e.g. generally based on Medicare Reimbursable rates or Charge/Cost Ratios)
- That you’re willing to pay the proposed amount immediately up front (if you can), which encourages the hospital to accept your offer (Optional)
- Thank the hospital for their services (Optional)
Don’t forget to proofread! It’s important that your letter look as professional as possible. Proofread the letter to make sure all of the information is correct and that there are no spelling or grammatical errors.
Send Your Letter
Call the number on your hospital bill and ask how you can submit a settlement request. They should provide a fax number and/or email.
Stand firm in asking about how to submit a settlement request. You may be asked whether you want to go on a payment plan or apply for financial aid. Many hospitals accept settlement requests but billing department employees are trained to redirect to other methods.
Step 4: Follow Up
Call the hospital to confirm that it was received 3 days after submitting it. You may have to call back multiple times over the next week to confirm receipt, but make sure you do. A favorite trick of hospitals is to “lose” your settlement request. Don’t let them do this, and don’t be deterred by roadblocks. *Patience and persistence are key.
Continue to follow up on the status of your settlement request until you receive a response. As a general rule, hospitals will not call you back unless you push them.
Once the hospital responds
- If the hospital accepts your initial settlement offer, congratulations! You’ve successfully negotiated and all you have left to do is pay the bill.
- If the hospital denies your settlement request, realize that this is just the start.
- Ask for a reason why and if they can provide a counteroffer. You may also request to speak to a supervisor to make your case over the phone.
- If they continue to deny it, thank them and then try again in 5 days.
The bottom line is, negotiation isn’t easy, and it isn’t for everyone. But we can offer some tips on how to be a better negotiator and (hopefully) achieve a better outcome.
Tip 1: Write Everything Down
Record ALL of your conversations in one place. The hospital and insurance company are taking notes on your conversations — so you should too. We want you to quickly and easily be able to go back and review all conversations so you can understand exactly what’s going on.
Include the following
- Who you connected with
- Phone number or email address to the person you connected with
- Notes on the conversation
Tip 2: Find an Advocate
As you call the insurance company and hospital and record more and more names, you may find yourself talking to the same person multiple times or someone who seems to be very focused on helping you out. This is why we say be polite and patient, yet persistent.
Your goal should be to get them on your side, advocating for your case internally. Oftentimes, finding an advocate at the hospital or insurance company is the key to unlocking savings.
Tip 3: Separate People from the Problem
Remember, no matter how frustrating the process may become, the person on the other end of the line is not your opponent or your enemy. Instead of being accusatory (“You did this” or “You did not”), phrase your words in terms of what the bill says or “what I’ve been told” more generally. Remaining calm, stay focused on the issue at hand: lowering your medical bill.
Tip 4: Persistence — Don’t Take “No” for an Answer
The answer and outcome you want may not come right away or on your first try. Be polite, patient, and keep trying. Often enough, it’s a matter of asking a question the right way, or it may take finding the right person on the other end of the line to be motivated to help. (Your politeness is motivating.) Whatever you do, don’t give up!
How to Appeal an Insurance Denial
Generally Insurance companies will deny coverage for one of two reasons:
- The medical procedure wasn’t covered under your insurance policy, or the medical services provided weren’t for a medical emergency.
- (e.g. A patient went to the ER with severe chest pains (thinking that they might be having a heart attack), only to be diagnosed with acute heartburn. The insurance company denied their claim because acute heartburn is “not a medical emergency.” The denial was overturned, as the reason for going to the ER — a potential heart attack — presented a medical emergency, and is separate from the actual diagnosis.
- Because algorithms are typically used to sort claims and issue denials, we often see erroneously denied claims that should obviously be covered.
- (e.g. misspelled name, wrong insurance ID, etc.)
- If your claim was denied because of a clerical error (e.g. misspelled name, wrong insurance ID, etc.), it should be relatively straightforward to fix. Call up your insurance company and ask for the forms to refile. Be extremely careful and deliberate to make sure there aren’t any mistakes on your refile.
If your claim was denied for another reason (likely either because the treatment received was not a covered procedure or not a medical emergency in the eyes of the insurance company), we recommend taking the following steps to appeal the insurance denial.
Step 1: Understand the Process and Paperwork
Your Explanation of Benefits (EOB) from the insurance company should clearly state both if your claim was denied AND the reason for your denial. It’s important to note the reason for denial, as that determines the best path to appealing your claim.
Appealing insurance claim denials is all about attention to detail, following the process to a T, recording everything, and patient yet persistent follow-up.
Many health insurance companies have deadlines for filing appeals, so make sure to act fast to get the appeal out the door and into the hands of the insurance company.
There’s a lot involved in filing a claim appeal so it’s important to track everything carefully.
You should be able to find all paperwork and the process for filing an appeal in your insurance company’s online portal. If you’re still confused, call up your insurance company and ask directly.
We recommend writing out a step-by-step process and a checklist of all the paperwork needed at each stage of the process. This allows you to track your progress and ensures that you have everything needed to properly file an appeal. Additionally, putting all forms in one place (a folder on your computer or in the cloud, or a hard copy near your desk) makes it easy to find and work on your case.
Step 2: Gather the RIGHT Information
Work with your doctor and the hospital to gather the relevant evidence that will allow you to overturn your claim. Depending on your individual case this could include:
- Referral from your doctor to another medical provider
- Medical history records to show a treatment or procedure was a medical necessity
- A note from your doctor affirming medical necessity (doctors and hospitals are usually very happy to provide this to you if you call them up and ask)
- Adjustment to diagnosis and treatment codes — sometimes the billing department enters incorrect codes that aren’t covered by your insurance. If this is the case, request that they change those codes to items that are covered.
- Explanation of covered procedure — if you believe that your procedure is actually a covered procedure, include an explanation of this (along with a note from the doctor)
Step 3: Write and Send Appeal
Now that you’ve gathered the evidence, submit your appeal claim form.
Don’t forget to proofread! Make sure that you read the claim form extremely carefully and follow each step exactly as it’s written. Any mistake can cause your appeal to be denied due to clerical error, forcing you to go through the process of filling out everything again.
Step 4: Follow Up
We recommend politely calling your insurance company every couple of weeks to check on the status of your claim.
Tips For Following Up
- Take notes. Every time you call, write down the date and time, the name of who you spoke to, what you asked, and what their response was.
- Don’t shoot the messenger! The person you’re talking to on the phone is not the same person responsible for filing and making a decision on your appeal. If you don’t get the response you want or things are taking a long time, remain polite and ask what you can do to change things. You want to make the person you’re talking to your advocate in getting the process done — getting angry never helps
- Make sure you also ask for an expected timeline for the appeal to be processed. Appeals can take time and it never hurts to check in on the status and see if there’s anything else to be done to expedite the process.
Part 3: Getting Help with Your Medical Bills
Our primary goal in this guide has been to provide you with as much information as possible in as clear a way as possible to help you lower your exorbitant medical bills yourself.
But if you’ve read Parts 1 and 2 of this guide, you can see how complex and drawn-out the process can be.
There’s also the matter of time — spent calling the hospital and insurance company, persistently following up, and trying to clear every hurdle they put in front of you — precious time that you may not have in the course of your day-to-day life.
Fortunately, you don’t have to go it alone. There are a number of resources that can help you navigate the medical billing system and negotiate on your behalf to lower your bill.
Find an Advocate/Negotiator
A Medical Billing Advocate is (usually) an expert on the complexities of the medical payments process and a seasoned negotiator. They can help you better understand the process, and they will demonstrate the persistence, patience, and expertise required to maximize your savings.
Advocates provide two major benefits:
- Negotiating expertise to help you maximize savings
- Peace of mind to allow you to relax and go about your life
Negotiating a medical bill can be a long and draining process. If you aren’t prepared to take the time to learn or consistently follow through, and if you’re too likely to accept “no” for an answer — an advocate may be a great option. And above all, if you don’t feel comfortable negotiating your medical bill, it may be worthwhile to find an advocate to step in on your behalf.
On the other hand, if you’re the type of person who likes to figure things out on their own, is persistent and patient in the face of a challenge, and don’t mind picking yourself up when you fall down — then this guide may be all you need to negotiate your bill.
When looking for help, consider medical billing advocates who offer free consultations in which to discuss your situation and provide guidance on how best to proceed. The best advocates won’t hold anything back or talk about “secret” processes — they’ll be open and helpful with their advice before leaving it up to you to decide whether or not to hire them for their services.
Find Financial Assistance
Sometimes, even after the best negotiation efforts, medical bills are still too large to pay. Even in this case, there are still a number of options available to you, including:
Hospital Financial Aid
It never hurts to apply for financial aid from the hospital, even if you think you may not qualify. Many hospitals will offer some form of assistance to people whose income is three or four times the federal poverty line. For example, the poverty line for a family of four is around $30,000- in annual household income, which means that a family earning up to $120,000 per year might still qualify for financial aid from the hospital.
Do a Google search for “[hospital name] financial assistance,” and find out what information is available online or who to call to see if you qualify for any assistance.
Your State Medicaid Office
Check to see if you qualify for help from your state Medicaid office.
State Children’s Health Insurance Program
If your bill is for a child, you may qualify for your state’s CHIP.
If your medical bill involves a particularly expensive drug, reach out to the pharmaceutical company that manufactures the drug and ask if they offer any grant programs to offset its cost.
Many pharmaceutical companies provide assistance programs for those with financial need to help pay for their drugs — since some of those drugs can be extremely expensive, financial need can be very loosely defined.
Medical Bill Charity Programs
A quick Google search for “medical bill charity for [treatment you received]” will show you a number of charities that can help you with your medical bill. Here are just a few we turned up:
- PanFoundation focuses on helping people with life-threatening, rare, and chronic diseases
- Healthwell Foundation helps the underinsured pay for medical care
- Leukemia & Lymphoma Society lends support to those suffering from leukemia or lymphoma
- CancerCare is a charity to help people pay for cancer treatment
GoFundMe can be a great way to engage friends, family, and your community for help in paying off your medical expenses. Each year GoFundMe leads 250,000 medical campaigns that raise over $650 million.
Take Out a Loan
If all else fails, it may be possible to get a personal loan to pay of your medical bills. But we recommend being very careful and to understand all aspects of the loan, as interest rates can be much higher than car or home loans. And you’ll still be responsible for making monthly payments to pay of the loan — plus interest. We recommend checking out personal loan companies such as LendingTree, SoFi, Earnest, Upstart, CareCredit, and Greensky (though there are many others), as well as contacting your local bank.
Hospital Payment Plan
If your hospital will place you on a payment plan, this can often be a much better alternative to taking out a loan, as these plans usually are no- or very low-interest, meaning you’ll pay less in the long run. The hospital will likely request that you pay an amount up front and then commit to making monthly payments at a low- or no-interest rate.
When all else fails, bankruptcy may be an option. We say “may” because bankruptcy laws vary from state to state and the viability of this path needs to be evaluated on a case-by-case basis.
The National Association of Consumer Bankruptcy Attorneys (NACBA) offers a “Find an Attorney” tool that lets you search for a bankruptcy attorney near you. Many bankruptcy attorneys offer free consultations to be able to discuss the specifics of your situation and to get a better idea of whether bankruptcy is an option for you.
*Do not declare bankruptcy without first discussing with an attorney licensed to practice in the state you live in.
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Part 4: About Resolve
Resolve: Empowering Individuals to Overcome Medical Bills and Financial Stress
An everyday medical bill should never be the cause of bankruptcy for everyday Americans. Unfortunately, healthcare bills have become the primary driver of financial hardship among American families. At Resolve, we are determined to change this narrative by assisting individuals in overcoming their medical bills and the immense stress that accompanies them. Our mission is clear: to eliminate the burden of stressful medical bills and provide much-needed relief to those in need.
Resolve is a trusted partner in helping patients navigate the complex landscape of medical bills and take control of their financial situation. Our team of experienced Advocates are expert negotiators, equipped with the skills and knowledge required to work directly with hospitals and billing systems. They are dedicated to shrinking and in some cases, eliminating medical bills, ensuring that individuals can regain their financial stability and focus on their overall well-being.
What sets Resolve apart is our Resolution System, which is the result of years of experience, a diverse range of proven tactics, and the analysis of millions of data points. We have delved into all aspects of healthcare billing to develop an effective system that helps people break free from the overwhelming burden of medical bills. By carefully analyzing medical bills, identifying errors or discrepancies, and leveraging our expertise, we have successfully saved Americans over $27 million to date. But our work doesn't end there—we are just getting started in our pursuit of helping more individuals in need.
The inception of Resolve came in 2016 when our founder, Braden, faced an exorbitant hospital bill for a 15-minute consultation visit. Frustrated by the challenges he encountered while trying to rectify the unjust bill, Braden was inspired to create a solution that would alleviate the burden of medical bills for others. Since then, Resolve has dedicated itself to delving into all aspects of healthcare billing, partnering with experts from various perspectives to free Americans from overwhelming healthcare costs and the burdens they bring.
At Resolve, we understand the overwhelming nature of medical costs and the stress they impose on individuals and families. Our commitment is rooted in helping people overcome these challenges and find financial freedom. We believe that everyone deserves access to affordable healthcare and the opportunity to regain control over their financial well-being.
Step 1: Tell us about the bills you are facing
When you sign up with Resolve, the first step is to provide us with information about your medical bills and financial situation. Through our user-friendly signup form, we gather essential details that help us understand your specific challenges. This information enables us to determine the best path forward and create a customized plan tailored to maximize your savings. We understand that each case is unique, and by understanding your situation, we can provide the most effective assistance. If you prefer, you can also opt for a free consultation with one of our Advocates before signing up to discuss your specific needs and concerns.
Step 2: Your Advocate finds savings for you
Once you've provided us with the necessary information, your dedicated Advocate takes charge of communicating with the hospital and insurance companies on your behalf. Our team of experienced Advocates is well-versed in medical billing practices and negotiation strategies. Leveraging our innovative Resolution System, your Advocate employs a variety of effective bill-lowering measures to secure the savings you deserve. This includes negotiating directly with hospitals and billing systems, identifying billing errors or discrepancies, applying for financial aid programs, and filing necessary claims. Throughout this process, we keep you informed and updated, ensuring that you are aware of the progress and developments every step of the way.
Step 3: Save time, money & stress
At Resolve, our primary goal is to alleviate the financial burden and stress associated with medical bills. On average, our customers save an impressive 60% on their medical bills, and in some cases, we have successfully eliminated entire bills. Once we have secured savings on your behalf, you will receive a discounted bill directly from the hospital. This reduced amount reflects the negotiations and efforts made by your Advocate. You will be responsible for paying this discounted bill directly to the hospital, ensuring a streamlined and transparent process.
Finally, you will receive a bill from Resolve, representing a percentage of the total savings we have achieved for you. This fee is only applicable if we successfully find savings for you. If we do not find any savings, your deposit will be refunded, and no fees will be charged. Our commitment is to provide results, and we stand by this commitment.
Conclusion to this Guide
U.S. Healthcare spending reached $4.3 trillion in 2021. That’s over $12,000 for every single person in the U.S., and nearly 70% of this can be avoidable.
Our mission is to make healthcare bills fair. We’re doing that by pulling back the curtain on an opaque system designed to make it as difficult as possible to lower patient out-of-pocket costs and get a fair rate. And our sincerest hope is that the resources in this guide help you to better understand your medical bills, recognize when there are items that can or should be corrected, and go about correcting them.
©Resolve Advocates, Inc. | 10 Buck Road | Hanover, NH 03755 | 877-245-4244