Marshall Allen, author of Never Pay the First Bill, explains how to fight inflated medical charges. Get itemized bills, check codes against fairhealthconsumer.org and hospital rates, then dispute in writing and negotiate discounts. Most people don't know they can haggle their medical debt down.
Questions this video answers
Nearly 5.4 million Americans
Aim for about an 85% discount from the sticker price (i.e., pay ~15% of the billed amount)
fairhealthconsumer.org
Contest the debt in writing (use a written notice/template)
Never Pay the First Bill and Other Ways to Fight the Health Care System and Win
Chapters
You may or may not be surprised by this notion that one of the leading causes of bankruptcy in the United States is medical bills. Our next guest, Marshall Allen, started off in Christian ministry and is now an award winning ProPublica reporter who just came out with a book called Never Pay the First Bill and Other Ways to Fight the Health Care System and Win. It's a step by step guide to show what consumers and employers can do to navigate the health care system. Marshall, first of all, thank you so much for joining us. The title of your book is is Never Pay the First Bill. I don't think you're suggesting that people shouldn't pay their bills, but what are you encouraging your readers for as far as when they receive that first bill in the mail, what should they do?
Well, Americans call the cost of health care their number one financial concern year after year after year, and it's only gotten worse. And the dirty secret that everybody knows within the industry is that the high cost of healthcare in the United States is not really justifiable. What we have is a system that's filled with administrative waste, filled with squandered spending. And so the system keeps taking more.
And more of our money every year and blowing it and then demanding that we pay more.
And working Americans are really hit the hardest. So I'm certainly not saying that we should not pay our bills, but the principle in the title, Never Pay the First Bill is that we should never pay the first bill until we have scrutinized it to make sure that it's accurate and to make sure that we have carefully looked at it to make sure that it's priced fairly. If you talk to experts who review medical bills for a living, they'll tell you that most medical bills contain some.
Kind of an error.
And so in my book, I show step by step how you can get an itemized medical bill, how you can.
Look up the billing codes, how you.
Can look up the prices to see if the bill is accurate and priced fairly, and then how to contest that bill if it's inaccurate.
And how do you know if it's inaccurate? Because I don't know if other people are like me, but I might have gone to one doctor's visit and months later I'm getting, oh, this lab, a doctor I don't know. And then I might, a few weeks later get another price from, because of, you know, from another lab. And so how do we know if it's accurate?
Well, it's obviously really confusing and we've been paralyzed by this complexity of our Healthcare system. So the first key is to get an itemized medical bill.
You know, when you go to the.
Grocery store, you get a receipt and it has a price of all the items that you purchased. When you go to the hospital, make.
Sure they give you an itemized bill.
So you can check and make sure that the services that you're charged for are actually services you receive.
And you said that people should be able to cross reference, like, okay, the cost of X should really be this.
Are you suggesting that people should go back to the doctor and then say, actually, you really charged me more than double what this should be and the that they're going to reduce it?
Absolutely. Again, one of the hidden secrets in our health care industry is that Medicare patients pay the least and working Americans pay anywhere from two to five, even 10 times more than Medicare patients for the exact same services. And hospitals will justify this. They'll make excuses saying, well, we have to pay, we have to charge working Americans more because Medicare doesn't pay us enough. And to me, I just don't think it should be fair that I or another working American should have to pay more than a patient who's over age 65. And so we do need to go back to our medical providers and say, look, we've looked up, using price transparency tools, we've looked up the prices and we've seen that we're being overcharged. And I want to mention a couple of these tools that people can use right now. One of them is called fairhealthconsumer.org if you have the billing codes and the description from your itemized bill, you can go to fairhealthconsumer.org and you can type in the billing code and the description. And you can look up what insurance companies are paying for that service in your community in your zip code. Also, the federal government now requires hospitals to post their prices on their websites. And if your hospital is not doing that, it is not compliant with federal rules.
Some really helpful information there. According to Families USA, the pandemic has left nearly 5.4 million Americans uninsured contributing to mounting medical debt. What's the first step for those Americans who now find themselves struggling because of unexplained expected medical costs?
The number one most important thing you need to do if you're getting chased by a medical debt collector is contest the debt in writing. And I have a template that you can use in my book. I have a template you can fill in the blanks. And basically you have to notify that debt collector that you're contesting their right to pursue you for that debt, even if you think you might owe that debt. My argument would be that you're probably getting overcharged and there are probably errors in that bill. Let's say you've established that you do owe that money and then you need to come to an agreement with that debt collector for a fair payment. And that fair payment should be much, much less than the sticker price of your debt. Remember, these medical bills are inflated. The sticker prices are way higher than what that medical provider would accept. And so I talked to some experts in my book to ask just how far off that sticker price should we be going for? They recommended 15%. So in other words, you should be looking to try and get in the neighborhood of an 85% discount from that medical debt collector if that debt collector has purchased your debt from that hospital that's pursuing you for payment. I really encourage people to think everything is negotiable in the health care system. Always ask for a better deal. And then the third thing with medical debt, do not enter an agreement that you can't fulfill. So if they want to pressure you to get on a monthly payment plan and you think you're not going to be able to afford it, don't ever get into an agreement with a debt collector that you can't fulfill, because then if you default on that, they're going to come after you for that full price. So just tell them, I'm really sorry I don't have the money to pay you. If you could reduce that amount and discount it enough, it could be a win for me and it could be a win for you.
We thank you so much for all of your insight and wisdom there, Marshall. Never Pay the first Bill and other Ways to Fight the Health Care System and Win is out today.
Hi everyone. George Stephanopoulos here. Thanks for checking out the ABC News YouTube channel. If you'd like to get more videos, show highlights, and watch live event coverage, click on the right over here to subscribe to our channel. And don't forget to download the ABC News app for breaking news alerts. Thanks for watching.
