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How To Negotiate A Doctor's Bill


When you have to pay all or part of a doctor's bill, you can negotiate the amount. Doctors negotiate fees with insurance companies,Medicare.and Medicaid all the time. According to a Harris Interactive poll, more than sixty percent of people who negotiate their medical bills get a discount. Hospitals and doctors are willing to negotiate because their retail rates bear little relation to the cost of providing care -- typical markups range from 200 to 600 percent.

You can negotiate the amount you are required to pay, interest rate on any outstanding balance, and/or the period of time you will have to pay the bill.

Don't be surprised if the doctor suggests you speak with someone else in his or her practice. For example, you may be referred to the office manager in a small office or to the billing department of a larger practice. You can always return to the doctor if you don't get the answer you want from a staff person. After all, it is the doctor that orders services.

There is no right or wrong time to bring up price. However, it is better to bring it up early in a visit with the doctor instead of at the end of the visit so there is time to talk about the subject if necessary.

There are four steps to negotiating a bill with a doctor . If negotiating is not one of your strengths, ask a friend to do it for you. In addition to your lawyer and/or financial planner, there are also companies that specialize in negotiating medical bills in return for a payment of percentage of the savings. For more information, see: Profeessionals Who Negotiate Medical Debt


Fair Price

Find out a fair price for the service you need in the geographic area in which you will receive the service. Keep in mind that prices vary by geographic area, and also by who is paying. For instance, there may be a different charge for people insured by different insurance companies, for people who are covered by government programs such as Medicare or Medicaid and for people who are not insured.

Following are methods to learn the price:  

  • If you have health insurance, check your company's web site to find out if it lists average prices for various treatments, tests and procedures. 
  • Check on line. For instance:
  • HealthCareBluebook lists average prices for common health care treatments in different parts of the country. Type in your area code and the treatment, test or procedure at: offsite link
  • Ask your doctor's office for the "CPT code" for the service.  A CPT code is the numeric code used by the American Medical Association to identify health services. Use the code to look up the Medicare reimbursement rate for the procedure in your area at offsite link
  • Call other doctors in your area and ask what they charge for the service or procedure for people in your situation. Ask what is the lowest they charge for the service you received - and who receives that charge (for example, the lowest fee may be for a person insured with a particular insurance company). While doctors are reluctant to give out this kind of information, it can't hurt to ask. 

If you received or used a product, find out what it cost the doctor. For example, if the doctor administered drugs i.v., how much did they cost the doctor? The charge may be a good deal less than you were charged. 

The Doctor's Office

If you made friends with someone in the doctor's office, let the person know that you are in a financial bind but that you want to pay the doctor. It would be helpful if the doctor would lower the bill. Ask: in what circumstances is the doctor likely to do that? To what amount? On what terms? 

What You Can Afford To Pay and When

The sooner the doctor thinks he or she will be paid, the more likely he or she will agree to a lower amount. If you can agree to pay whatever is due within 30 days of the agreement, you are likely to get the best deal. 

Consider how much you can reasonably pay now, and how much you can pay on an installment basis (such as every week or every month) - perhaps starting in a month or two. Once you reach an agreement, it is important to hold up your end of the bargain - particularly if you want to work with the doctor in the future.

If you do not know what you can afford, consider creating  a Cash Flow Statement which shows your income and outgo, and a a Budget to help you reduce expenses. For tips about increasing your income, see: How To Increase Your Income If You Are Working or How To Increase Your Income If You Are Not Working. Look at How To Deal With A Financial Crunch for fund raising ideas.


Find out if you can qualify for Medicaid (Medi-cal in California.) Medicaid not only pays for services going forward, it also pays for some services recently received. (This is known as services received "retroactively.") 


Only negotiate with a decision maker - someone who has the authority to change the amount of the bill.

  • While you would assume it would be the doctor, experience indicates that doctors are seldom aware of the amount charged. 
  • The office manager is a good person to start with. If he or she is not the right person, you will be directed to the correct person. 
  • Bookkeeping staff can provide inside information, but they seldom have authority to make a financial arrangement. 


Consider whether there are circumstances other than your financial situation to use in the negotiation. For instance:

  • If your health insurance includes a provider network, and the company didn't pay the full bill because your doctor is not in the network, ask the doctor to accept the amount the health insurance company pays. Doctors similarly situated consider it to be a fair rate. (Do not be surprised if he doctor reminds you that those doctors receive more business from the insurance company which is why they accept a discounted rate. If he does, consider agreeing to tell other people with a similar health situation about your positive experience with the doctor).
  • Think about how long you and close family members have worked with the doctor and how much the doctor received over time. The more that was paid, and the more that is likely to be paid again, the more the doctor will want to keep your business.

At the least, explain your financial situation. If you've completed some financial planning tools such as a Budget or a Cash Flow Statement, use them - particularly if they show severe financial hardship. Keep in mind that if a deal is reached, you may be required to provide proof of your finances beyond a statement you create. Every creditor knows they can't get money if there's none there. 

Let the doctor know that bankruptcy is an alternative if it is. The bankruptcy process would delay the doctor's receiving payment -- and the payment may end up being pennies on the dollar.

It is best to have a rationale for a dollar amount you ask for. For example: Consider offering to pay: 

  • The amount other doctors in your area charge
  • The amount Medicare pays or the amount that Medicare pays plus a small, reasonable amount, such as 10% of the price Medicare pays..
  • The amount the doctor billed less a discount to take account of how much the doctor would have to pay a collection agency if you don't reach agreement - and how much time that would take. Collection agencies generally receive at least 30% of the collected amount.
  • If you received the use of products, ask the doctor for his or her "charges-to-cost" or "markup" ratio. This represents the difference between the doctor's cost and what is charged a patient. The national average has been as much as three times the cost (billing $3.00 for every $1.00 the item costs the doctor.). Consider negotiating to pay cost plus a percentage, such as 25%.

Consider suggesting a barter system where you pay off the remaining debt with services you provide to the doctor. It's a win-win situation: the doctor gets the services he or she needs and you get your bill paid off. If the doctor cannot use your services, perhaps you can barter your services to someone who needs them, who in turn can provide needed services to the doctor. Information about bartering is in the document in "To Learn More".


Think about whether you want to continue to see the doctor again or whether you are willing to burn your bridges.

If you want to see the doctor again, work out an arrangement that is satisfactory to both you and the doctor, and that will give the doctor incentive to continue to work with you. 

Keep in mind the doctor's interests. In general, the doctor's interest is to get as much money for each bill as he or she can. At the same time, doctors understand economic realities. If you do not pay voluntarily, the doctor will have to engage a collection agency which costs money (such as one third of the amount collected.) Collection also takes time.


  • If you need to see the doctor again, and cannot afford to pay for ongoing services, ask if he or she provides service through a free clinic. If so, you can see the doctor through the clinic.
  • If you have a hospital bill to negotiate, see: How To Negotiate A Hospital Bill
  • If you are being dunned by a debt collector, you do not have to put up with aggressive collection activities. See:Debt Collectors and Creditors: Your Rights

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