Got charged ridiculous amount for doctor's walk in visit. What are my options?
You should start by calling the clinic and asking them to tell you how the visit was coded. Some clinics have different billing codes based on the complexity of the visit. If you have one thing you are seeing the doctor about, that could be coded differently than if you have 4 things you are seeing the doctor about. In fact, even if you are there just for one ailment, but while you are there you happen to ask a few quick questions about other possible ailments, the doctor could decide to use the billing code for the higher complexity. If when speaking to the billing department it is determined that the visit is using a higher complexity billing code (and a higher charge as a result), you could then request that it be re-coded with the lower complexity visit. Realize if you request that they will probably have to first get approval from the doctor that saw you. Note: I am basing this answer on first hand experience about 6 months ago in Illinois, where the situation I described happened to me because I asked some unrelated questions about other possible ailments at the end of a visit to an after hours clinic. The billing department explained that my visit was coded for 4 issues. (3 of them were quick questions I asked about at the end of the visit, one of which she referred me to another doctor. My additional questions probably extended the visit by 3-4 minutes.) In my case I never got the bill reduced, mainly due to my own laziness and my knowing that I would hit my deductible anyway this year. Of course I can't say for sure if this is what happened in your case, or even if this practice is widespread. This was the first and only time in my life that I encountered it. As a side note, your primary doctor would likely rarely ever bill you for a more complex visit, as it likely wouldn't lead to much repeat business. As for your last question regarding your credit: if the provider decides to lower the price, and you pay the lower price, this in no way can affect your credit. Surprising Update: When I called the billing office months ago, I had asked if they could confirm the code with the doctor, and I was told they would look into it. I never heard back, never followed up, and assumed that was the end of it. Well, today I got a call back (months later) and was informed that they had re-coded the visit which will result in a lower charge! It's still pending the insurance adjustment but at some point in the future I expect to receive either a credit on my next statement or a check in the mail. (The price difference pre-insurance in my case has gone from $359 to $235.) Update: I did receive a check for the difference. The check was dated July 20, 2016, which is just over 2 months after the phone call informing me I would receive it. Some doctors will give folks who are not covered by insurance a price break. If that describes you, you could ask. But if you didn't discuss the price in advance, that isn't the doctor's fault, any more than it would be the mechanic's fault if you asked for auto service without getting an estimate first. Consider it a cheap lesson in not making assumptions. If you are disputing the size of the charge for specific services, like you think that they overcharged for lab work, you can try disputing it with the business office staff at the doctor's office. If, on the other hand, you just think that the overall bill is too expensive then you really only have one option. You can ask if they will reduce the bill for you. Most hospitals and clinics I've dealt with have programs set up for this, but you usually access them by filling out paperwork demonstrating financial hardship (along with supporting documents). It never hurts to ask. But with the services already rendered the only person with an interest in reducing the bill is you. The reduction, if any, will probably depend on what the clinic thinks your ability to pay is compared with the cost to them of pursuing you for payment, as well as the amount of funding they have for bill reduction. When I worked in the financial services office of a hospital a $400 bill would not even have been reviewed for discounting-- the balance would be too low to devote staff time to reviewing. It's frustrating, and even asking in advance might not have given you accurate (or any!) information on what the cost of the visit would be, so your ability to shop around is limited. Unfortunately, that doesn't give you any additional options in this case. To answer the specific question of whether you can get the bill reduced without hurting your credit, yes, as long as the bill never goes to collections, there's no reason it should ever show up on your credit report. Will they reduce your bill without sending it to collections first? Maybe. All you can do is ask. You will often receive a lower bill if you simply wait for a second or third billing statement. I was once given the advice to never pay a medical bill until after they had sent three notices, because they will almost certainly reduce the amount due. Sounds crazy, right? I have excellent credit, so the idea of risking it by ignoring bills disturbed me greatly, and I scoffed at the advice.  I then had a similar experience to you, and decided to take the advice. By the third statement, the bill was reduced to less than half of the original, with zero intervention on my part. I then paid it without any impact to my credit whatsoever. I've since done that every time I receive healthcare services, and the bill is always reduced on subsequent statements, generally to less than half of the original bill. Sometimes it's because insurance finally got around to paying. Sometimes a credit is mysteriously added. Sometimes line items disappear without explanation. (Line items sometimes appear over time, too, but the overall balance generally goes down.) I don't know the reason for it, but it works. This has happened with a variety of providers, so it's not just one company that does it. Granted, I never called to negotiate the price, so I can't say if I would've gotten a better deal by doing that. I like it because it requires no time or effort on my part, and it has greatly reduced my medical bills with zero impact to my credit. I only have personal anecdotes to back it up, but it's worked for me.
"For the person being hired this is a tricky situation. Specially with the new laws. There is no real magic number that can be applied as a lot will depend on what benefits you want, and what is actually available. This will really shift the spectrum quite a bit.  Under the affordibal care act, everyone has to have insurance or pay a ?fine? (were really not sure what to call this yet) but there are two provisions that really mess with the numbers you look at as an employee.  First, the cost of heath care has skyrocketed. So the same benefits that you had 5 years ago now cost maybe 10-15 times as much as they used to. This gets swept under the rug a bit because the ""main costs"" of insurance has only increased a tiny amount. What this actually comes down to is does your new ACA approved heath plan cover exactly the benefits you need, or does it cut corners.  Sorry this is complicated, and I don't mean it to come off as a speech against the ACA so I will give an example. My wife has RA, she really has it under control with the help of her RA doctor. This is not something she ever wants to change. Because she has had RA from the age of 15, and because it's degenerative, she doesn't want to spend 5 years working with a new doctor to get to the same place she is with her current doctor.  In addition, the main drugs she takes for RA are not covered under any ACA plan, nor are the ""substitutions"" that her doctor makes (we are trying to have kids so she has to be off the main meds, and a couple of the things this doctor has tried has been meds that reduce inflammation, are pregnancy safe, but are not for the treatment of RA) You now have to take into effect rather the cost of health insurance + the cost of the things now not covered by the heath insurance + the out of pocket expenses is worth the insurance.  Second the ACA has set up provisions to straight up trick those people that have lower income and are not paying close attention. When shopping for insurance, they get quotes like ""$50 a month"" or ""$100 a month"". The truth is that the remainder of the actual cost is deducted from their tax returns. This takes consideration, because if you thing your paying $50 a month for insurance but your really paying $650 then you need to make sure your doing your math right. Finally, you need to understand how messed up things are right now in the US with heath care. Largely this goes unreported. I'm not really sure why. But in order to do this I will have to give examples.  For my wife to see a specialist (her RA doctor) the co-pay is $75. So she goes to the doctor, he charges her $75 and bills the insurance $200. The insurance pays the doctor $50. With out insurance, the visit costs $50.  At first you want to blame the doctor for cheating the system, but the doctor has to pay for hours of labor to get the $50 back from the insurance company. From the doctors perspective it's cheaper to take the $50 then it is to charge the insurance company. And by charging the insurance company he has no control over the cost of the co pay. He essentially has to charge more to make the same money and the patient gets the shaft in the process. Another example, I got strep throat last year. I went to the walk in clinic, paid $75, saw the doctor got my Z-Pack for $15, went home crawled in bed and got better. My wife (who still had separate insurance from before the marriage) got strep throat (imagen that) went to the same clinic, they charged her $200 for the visit ($50 co-pay) and $250 for the z-pack ($3 co-pay). The insurance paid the clinic $90 for the visit and $3 for the drugs. Again the patient is left out in this scenario. In this case it worked better for my wife, unless you account for the fact that to get that coverage she had to pay $650/month.  My point is that when comparing costs of heathcare with insurance, and without out insurance, its often times much cheaper for the practices to have you self pay then it is for them to go through the loops of trying to insurance to make them whole. This creates two rates. Self pay rates and Insured rates. When your trying to figure out the cost of not having insurance then you need to use the self pay rates. These can be vastly different.  So as an employee you need to figure out your cost of heath care with insurance, and your cost of heath care without insurance. Then user those numbers when your trying to negotiate a salary. The problem is that there is no magic number to use for this because the cost will very a lot. For us, it was cheaper to not have insurance. Even with a pre-existing condition that takes constant attention, it's just better if we set aside $500 a month then it is to try to pay $750 a month. That might not hold true for everyone. For some people or conditions it may be better to pay the $750 then to try to handle it themselves.  So for my negotiations I would go with x+$6,000 without insurance or x+$4,500 with insurance.  Now as an employer it's a lot simpler. Usually you have a ""group plan"" that offers you a pretty straight $x per year per person or $y per year per family. So you can offer exactly that. Salary - $x or Salary - $y. AS a starting point. However this is where negotiations start.  If your offering me $50,500 and insurance, I would rather just have $57,000 and no insurance. Of course your real cost is only $55,000 cause you don't care about my heath care costs only about insurance costs. So you try to negotiate down towards $55,000 and no insurance. But that's not good enough for me. So I either go else where and you loose talent, or I accept $50,500 and insurance (or somewhere in between)." $1160 per month, lets say you only have one kid.  Oh, wait, taxes are taken out.  You really only have about $1,000 to work with.  Cheapest rent in my area is about 400 a month, and then you're living in the ghetto.  Seriously, a really not great place to raise a kid but I'm being generous here to prove a point.    What's this?  Walmart is not within walking distance of the ghetto?  Damn, you need a car.  Lets say you have about $100 a month in car payments for a pretty cheap car that just goes from A to B.  Liability only insurance (being generous since if you're making payments you probably need more than liability only) also for another $40 a month.  So we're already at 540.  But since you need to drive to work, we need gas, too.    Let's say you live between 5-10 miles from work.  That means you drive about 20 miles a day, at least.  Your car only gets about 20 miles to the gallon, probably less with city driving, and gas is about $4 a gallon, so $4 per day times 20 days a month (we'll assume you only work $5 a day) and there's another $80.  $620 dollars so far.   Assuming you actually cook at your house instead of eating out.  $75 dollars is average for two people for food for a week, so that's $300 a month (4 weeks.)  $920 so far.  $80 left.  Let's average your utility bill out.  Lets say you don't even have AC, as you can go without it and just be incredibly uncomfortable in a temperate climate.  Just normal electricity and heat in the winter, we'll GENEROUSLY make that a $50 a month bill to average out for the entire year.  $30 left.  In one full year, you've saved up $360!  You're rich!  No, wait...that kid you have probably needs school supplies.  They're growing, too, so they probably need clothes.  For that matter, you also need new clothes.  Even used clothes from Goodwill can be costly over a year.  I really hope your car doesn't break down because that can set you back at LEAST $200 most times.  Also, better hope you don't get sick, because you don't have insurance and a doctors visit or emergency room visit could EASILY break that budget.  No preventative care, either, so your risk of getting sick is substantially hire to begin with than the insured.  I also have not included ANY luxury utility bills, let alone any kind of phone at all or especially internet.    Also, all of this assumes that you work full time, which at WalMart most employees do NOT because Walmart wants to avoid being forced to give benefits to employees.  Do you REALLY want to continue to sit on your high horse and tell me that people can make it raising a family on minimum wage? Who says that both parents have to work?  Also, why would you include that as an opportunity cost when a parent staying home can and often does save money from work clothes, lunches out, extra gas, car insurance for a second car, not to mention paying for and repairing a second car.  In the end, when I did my analysis for my own life, if I worked full time, I was going to be in debt to keep working.  My actual per hour pay when taking all of these things into account was less than $1 an hour. That doesn't even take into account daycare, days off of work for doctor visits, or anything else.  It is actually much cheaper for a woman to stay home and be employed in the home economy when she is not making at least $10 to $15 an hour depending on where she lives.    If my husband worked and I diligently tried to save money in other areas we were not currently saving money in, I would actually be earning my keep through home employment.  Things like sewing clothes with materials found, canning foods, baking, gardening, raising our own milk and eggs in small amounts, and recycling everything instead of tossing and buying new reduced our cost significantly.  Look even Elizabeth Warren says in this economy, that low skilled workers with less than a Bachelor's that want to have children would be better off doing it this way because of the price of everything.  It is tantamount to turning everything we have been taught on our heads, but it is true if you run the numbers. Generally, the HSA is self-reported.  The bank/financial provider will allow you to withdraw/spend whatever you want from your HSA.  They report to the IRS the total that you withdrew for the year (your gross distributions) on a 1099-SA form.  At tax time, you use a form 8889 to report this number of your gross distributions, and how much of it was used for medical expenses.  Ideally, all of it was used for medical expenses.  If it was not all for medical expenses, there will be extra taxes/penalties due.   Different HSAs work differently, but for mine, which is held at a credit union, I can get money out several ways.  I have an HSA checkbook and an HSA debit card that I can use anywhere.  I can also transfer money out of my HSA into my regular checking account to reimburse myself for an expense, or even stop in at the teller window and take out cash.  The credit union doesn't need to see any receipts for any of this.  They don't care if I'm spending it at the doctor's office or the casino.  It is up to me to make sure I'm spending the money in accordance to the law and that everything is reported correctly on my tax return. Nothing is verified unless you get audited.  You definitely should keep documentation on the expenses, because if you are audited, you need to be prepared to account for every withdrawal.  Make sure you are very familiar with the rules on eligible medical expenses, so you know what is allowed and what is not.  IRS Publication 502 has all the details on what is allowed. As far as how it gets counted towards your deductible, you need to make sure that all of your medical bills get sent to your health insurance, even if you will eventually have to pay for it.  For example, let's say you go to the doctor, and the bill is $150.  Even if you know that the deductible is not met yet and you will be responsible for the entire $150, make sure the doctor's office submits the bill to your insurance.  The insurance company will inform the doctor's office that you are responsible for all of it, but they will apply the amount towards your deductible. "Legally: gods know. I would strongly recommend asking the Law asre of Stack Exchange to advise on that. Practically: What's the worst that happens? They audit, you say ""Yeah, I could probably have claimed these deductions but I didn't want to; is that a problem?"", they decide and either nothing happens or they issue you the unwanted refunnd. They aren't going to fine you for overpaying. Unless this would expose something criminal -- or you're a public figure and it would be embarassing -- this strikes me as falling firmly within the bounds of ""no harm, no foul""." Slightly off topic... Not merchandise, but I paid for various doctor's appointments with cash (as opposed to paying with health insurance).  I'd call ahead of time and notify them that I'd be paying in cash.  I got ridiculous discounts, sometimes even less than the copay.  I do not know why this discrepancy exists and I didn't want to ask for fear of messing up a good thing. As a customer I have proof of this happening. I'm an IT manager and have major fluctuations in invoices (of over 60% price changes) that I've had to battle CenturyLink to correct the price. Is there somewhere I can share this with to help the case? Caused about 4 months worth of headaches due to CenturyLink and this would remedy that. "check the DATE OF SERVICE on all your invoices carefully.  It's possible you actually DID pay already. Sometimes when a medical provider gets ""mostly"" paid by a third party insurer, they just drop the (small) remainder, as it's more cost than it's worth if it is a trivial amount.  Alternatively, they wait until you show up for another office visit, and ""ding"" you then!"