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Email template to negotiate a medical bill

You have a medical bill you cannot pay in full, or one that seems far above what the care should cost, and you want the amount lowered. Medical bills are more negotiable than most people expect. Hospitals have list prices that almost nobody pays in full; insurers negotiate them down, and self-pay patients can too. Nonprofit hospitals are required by federal tax rules to have a financial assistance policy that reduces or forgives bills for patients below certain income levels, and many for-profit ones have something similar. Beyond that, most billing offices will take a smaller amount paid promptly over a larger amount paid never. Putting the request in writing gets you a specific answer and a record of any reduction they agree to.

Before you send

  • The itemized bill, so you are negotiating from the detail and not from a lump sum. If you do not have one yet, request it first.
  • Your household income and size. Financial assistance is usually based on how your income compares to the federal poverty level, and the application will ask.
  • What the service typically costs. Hospitals must publish their prices online, and your insurer's explanation of benefits shows what the insurer's negotiated rate was.
  • A number you can actually pay, either as a lump sum now or as a monthly amount. Offering a real figure works better than asking "can you do anything."
  • Whether the bill is already past due or in collections. If it is, you still negotiate, but with the billing office first, and ask them to pull it back.
Subject Request to reduce bill on account [account number], date of service [date] 
Hi [Billing department or name],

I'm writing about the bill for [amount] on account [account number] for [patient name] for services on [date of service]. I want to resolve this, and I'm asking for your help getting it to an amount I can manage.

[My household income is about amount a year for number people, which I believe qualifies for your financial assistance program. Please send me the application and hold the account while it is reviewed.] [or] [I'm uninsured and paying this myself. The published price for these services is amount, and insurers typically pay far less than the list price, so I'm asking for the self-pay discount.]

I can pay [amount] within [ten days] of receiving a revised bill if you can accept that as payment in full. If that is not possible, I can pay [amount] per month on a payment plan without interest.

Please let me know in writing what you can offer. I'd appreciate a reply by [date].

Thanks,
[Your name]
[Phone number]

Everything in brackets is yours to fill in. Keep the rest as it is or change the tone to match how you write.

After you send

  • Expect a financial assistance application, a discount offer, a payment plan, or some mix. Fill out the application even if you think you are over the income limit; many hospitals help patients well above the poverty level.
  • A bad reply is a flat "we don't negotiate" or an offer of a payment plan with interest. Ask again for the self-pay discount or a prompt-pay discount, and ask for the name of a billing supervisor or patient advocate.
  • Get any reduction in writing before you pay, with the exact amount, the account number, and the words "payment in full." Then pay by a method that leaves a record.
  • If you cannot reach agreement, your state may have a hospital billing complaint process, and nonprofit hospitals' financial assistance policies can be enforced. Ask the hospital for a copy of its policy.

Or don't send it yourself

Forward the job to myagent@standinfor.me and let StandIn run the whole thread.

StandIn is an email assistant that handles conversations with businesses for you. You write it one email saying what you need. It writes to the business, waits for the answer, follows up when they go quiet, pushes back on the number when it should, and brings the results back to your inbox for you to decide. You don't need to install an app or sign up. The first email you send is already the start of the task.

Hand this to StandIn opens an email to myagent@standinfor.me with the job already written out

To myagent@standinfor.me Subject Negotiate a medical bill down for me 
Hi StandIn,

Please negotiate a medical bill down to something I can pay and get the deal in writing.

The provider: [hospital or clinic name and billing office contact].
The bill: [account number, date of service, amount, and whether it's past due or in collections].
The patient: [name, date of birth].
My situation: [insured with insurer / uninsured, household income about amount for number people].
What I can pay: [lump sum amount, or monthly amount].

Get the itemized bill if I don't have it, ask about financial assistance and self-pay discounts, propose my number, and go back and forth with the billing office. Check any offer with me before agreeing, and make sure the final amount is confirmed in writing as payment in full.

Thanks,
[Your name]

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