Posted by Elisabeth Leamy, Mon Sep 13 2010, 11:39pm

The economy continues to have a case of the flu, and if you have one too, you may be considering skipping a trip to the doctor

The economy continues to have a case of the flu, and if you have one too, you may be considering skipping a trip to the doctor. A recent poll by the Deloitte Center for Health Solutions found that one out of every five Americans surveyed decided not to get medical treatment when they were ill or injured. In some cases that could be a tragic decision, so I'm here to tell you that there is another way: negotiate with your doctor or hospital for a lower fee.

Another poll, this one by Harris Interactive, found 61 percent of people who negotiated with a doctor were successful in getting a lower fee –but only only 12-percent had ever tried! And many hospitals offer deep discounts too, as much as 10 to 50 percent off.

So, where to begin? Problem is, if you're negotiating for a toaster at a garage sale you know what you're willing to pay for it. And if you're negotiating for a new car, there are dozens of websites that will tell you how much it should cost. Well, turns out there are sites that tell you how much different medical procedures should cost too. Once you have a feel for a fair price for a service, it's much easier to approach the doctor or hospital.

That's where comes in. The site lists what it deems the "fair price" for a medical service, which you can look up by key word. That price is based on the "contracted rate" or "allowed amount" that insurance companies are willing to pay for the same service. As you probably know, most doctors agree to accept a discounted price when they join an insurance company's Preferred Provider Organization or PPO. It can be two to five times less than the doctor's regular rate.

"Most patients would never expect that a common test or procedure might cost $500 at one office and over $3000 at another," said Dr. Jeff Rice of "Most patients have had insurance that limited the amount they had to pay regardless of the total price…. you can literally save $1000s by simply asking about prices and checking around."

Now Healthcare Blue Book has gotten a huge boost, through a partnership with the giant service review website, Angie's List started by offering consumer reviews –always non-anonymous-- of contractors and mechanics and is now applying the same grass roots principle to healthcare. So, you can go to the site and read unvarnished reviews of doctors or hospitals you are considering and then click through to find out how much you should offer them for the care you need.

Angie's List founder Angie Hicks was inspired to partner with Health Care Blue Book after finding a $1,000 overcharge on one of her own medical bills. By being vigilant and making a few phone calls, she saved a thousand bucks.

It's not enough, though, to try to negotiate on medical costs if you don't
know the going rate first," Hicks said. "That's why we got involved with the Health Care
Blue Book. It empowers health care consumers with more information on
acceptable medical rates going in, so they are able to bargain from a
position of strength and better their chances of successful negotiation."

If you want to double your chances of success, another tactic is to look up what Medicare pays for the medical procedure you need. Just ask the doctor's office or hospital for the "CPT Code" or Current Procedural Terminology Code. CPT codes are developed by the American Medical Association to describe every medical service. Type that code into the CPT search section of the AMA's website, here. You must search the correct code plus the city and state where your doctor is located to get an accurate price, as Medicare prices vary regionally. Between the insurance company rate Healthcare Blue Book provides and the Medicare rate you can learn from the American Medical Association, you have good numbers to make your approach. Now, here's more advice for a health success:
• Approach your doctor directly, not the front desk person and certainly not the billing manager, who may be paid based on bills collected.
• If the care you need is a financial hardship for you, say so. Compare the cost of the procedure and your income level.
• Offer to pay cash in advance if you can. Even at 50 percent off, this can be attractive to doctors who spend thousand chasing after unpaid bills.
• If you need hospital care, say for a surgery, find out all the hospitals where your doctor has privileges and choose the least expensive one. Make sure that hospital accepts your insurance, if you have it.
• Also make sure that everybody involve din your care also accepts your insurance –anethesiologists, for example.
• Ask the hospital if it is willing to provide your care for a flat fee. That usually yields the best deal, plus you then know exactly how much you will owe, which can be comforting.
• Get the hospital's offer in writing, signed by somebody with the authority to cut deals like this.
• If you were hospitalized unexpectedly, it's still possible to negotiate your bills. I suggest doing so with the help of a Medical Billing Advocate, a professional who knows this arcane world. Find one here.
• If all else fails, ask for a payment plan. Many doctors and hospitals will agree to this if they won't agree to a discount. Even better, press for a no interest payment plan.