Episode four seventy is episode two thirty Negotiating Medical Bills with Doctor Vergie bright Ellington.
Welcome to the Frugal Friends podcast, where you'll learn to save money, embrace simplicity, and live your life here your hosts Jen and Jill.
Welcome to the Frugal Friends Podcast. Happy Christmas Eve, Happy Hanukah Eve.
My name is Jen, my name is Jill, and.
We are re airing our probably this year, our most recommended episode. It's the one we personally have told so many people about in the last I guess two years, because that's when it aired, was two years ago, and it's definitely been the one that we've recommended the most on negotiating medical bills.
It's such a practical need that we all have, are currently facing, or will face. This is one of the episodes that I've recommended to just personal friends of mine. I'll be like, you don't have to listen to my podcast on an ongoing basis, but here's a really helpful one. When people have questions about it, I just think it's so so tangible, useful. So we're putting it at the top of the list again so you don't have to dig through the archives. But first, this episode is brought to you by.
Gold gld baby pure unadulterated gold like previous podcast episodes that just crushed and the book that is probably being printed as we speak.
You know, our book by What you Love Without Going Broke. If you want all the golden nuggets and even a few golden bricks right at your doorstep in your hands, pre order that book by what youlovebook dot com. There's still time. It is the day before Christmas. If you want to give yourself a little.
Extras your self a gift, yes, and pre order that book baby, Yeah, and it'll be it'll be too ye really here seven here's the best gift if you pre order before the twenty ninth, So if you're listening to this on the twenty fourth or maybe the twenty six, On December twenty ninth.
We are doing a live class for only pre orderers on creating a one year meal plan. So if you are struggling with food costs, if you are a human being, then you're definitely going to want to be there for our live class on creating a one a practical, doable, one year meal plan, and that is exclusive to pre orderers of the book, So head to buy what youolovebook dot com and once you purchase the book, that same page is where you would submit your proof of purchase
to get access to that live class. And then on January twenty ninth, we are doing one more on making a one year spending plan.
And we are recording those two. So if you can't join live, but you've pre ordered the book and you filled out the form on that same website by what youlovebook dot com, you'd still have access to the content. So if having a full year MEIL plan and having a walkthrough of making a full year spending plan feels useful for you this time of year, turing into a new year, then then at least at least buy the book.
You got both of those things and a book for twenty five dollars. That feels like a good gift. So, speaking of saving money and ways to lower your expenses medical bills, we have done several episodes on negotiating because it is a really effective way to lower what you pay and also increase what you earn. We've got episode four forty nine how Women Can Negotiate Better with Catherine Valentine, and then episode three thirty nine how to negoti and Save Lots of money. Those are two of our most
recent negotiation episodes. But you can search Negotiate Frugal Friends on your podcast player find different episodes also on our website Frugal Friends podcast dot com. But this is such a great episode, full of great facts and tips and I can't wait for you to hear it.
Let's get into it.
Doctor Virgie, Welcome to the Frugal Friends Podcast. It is a honor and pleasure to have you on.
Yeah what, ladies, It is my honor and pleasure. And I've been following you guys for a few years. I've been on your list serve and I'm trying to think of how many years has been, but I know it was like way before the pandemic. So when I saw you guys have a podcast, I'm like, Hey, the world is small, this is awesome. Life is good.
So we're just fanning on each other, but mostly we are here to highlight you, doctor Virgie, your knowledge and experience what you have to share with our listeners today. So thanks for being here and sharing what you know.
Thank you so much for having me.
Yeah, so let's dive in. You are an expert on medical billing and medical debts. So I know the first thing people will usually get is a surprise charge on their bills. That's happened so often. How should people handle surprise charges on their medical bills?
So surprise charge, we called surprise billing is actually a formal description. There's an actual The term surprise bill or surprise billing refers an actuality to cases in which you have insurance and you go to get care at a facility and maybe you had the option it was an elective thing and you had a knee surgery had planned, or unfortunately, if you had an emergency and you go to a facility and you know that they take your insurance when you don't have any choice of the physicians
that are involved with your care. Physicians that you have no choice in choosing, like the er doc, the anesthesiologist. They're radiologists who reads the X ray of they're broken to determine if your bonu is broken. If you have the elect of surgery, they take tissue, they send it
off anything that's taken from the human body. They'll send it off to pathology for a physician to look at it under the microscope to make sure it's it's always benign meaning non canceros versus they don't see any cancer cells. Those are all folks. Those are all physicians that you don't have any choice in picking. And if they are out of network, that means that they'll send you a bill for their whole full retail price and you're stuck with it. So this has been an issue because there
are business models. There are there's private equity, there are corporations whose business model is to say, Okay, we're going to hire all these docs who you have no choice in picking when you go to the hospital or you need care, and we're going to charge the full price, which is often tends and tends and I can't explain how outrageous the numbers are when they don't take insurance.
They take no insurances, that's their business model. And you go in thinking that you've done all of your research to make sure that you're in network with this facility, but they hire physicians who are not. That results in a surprise bill.
So how do we when we do we have any power over that?
Either before or after?
Yep, the great news is as of January first of this year, a bill was passed it's now federal law where if you have insurance and you go to an in network provider and you are given sent a bill by other physicians that are involved with your care who do not accept your insurance, they have to negotiate directly with the insurance company to work out a payment, you know, workout is it going to be the in network rate that they usually pay, or are they going to pay
a little bit of a premium. Whatever it is, the patient is out of the middle. So until now, until January first of this year, there are a few states that had you know, bills were in that state that you could not get a surprise bill. Well, it was illegal in that state to charge patients who you if they're out of network, if you charge them out of network prices. But now it's a federal law. So that's
how you protect yourself. You make sure that if you've gotten a bill from you go to get care and you've gotten a bill where it says, you know what, we're not in network with your provider, well with your insurance rather, well, not my problem anymore. As a January one, twenty twenty two, you're going to put them in touch.
Then they know this the providers know this, they have to deal with your insurance directly and leave the patient out instead of having the patient holding the bag, which has been the case for eons until now.
So if you get that bill, if we get that bill in the mail and we realize this, we've now listened to doctor Virgie and we know a bill has passed and we're not responsible for this. Would that just be us reminding the provider of that law and please talk to my insurance company.
Yeah, talk to my insurance company. You know they say, comp to the hand, talk to my insurance company. I'm out. So, you know, I really like to use this as an opportunity to talk about there's a reason why. This is the reason why there's only one right way to pay a medical bill, and that's because usually, unfortunately, I would say nine times out of ten, a medical care facility will send you a bill that's not a real bill,
and they do that because they know it works. We panic and we'll figure out how to pay this off. So I'm going to take you through the one right way to pay a medical bill. There's three steps. And in this process, Jillian, we're going to say, Okay, you know what, by doing this process of the one right way of paying medical bill. Going through the three steps, we're not going to get caught by any tricks like
surprise billing. So it's the one right way to pay a medical bill will protect you from, among other things, surprise billing. So the one thing you want to do when you get up any medical bill is to look to make sure that it's an accurate or itemized bill. And what I'm calling now a real bill. A real bill has what's called CPT codes. CPT codes are just
like bar codes. When you go into a store. Every product has a bar code, right you take that product, you run it through the scanner and it'll tell you. It'll all identify you some description of the product and the price that the facility is charging for that particular product. Same thing with CPT codes. Every single medical service in the United States has ACPT code. And I won't worry
you with what CPT stands for. There are people who work in the insurance company I know for years and they can't remember what CPT and you know, it has a long name, you know, common procedural terminology, which is why we don't use We just call it CPT codes. And I was talking to a radio host a couple of months ago, and he says, you know what we should call it can't pay this. That's what CPTs anyway. So oh yeah, right, So you get a medical bill and you make sure it has CPT codes at the top.
You'll see CPT at the top and under it. CPT codes are usually like a five digit number describing a service. So that's what you're going to do. You're going to the first step is call your provider and get a real bill. So what I've been talking about this and some one of those things that's been blugging me this week, I'm realizing, you know, these bills that we often get that consumers, the American patients, the public gets are just
not bills. They're kind of like wishful thinking. They're like, oh, maybe they'll pay it if we send them this with no CPT codes and it has a description and that's it. You know, they think that it's a real bill, but it's not. So first step always call to make sure you get a real bill, which is an itemized bill basically fancy name for a bill with CPT codes, and that takes you to the second step. When you get
that bill with CPT codes. You're going to take it and google the codes to make sure that each of the codes describes the service that you think you got or services that you think you received during your stay or during your visit. Great, once you get those codes will come up as a description and awesome, and you're making sure that makes sense in terms of what you got, makeing sure you're not getting double bill that kind of thing, or bill for something you know that you didn't get.
Then you're going to take those codes and you're going to continue to google, but this time you're going to google what Medicare pays for each of those codes for each of those services. So Medicare is federal government care healthcare, and CMS which stands for Centers for Medicaid and Medicare Services, has a standard list of things that they pay for each CPT code. Right. The thing is is that I
consider Medicare the basic flat rate. So there are a lot of people who do this kind of work, meaning trying to help people or struggling with medical bills, educating the American public in terms of medical financial literacy. And they say, well, okay, we look this up, but we're going to agree to pay two times a Medicare rate. That takes us down to step three. I disagree. I think start at Medicare. Start at the Medicare price. That's
the point where you're going to negotiate. Don't go straight to negotiation without doing the first two steps because you're being overcharged. Their retail rates are often three hundred to five hundred percent more than what Medicare pays. And so when I say, you know what, I start at the
Medicare rate. When I say step three, that's the number you're going to start when you call back the medical billing department or the patient accounts department of the facility and say, you know what, this is what I can afford. These are the services I got, this is what I'm able to pay. I think this is fair from my research and the care that I received. Now, some folks like I was saying, thinks, you know, I think that two times a Medicare rate is a good place to start.
And that's because if you call some of these facilities, you're going to get pushed back. And the general thought is the general push is, well, if everybody paid Medicare rates or paid the Medicare prices, we wouldn't be able to stay in business, we wouldn't be able to provide care to everyone. I'm not so sure about that, and
even so, not my problem, not my problem. If I have a budget which takes me to step three, you're going to call back the provider's office, billing department, patient accounts office and ask for number one an interest free payment plan that fits your budget. And this is really important because people get upset when they think about how long it's going to take them to pay off a bill. They said, oh my gosh, it's going to take me five years, seven years, ten years, and so what right?
So the reason why you make it. You're going to get probably pushed back when you call back the department billing department and say, hey, this is what I'm willing to pay. You know, I need an interest free payment plan. They're going to say, you know, well, this is a ten thousand dollars bill and you know you're paying is turn in and fifty dollars a month. It's just going to take us forever to pay it off. Can you
do you know we discussed this too. That's just too little and this will take us too long to get paid. Can you do three fifty. No, I can only do two fifty. And the reason why you want to stick with that is because if you make an agreement with the care facility, it doesn't get reported to credit agencies, right, It's it's blind. It doesn't impact your credit report at all, which is awesome. But if you agree to any payment plan and you can't make a payment, they will automatically
really quickly, and surprise how fast they do it. They'll send it right to collections, to deck, They'll sell it to a debt collections for pennies on the dollar. So you may say, okay, well why wouldn't they why would they agree to take so little over a long period
of time? And I say the reasons while you want to stick with your budget when you're calling the facility and talking about the payment plan that you need, it's because, as they say, a little bit of something is better than all of nothing, right, they know it's cheaper, you know, to take it, you know, instead of having to chase you potentially and or have to sell it if they have to chase you long enough for pennies on the dollar,
you know, to a collections agency. So those are the three steps for the one right way to pay a medical bill.
That's so hopeful. And at the end of the day, you have already gone through the first two steps where you are equipped with knowledge, You've been able to get rid of any bills or itemized line pieces that you are not actually obligated to pay, You've lowered the rate, and then if it is still too much for you to be able to pay outright that interest free portion.
Of course, not of us like having those payments, but if it's interest free, that makes a big difference, especially as it concerns healthcare things that we need to stay alive. We're not just talking about some luxury item exactly.
It's not consumer debt. Yeah, and you know the current administration is realizing, hey, you know what, we need to treat it as such medical debt. Medical bills are not a choice. Student loans at the end of the day, is a choice. But you know, none of us ask to get here, right, none of us has to be born. And once we get here, we're living creatures, and we get sick, things happen, we have accidents, and so it's
not consumer debt. And I'm glad that the administration is trying to teach folks that, hey, we need to treat medical bills differently than consumer bills, medical debt different than consumer.
Debt well, and it carries so much anxiety because not only are you managing physical health both problems, but also financial difficulties too, depending on the amount of money that's owed and whether or not insurance is covering it or you're able to pay. And so I think we've got a couple of layers here of just receiving a bill that might be overwhelming that we can't really pay, but then that can stack up to medical debt as you're
describing here. And I know even before we got on you were even beginning to talk about preventative measures, So talking about preventative but as well as maybe even reactive because sometimes we find ourselves there. What are some of your tips when we are deep into some medical debt? What can be done?
One of the things you know, I like to you know, remindfulks about is that you know it's not your fault, and you think that, oh my gosh, it's scary, it's complicated. You know, I'm screwed. What am I going to do? I'm going to have to declare bankruptcy. I can't pay this, and many people have. So the first thing I tell folks is that it's not your fault, and yes, there are things you can do, so yes, go through and
we'll let me just say one more thing. The reason why we also panic is because an often panic in addition to all of this, is that this happens to us when we're at our most vulnerable, when we're sick, in pain, scared, afraid, unable to work. You know, whether we have insurance or not, most of us get for our insurance and our employers. If we miss enough work because of the illness or the accident, we'll lose our
job in there for our insurance. So that there's so multiple, many reasons why folks in this country get taken advantage of by the system this, you know, healthcare industry and our country for profit healthcare industry in our country. So what I tell people number one is to step back and if you're able to pull all of your bills, don't ignore the bills. You know, if you can be ahead of it and call them first, the billing department first, as I explain, and go back and ask for real bills.
And a real bill has a CPT code. The other thing I tell folks is to make sure that you're not confusing a real bill with because you're not confusing a real bill with if you have insurance and explanation of benefits or an EOB. And I've gotten multiple calls and examples of where folks, so I got this bill from my insurance company. No, you're not going to get
a bill from your insurance company. What you received is a notice of what they paid and or what they're saying they're not going to pay, and what you're going to be responsible for, and you're gonna have to deal with the provider yourself. So I make sure that I ask folks to pull out anything that says Usually it'll say it right across the front page and subsequent pages, this is not a bill. Those are EOB, your explanation
of benefits. So pull that out and then pull out the actual bills that don't have that's at the top, that's not from your insurance company. If you have insurance and call a provider, ask for the real bill with CPT codes, and then if it's less than I tell people this all the time, if it's less than six months out from the services that you received. You can still go back and apply for financial assistance and in
some cases even Medicaid. Depending on the state that you're in, you can go back and apply for Medicaid, or if your income is low enough, sit for bills that are six months less than six months old. So that's one option. Often we're kind of in between that we're not at the point where we have to say, Okay, you know what, I have zero income, I need to consider applying for medicaid. Most of us are in the position where we've gone
to a healthcare facility that is nonprofit. Most of the majority of healthcare facilities hospital medical systems in this country are nonprofit. And I stop calling it nonprofit, I call it tax exempt because they really have a lot of surplus.
Let's put it that way, right, exactly right. So sixty five percent of hospitals in the United States are tax exempt aka nonprofit, and in exchange for the bi federal law for tax exempt nonprofit status, they provide sliding scale, income based discounts to the public in the community that they serve. So what this means is many bills that you get if you just go to them and say, look, call up the office and say, look, this is the research I got, the real bill with CPT codes of
researched it. This is what I can afford to pay. And for how long you call them up and say, yeah, you know, this is what I can do. You'd be surprised that, although by law they're supposed to make it post it publicly nonprofit facilities, that of what the process is to apply for financial aid. And a lot of people don't like that term financial aid, you know, but you know they think of it as charity care as different euphemisms and right, charity care, financial assistance, financial aid.
It's all income based discounts. And if you have you'd be surprised at the high income you can have. If your bill is high enough, you may able to get it completely wipe gock just based on your income. I've seen a bill as little as I think it was like thirteen thousand dollars. I don't mean little, but compared to their income. The person have like one hundred and fifty thousand dollars gross income that they showed on you know, you're going to be asked to show documents and things
and based on their income. And the bill bill was so large in relationship to their income. The whole thing, the whole bill was wiped away.
Wow.
Wow, Now if you had not right, if you had not been aware that you have rights as if you went to a non profit facility, tax exempt facility, yeah, you have. We have options. So just because the majority of healthcare facilities in our country are nonprofit, sixty five percent of them, this is an option. Now, someone brought something to my attention. They see that even for profit facilities have financial assistance programs. You know, if you don't ask, you don't get right, So always always ask.
A few things are standing out to me and what you're describing here. First of all, knowing what you can pay, of course, once you've realized what you are actually responsible for, because sometimes they might charge you for things you're not responsible for. But then once you figure out this is what I actually oh, going to them with a number, which is classic negotiation tip for any type of thing
that we're trying to negotiate. Having that number, not just going and saying I don't know, what can you do and then going from there, but also recognizing that this is available to us, and there is no shame in pushing for lower rates because you might not actually have to pay that high rate, and why would you if you're not able to if the organization, the company, the hospital has ability to give it to you at a
discounted rate. I think the thing that stands out to me is just the time and energy that all of this takes, the know how of going through the paperwork, of finding the phone numbers, of sitting on hold, of
doing the research. And it's worth it, and we've seen that it's worth it, but especially when you might be going through a time that is physically demanding or exhausting and you've got various medical canncerns that I think that that's a it's a big deal and and I don't know if there's much that can be said or a magic wand that we can wave over that, but community hopefully someone to sit by your side as you're going through all this paperwork. But yeah, there's there's a couple of layers here.
Yeah, the most difficult about this is that this happens to us. This is done to us, not by accident, just because they know they can get away with it, frankly, and in addition, they know they can get away with it more likely because it's when we're at our most vulnerable. You know, we're sick, we're tired, we're scared, we're in pain, we're grieving, you know, and why do they do it? Well?
It works, It works. I was talking actually with my husband, who's a thirty five year law enforcement veteran, and you know, we talk about you know, laws, federal laws versus state laws, that kind of thing. And I said to him, I said, you know what, I've been going through a lot of medical bill mistakes and going through, you know, looking at
bills and saying, well, this is a mistake. And if you can imagine eighty to ninety percent of every medical bill and generating this country has mistakes, and if you can imagine, they're not going to be in the favor of the patient, right, They're going to be in the favor of the provider and or the insurance company. I was talking to them and I said, you know, it just hit me. Why should consumers patients be given bills
that don't have CPT codes. If there is zero insurance company in this country that would ever ever even consider a bill submit it from the provider that doesn't have CPT codes, So why do they generate them and send them to the patient. Why do they sip? Why do they generate two different kinds of bills? One that's not a real bill. I call it a summary bill. Sometimes I'll call it a detailed summary bill. It doesn't matter. It doesn't have CPT codes. It's not a real bill.
Why generate something separate that you just send the patients if it's not the same thing that you send the insurance companies, And insurance companies you always send if you want to get paid as a provider, you're going to send the insurance companies bills with CPT codes, right, So why do we generate Why do providers, healthcare facilities generate bills that have no CPT codes to patients? Because it works, and because by law there's no law requiring them to
do it. I thought, you know what, there needs to be a federal law to have the same bill that is sent to insurance companies sent to the patient, just so there's no confusion. Right. And my husband's like, oh, good luck with everge. You know the political climate. He says, you may be able to do it state by state, and he says you can start somewhere.
But I loves you're having for another, go ahead and try it years down the road.
You know, something else to work on in my spare time, right.
Right, But it is smart to realize these things because as consumers we don't know. We don't see a ton of bills. Like, if you don't work in the healthcare industry, you have no idea you know that what CPT codes are. The huge book full of CPT codes, Like, there's so many of them.
There's three specifics exactly, there's more than three hundred thousand CPT codes. And you don't have to memory. You don't have to know any of them. You just have to know where to find it. You know, it's not you know how it goes, not what you know, it's you know who you know? Right well, you know, doctor Google, You'll take up CPT code and you'll google it. You don't need to remember, you don't need to memorize any of them. So I use the analogy gin of going
to a car mechanic. Right, So, your car doesn't work, it's not doing something it is supposed to do. You take it to the mechanic. Well, you don't have to know fancy mechanic words and how the car runs. And that kind of thing to know, number one, what you're able to pay for it. Right, You don't need to know fancy medical words and CPT codes. You don't have to have them memorized and know what they are to be able to understand what fits in your budget when you have to pay for your care.
I know I can go to a car dealership and be like, I can't afford a car that's more than twenty thousand dollars, and they will do you know, they will tell me what I need to compromise on to stay in my budget. And it's just not the same with healthcare exactly.
That's you know, Jen, that's the exact that's the exact analogy I use. I say, you know what, when you go to a car dealership, we know personal financial literacy. We know that if you're buying a new car, old car, you are expected to negotiate. There's just basic things you're supposed to know. And you don't think that well, I don't know any thing about how cars work. I don't know any fancy car terms, but I know that I want like a big car with a big engine, so
I know I want a V eight. We don't you don't have to know how the VA works and all the little fancy things connected to it to know how much you can afford to pay to stay in your budget, to stay in your spending plan for you and your family.
Some of us just want good cup holders, that's all. I'm hey, you know what.
I didn't want to, but I had to buy a new car, my my baby, my favorite Bella. It was diagnosed with a terminal disease, so I had to let her go. So I had to get a replacement. I call her Bella Junior. So when I was checking out Bella Junior at the dealership, the guy was like, hey, in showing me all the features everything, he says, and it has a sunglass holder for your sunglasses. I was like, ah, sold, done. I kept playing with.
Things.
I'm with you jillion yes.
So say somebody has a medical debt that's been it's been longer than six months, and you know they've already sent it off to collections. What is a person's move then? Should they you know, it's on their credit report? How do they get it off their credit report? How do they deal with it? What's the next what's the move there?
Okay, so this I'm going to talk about the old number. So as of July first, as of last week, it's less than a week old. The three credit reporting agencies have to they have to wipe off, remove and not report any medical bill or debt that's been paid off that's already in collections, that was in collections. They can't report it anymore. Once you pay it off. It doesn't stay on for seven years like other consumer debt. It gets wiped off as soon as you pay it off.
The other thing is is that the facilities have to wait now twelve months instead of six months before reporting it to collections or selling it to collections. So that's awesome news. I just wanted to remind us of you know, this is something that's new.
Yeah, I had no idea.
Yeah, yeah, good stuff. Right. Yeah, So I'm so this next thing to answer your question, Jen refers to prior to any bills that came up before July one, twenty twenty two, before last week. So what you would do is you really want to call and make sure that you owe that. Let me back up. If they call you, when they call, you say hey you owe this, it's in collections. You want to make sure you really owe it, so they have to prove by law. There's a federal
law that's been in effect since the late seventies. It's called the Fair Debt Practices Fair Debt Collection Practices Act that says that if you get called by a debt collector, they have to show send you documentation that you signed for the service or product. So you're going to have to You're going to have to go just og on them, just old school and say, hey, look, I don't know anything about that. You need to send that to me in writing. Show me my signature where I agreed to
pay for this, that I received the service. Show me that. So if they don't show you that, they don't send it to you in writing, you don't know it. The second thing is okay, so let's say they send it
to you and you owe it. There are credit repair agencies that say, you know what, you're better off just working with let me back up their consumer journalists and folks that you have experience in doing this work in consumer debt, say you know what, instead of paying it off with the debt collector, just work with a credit repair service business company because your credit has already been deemed so they suggest, you know what, maybe you even
want to pay it off because it's already hit your report, your credit report and being your credit number, your fi GOO score. So some people suggest doing that. Others say, you know what, work out a payment plan, you negotiate with them, and you know they bought it for pennies, so you know they're going to get a little bit of something, and again a little bit of something is
better than nothing. If you found out you did, you went through the steps, you found out you did owe it, you really if you can, if you can, this is more difficult to do to get the real bill with your signature with CPT codes, that that's ideal. But if they have a signature from you and it looks like, okay, yes this documentation I signed for these medical these care services. If you can, I go back to step three applying
the three steps again. If they can't give you CPT codes, then you know with the you know the documentation that they have that you think that you really do oh you receive those services. Take it down step two. What the services you receive? What prices Medicare pays for it, or you can go up to two times Medicare rate.
If you're so inclined to start there with your step three negotiation, say okay, I'm able to do this interest free because they've already ding my credit interest free payment plan, and it doesn't matter how long it takes. You stay in your budget. Don't let them wipe out your Frankly, you know Americans want to We love our nurses and reappreciate our dots. You know, they save they can save
our lives, and we're grateful. But just because the facility and or the providers saved your life doesn't mean that you should destroy your financial life and give up your life to pay them. Right, So don't give up your don't compromise or risk your ability to get to work. The roof over your head. So make sure you can make your mortgage. You have a budget, your spending plan that includes your budget, I mean your mortgage or your rent, your car payment, your ability to get back and forth
to work. Medical bills come last. Frankly, You've got to make sure that you stay with your ability to stay healthy. And if you're financially stressed, you're going to You're not going to stay healthy. So protect your ability to keep a roof over your head. Your ability to get to and from work. Pay those bills first, and then work out something that you can cover those that medical debt
collections saying that you owe. But some people say, if you've already got if it's already gone to collections, it's already dinged your credit score. Consider that. I'm not an expert in this, and I'm not suggesting one or another, but some folks say, once it's gone to debt collectors, consider working with a credit repair agency or a business company.
Yeah, definitely, if you're going to go that route, make sure it's a non not for profit like come.
Yeah, oh that yeah, big De'll thank you for bringing that up. That's that's important.
So I've heard, and I've I've experienced getting like a pay in full discount. Do you recommend the interest free payment plan over possibly getting a pay in full discount for either a bill or a debt.
It's up to you once only only only only after you've gone through the three steps. If you've done the first two steps, sure you know whatever works for you. So yeah, okay, I've done the three steps. First step, I got the CPT codes described in the services that I received. Number two, I took those codes and found out what Medicare pays for those services, and so this is a fair price. So you go to three. Okay,
this is why I'm willing to pay. So let's say that I guess sent a bill and this is not unusual. You've got sent a bill for ten thousand dollars, and you worked out the numbers, you know, did the three steps, the first two steps, and you googled up actually Medicare pays, you know, three thousand dollars for these services. Well, you call them back and you say, you know what, if I pay you in full three thousand, will you take it? This is what Medicare pays. Will you take it? If
you don't ask, you don't get. And then if you believe that that's what you've done the research, meaning you googled the CPT codes and what Medicare pays for them, then and you believe that the actual fair number is three thousand dollars, say look, this is all I'm willing to pay. Take it or leave it, and you know you'll give me a seventy percent discount if I pay you in full?
Now, yeah, for someone at that step two of comparing to Medicare prices where can they go to find that information? To go back to the car illustration? Is there like a how is their blue book?
Actually there is a healthcare blue book. You can start there, but that the healthcare blue book looks at the prices that are paid are charged and paid in that particular region where you live. Medicare does a little bit of tweaking based on regions, but not a whole lot. So I usually tell people to go to healthcare dot Gov is the big one where I tell people they can start their search for the actual prices that Medicare pays for certain services CPT codes services.
Yeah, so that's where having that code comes in hand. Toy that.
So that's why step one call them.
You know.
The first step is easy, just a phone call. Yeah, you know you're going to be on hold. You know, well, you're in front of the TV. Just put the TV on mute and a commercial and call, you know, just and then watch and then when they come and they pick up, you know, ten minutes later, fifteen twenty minutes later, however it is, you can put your TV on you and talk to them and say, I need a real bill of CPT codes.
Mm hmmmm, nice.
Yeah, you know what else I need. Every week, it's it's on the same level as this conversation.
The bill of the week.
That's right, it's time for the best minute of your entire week. Maybe a baby was born and his name is Williams.
Maybe you've paid off.
Your mortgage, maybe your car died, and you're happy to not have to pay that bill anymore. Stuff bills, Buffalo bills, Bill Clinton, this is the bill of the week.
Doctor Virgie. Every week we invite our listeners and our guests to share with us their bill of the week, and we, as a billing expert, we are very excited to hear what your bill is for the week.
So my bill, actually I talk about it in my book How to Crush Medical Debt, or I call it just Crush Medical Debt. What your doctor wants you know, how to crush medical debt, And I talk about it because it is a subset a great example of what we talked about at the beginning of our conversation, which is surprise bills. So surprise bills, as I said, is when you go to an in network provider and a hospital facility, but they have out of network dots taking
care of you. Providing the service. Okay, so that's a subset of balance billing. Balance billing is when you go to an in network provider, meaning they accept your insurance, and they send you a bill for the real I call mrsp right, as we were talking about cars full manufacture retail sticker price. They send you a bill for
the balance between what their retail their full price. I laugh, so I don't cry, really, and they send you a bill for the provider send you a bill for their full price, even though they're a network of their provider. So let's say that, just to keep the math simple, say that I go get Care and the insurance pays ten dollars for this particular CPT code, right, this particular service,
but the provider's full price is one hundred dollars. So instead of saying, oh, we're a network, we've agreed to accept whatever they pay for their members as payment in full, we accept that ten dollars and it is what it is. Right, they send you a bill for the balance, which is ninety dollars.
Right.
That is balance billing. So the reason why that's important, and we talked about the surprise billing is a is a type of balance billing. The reason why that's important is because if you can imagine, it's if it's just you know, one hundred dollars or two hundred, and never say never put just in front of the money. Right. If it's just you know, one hundred, two hundred dollars, okay, you know it's gonna you're not gonna be happy about it. But if it's thousands of dollars for the services, that's
that'll put you in bankruptcy land debt land really quick. Right. So anyway, so my medical bill mistake of the week is I went to a hospital for emergency surgery and I got a balance bill. They tried to balance bill me. Uh, they said, my I always laugh. I really I laugh, I don't cry. They sent me a bill six months later that had one CPT code and the rest was like general you know, so it wasn't a real bill because it only had like one CPT code describing you know,
in patience, day, surgery, all this stuff. Right, So it's like, okay, this is this is interesting, this is going to be entertaining for me, So please send me a bill for three hundred that said, well, our charge is for your surgery and all this and the inpatience day is three
hundred and fifty one thousand dollars. But then you put a second line in that said, this is quote unquote insurance adjustments slash payments of like two hundred and sixty thousand dollars or something, and then it says patient third line, patient responsibility and up at the top, same number, patient due you know, within like thirty days or something, you know, lolo price of like almost ninety thousand dollars. Right, Oh my gosh.
So manageable, right, we just help you out.
Yeah, exactly right. So I have to say, you know, I was I was laughing because they didn't realize, you know, they're putting one over on the author of what your doctor wants you to know at a crush medical debt, right, not for crush medal debt. And I was cracking up, and I had to I was. I was working from home that day, and I had to just let it. I had to talk to someone. So I call my
best friend and I tell other story. I said, I just got a balance bill for ninety thousand dollars from this facility that was in network, that is in network with my insurance, and I'm telling other story and just cracking up laughing, and she finally says, you know, Virgie, you're the only person I know who laughs when everybody else would be curled up in the fetal position in the corner crying. And you know, I tell this story because it is a perfect example of why we have
to educate ourselves. We have to have medical financial literacy, just basic three steps and it'll save you literally sometimes one hundreds of thousands of dollars. If I'd gone back and applied the three steps, I would have called the provider, asked for cp real bill with CPT codes for everything, and not just like I think they gave me a CPT code for like the tissue they took during my
surgery and sent it to the lab. They sent me a CPT code they broke it out with our services and stay three hundred and fifty one, three hundred and fifty thousand and nine hundred ALLA, and then CPT code for lab service Pathology service forty four dollars. It was just like that is rich?
Is so?
Yeah?
If I'd applied all three steps to that, I would have gotten a real bill, and then I would have figured out that hey, when I've gotten the EOB for my insurance that the number they were actually charging me, that ninety thousand dollars was the same number that they sent the insurance company to pay. The insurance companily paid ninety thousand dollars, probably less, but you know, they figured
like nine times out of ten, it works. Wow, And they were going to I was sent a bill for ninety thousand dollars that I didn't owe, and they sent the same claim, the same bill to my insurance company.
So you didn't actually owe any of that.
No, I owed nothing. So yeah, that's a great question. So a year later, I was talking to my best friend again about something and I said, you know, well, yeah, that's why you know. I You know, I call myself the lady that got out of paying the ninety thousand dollars medical bill. And you can too. Let me show you how. And she says, well, Virgie, by the way, she says, you didn't pay that, right. I was like, of course not. I told her I wasn't going to pay that. And she says, well, are you sure like
it didn't get sent to collections? Maybe check your credit report, your credit number, your five call score. I'm like, who are you talking to Like what I was like, you're you know, you're talking to the author of Crush Medical Debt, right, I said, you know, dude, I just refine. Asked my mortgage last month, my credit score, my fi Pal score was They said it went down from the month prior. It was now eight forty one. And I was like, what I mean, I missed the snapshot. I got a
screenshot and sent it to her. But apparently the month prior it was eight fifty. So I said, there's no They didn't say, it's about that's what balance billing is. It is. It's she's a lawyer. She won't let me use the word contract fraud, but let's say it is. It is not. It is not in contract. You're if they when they send you a balanced bill. When they send a balance bill, they the provider sent a balance bill to members of insurance companies who they contracted with
to accept their insurance. Sending a balance bill is breach of contract.
Yeah, I mean recognizing that what is happening here with medical billing is not always ethical, and sometimes we think what's illegal is the same thing as unethical, and it's not the same thing.
You so much for saying that I tell folks this all the time. Jillian. It's like, you know what, these insurance companies and the providers know it's immoral and unethical, but they also know it's not illegal.
And they spend a lot of money every year making sure it never becomes illegal. And it's your money they're spending.
Exactly, lobbyist, you know, hundreds and hundreds of millions of dollars. Yes, ma'am, January hit it right.
Thanks to doctor Vergie, we are one step closer to being educated and armed with knowledge and we don't have to pay that ninety thousand dollars medical bill. If you all listening have a similar story to getting out of a ninety thousand dollars bill, I mean, definitely call us Frugal friendspodcast dot com slash bill. But if it's anything, if it's a wrong bill, if it's a double bill, it's a double bill that you like. Whatever it is, the right bill, leave us your bill Forrugal friendspodcast dot
com slash bill. Now it's time for the lightning round.
The lightning round, so we are playing this is a little bit of wait, wait, don't tell me style. We're talking about negotiating medical bills and debt. For the Lightning Round, we want to know what's your best negotiation experience in general. It can be medically related, but it doesn't have to be so doctor Virgie, we will let you go first. What was your best new negotiation?
My best negotiation is probably then this. This has so nothing to do with medical bills because I just described My best negotiation is saying, no, I'm not paying any of it. Yeah, this is very funny, this will this, Oh, this will be a great story for my book. But no, you're not getting a dime because you don't owe it.
Nice try, but no cigars. My brother used to say, probably my best negotiation is being at a tax sale a yard sale and getting they were giving away or you know, selling a plant or something, and I was just talking with them and gave them, you know, a beautiful smile, and they just said, hey, just take it. I was willing to pay twenty fifth. I would have paid whatever. It was a gorgeous little plant kind of
you know, like a small tree kind of thing. And they're like, oh, you know what, you've been here before. They had a sale prior, a couple months prior, and I bought something. They were like, you know what, just take it doctor.
I don't know that's negotiating. I think that just might be the beautiful, the being beautiful discount that you got. I don't know you.
I would if I could smiling a discount, that would be my favorite.
I would my old mile you know, the twelve year old virgie smile that wasn't so beautiful. Then yeah, I'd have to come up with another negotiation. I think just being kind so you.
Can just negotiation necessary.
Mind and with them and you know, creating relationships.
So that is a pastic negotiation tip is be kind and fred like befriend Sometimes.
It doesn't even need to get to the combative stage. You just flash a smile and walk home with a freaquent.
So my my husband says that, He says, you know, when you you're at tag sales and yard sales and that kind of thing, you'll bundle it. You know, well, I bought something already, can you throw in this? Or okay,
well how much is this? You already have a couple of things in your hand, and we just did this this past weekend, and he says, well will you do I think it was like she wanted three dollars or five dollars then something the third item, and he already had two items in his hand that he didn't hadn't asked her about the prices for, and he says, well, will you take ten dollars for all three? Just like yeah, So that's my negotiation tip. Be kind relationships and yeah bundle.
What about for you, Jim, you love negotiating.
Yes, I will say My biggest one has a little bit to do with relationships. Also slightly stalking. Oh, you be the judge. It was our first house and I wanted that thing so bad, and our realtor at the time very much helped us negoti But when we got under contract, they still had an open house, and I went to the open house and I like stocked it and just made sure that nobody else wanted it. And I talked with the flippers who were also the sellers,
and just found things we had in common. One of them had went to school with my old boss, good old Greg, and they and so I just made sure that once the negotiation was like done, that I really had it on lock. That was That was my favorite negotiation experience, and it ended up being well, we had no money. At the time, we were being kind of forced out of our rental, so we had saved nothing, so we had to figure out how to get the house with little to no money.
I mean, that's great when your best negotiation is on your biggest asset, your biggest expense.
Yeah. Yeah, and we thought we paid more, but we actually made out really good being like two kids in their twenties getting this like fully flipped house. So that was that was my favorite, My favorite negotiation experience of Travis's. And this is really the best story is that Travis sat on the phone with Sprint for six hours one time to end up with two free iPhones.
Mm hmm, that's amazing.
That was money. I was time well spent for the money that was saved.
Right, But who wants to sit on a phone for six hours?
Yeah? Yeah, hourly rate? How much are those two phones worth? And divide sick into what is he so think about his job when he gets paid, you know, break it down, divide it up his annual salary, divide it monthly. Then you can divide it into his HOURI rate, right, and then you know, take that number, compare it to what two iPhones together at least seven hundred dollars to make the math easy, six hundred dollars, So six hundred dollars he saved right or got product services were six hundred
dollars over six hours. That was one hundred dollars. He made one hundred dollars an hour.
Yep, yep.
So it's crazy and he wouldn't want to do it again, but it's it's a story. Probably I tell the most about negotiating bills and stuff because he just I got home, he was on the phone. I left for a girl's night and came back. He was still on the phone. It was an early girls night, Yeah it was.
It was mom, I wasn't with you on that girl's night. No, no, so yeah it was.
Uh that was That's the best negotiation experience. It just wasn't my experience.
Wow, he learned from it, Jill. You learn at the knee of the master. That's awesome.
I do learn from the master.
This was something for both Eric and I were living in one hundred and seventy square feet a tiny little trailer camper and working from home, like working remotely, So you can imagine what that looked like for both of us to be working in one hundred seventy square feet, so we needed an office space, so we were looking at rentals and ended up finding this amazing renovated barn at a very reasonable rate for us to be able
to work there. Well. It was also on lots of acreage and it looked like a perfect place to also park our RV, so we negotiated for them to allow us to park our RV on the property use the barn the renovated barn for our co working space for the same price that they were hoping to get out of renting out the space, just like, well, you let us also live there at no cost, and they did. And you know what, doctor Virgie, it might have been some extra smiles that got us that much, because.
Really, your office space, so you throw it a place for us to live too. There you go buy.
It was bundling, and really they needed someone really specific to be able to rent because they had young kids who were playing in the driveway, so they didn't want a company renting who was in and out of the driveway a lot. We were really quiet, We kept to ourselves. It's what allowed us to be able to afford the office space and still live in the trailer, so that was probably our best negotiation. Yeah, we'll rent this space from you can We also live here in our RV
right next door. They were awesome, became friends, which was great.
So oh I love it. I love these stories, Doctor Vigie, thank you so much for joining us. Where can people get more from you and get your fantastic book.
I can go to Crush Medical Debt dot com and on Thursdays on Voice America dot com at five pm Eastern two pm Pacific, you can find me at the Aska Doctor What your doctor wants you to know with doctor Virgie show awesome.
Yes, and definitely check out your book, Crush Medical Debt. It's available Amazon and it's gonna help so many people really escape this h this crushing medical debt. So thank you again, doctor Virgie.
Now, thank you so much for having me. It's been so much fun talking with the ladies. I really appreciate all you guys do.
Bi gwise, Doctor Virgie, thanks for being here.
I'm so glad that you got to hear that one and again you you can get more from doctor Ellington's website, Crush Medical Debt dot com. She has We've referred several of our listeners to her that have had specific questions in the past, and she's been so generous in answering those. So crush medical debt dot com And yeah, I hope it is definitely rough. I've recently been and we've both this year been inundated with some medical bills that we have had to navigate, and it is crushing.
Yeah, But having had recorded this interview, I was much more equipped to face some of those things. I think we are better off if the medical things can be scheduled like that was my circumstance. I had a surgery this past year that I was able to see coming and schedule and ask the questions ahead of time. You face some things that were just emergency situations and now
you're receiving the bills afterwards. But in both scenarios, knowing about asking for CPT codes and breaking down the costs and comparing it to you know what those things are supposed to cost.
Being as annoying as possible has been my honest My real takeaway is if you are not annoying, you don't get hurt. And I don't. Yeah, I don't want to be annoying. I want to assume that people are doing the most for me, and they just can't. They don't have the capacity to so to be as annoying as possible, but with kind, not to make somebody intentionally not want to help you.
Out, and my strengths based perspective on that is just being persistent.
Yeah, well, we have different words for this to say thing. Thank you so much for listening. We love, love, love reading your kind reviews kind of like this one from Lori T ten. It's titled Millennial and teacher Friendly happens to be five stars. It says Jen and Jill have done an incredible job of taking money topics and making them understandable and applicable for any person of any income.
I am a teacher who has been struggling with payoff and saving, and these girls take away the shame of not being financially savvy and truly feel like I'm just chatting with most non judgmental friends.
I love that that's coming across. We're not out here judging or telling you exactly how to do it, but hopefully giving you the tools and resources to be able to implement beneficial money decisions that make sense for you. So thank you so much, lot, Lori t ten for those words. If you all are listening and you've not left words for us in the form of a rating and review wherever you're listening, that'd be so so helpful.
Not only does it provide us more content for every episode that we record because we read them during our episodes, but it also helps other people find this podcast know whether or not it's right for them. So thanks for doing that.
Yeah, and we will see you next time and next year, let me see. We'll see you before, but we will not see you before the holiday. So I hope you have a fantastic holiday tomorrow. And if you've already had it, I hope it was really.
Special and you can make it even more special by whatulovebook dot com.
Google Friends is produced by Eric Sirianni.
Okay, Jen, I had a medical event this week where, first of all, I woke up at four fifty am.
Oh gosh, yeah okay. I was like, oh, this is worries someth.
I went to exercise publicly, which you know me, this is again Jill speaking. I don't do that. I exercise in the privacy of my own home. I was really shocked.
I was really shocked by this.
Everyone's surprised surprise that I went and worked out. So a friend invited me. It was a free class because it was the first time that I was visiting and she goes regularly. She's like, hey, you want to join me, And for whatever reason, it was just like, yeah, you know what, I want to try something new, different, I want to do something that scares me. I did ask her like is it going to be scary because it is one of those kind of CrossFit adjacent type of gyms.
But I did it. I did something that scared me. It worked out. No one was paying attention to me, which is great, except for the trainer. A couple of times she came out and she's like you good, yeah, yeah, yeah, I'm good. I'm good. I'm just out of breath. And so anyways, what I'm about to say really has nothing to do with that. Well, but I will tell it in So I get home. I get home at like seven fifteen, it's still so the sun has just now come up, and I'm like, awesome, so much more time
in the day for activities. I'm going to put the dishes away. Well, a few days before I had made sour dough bread and I do have a razor scorer, a thing to score my sour dough bread with that's very very sharp. And I was pulling out one utensil and that one fell and sliced my fingy, my middle finger, the one that I realized I used the most for all sorts of stuff. That middle finger is putting in
some overtime. Sliced it real good, like it is a it's a sharp razor, and I think it like went to the bone thankfully, just like kind of on a knuckle and not go to the bone on a knuckle. I think it's bruised. It like was at the bone. Anyways, Eric heard me. He came out and it was it was a lot of gushing that was happening. But tried to dry it up as quick as possible while it's still actively bleeding. Super glued it together, because that's what we do in the Syriani household. We have super glue
in our first aid kit. First slice ourselves. We slice ourselves real good, and we're not trying to get ourselves into a situation where we have to spend persistent time negotiating medical bill is.
Did you put super glue in your first aid kit? Because of the dishwashing incident when you were renovating that house.
Mm hmm.
Eric had used super glue before too, so this was just like this your fingers, Yeah, it's on that same hand. Can you see the.
Scars, h your poor fingers.
My thangees. Yeah, they're gonna look a little gnarly because we just do our own stitching with with glue.
They're great though, but they're fantastic.
I so my takeaway, here's how I'm tying it in. I shouldn't have been up so.
Early, well, agreed. I did a six am class once and I did crossbit and I was doing a push press. I had a barbell over my head and I brought it back down and no, no, no, it was when I was lifting it up. Oh, I totally like caught my chin and I started bleeding, like I bled.
Bleeding from your chin from the bottom. Could you also like bite a lip or a tongue?
One?
No, not that, but I and I also brought it down on my head with the same motion. I don't remember, but I just remember after I brought it down on my head, I was like, never again. And I have never worked out at six am.
Okay, see I didn't do barbells, and my friend who goes there, she was even like CrossFit traumatized me on the barbell I'm only doing dumb bells. And I was just following suit. I'm like, if the barbell's not for you, it's not for me.
I will use barbells like I still use barbells. I love barbells. That's fine. I just don't use them before the sun comes up. That's a rule now that I have. The only time I will be working out before the sun comes up is if I'm doing a Disney race. That's it. Like even when I ask you to run, it's free and it's in six at six thirty in the evening. I just invited you to one that have free cookies.
Are you going to that? Yeah?
Probably?
When is it again?
I don't remember, but fourteen there are cookies and you still always say no.
I might do a mile. I might take you up on the invitation. I could do a mile.
You could even do You could even push the stroller if you don't want to run.
Who's in the stroller at listen?
Kai?
Oh? They would be like there, yeah, okay, where are.
We going to take them?
I don't know I'm not thinking through the logistics of how you're going to join a cookie run.
I don't know.
Do you normally like push your kids on like five k's and marathons and stuff.
Well, not marathons, but like a cookie run at the running company.
Yeah, we did it.
We took him to the Turkey Trot on Thanksgiving.
Do you think Travis is going to do the run with you?
I don't know. He's having a thing with his ear. This is a little too much.
Information for the podcast. We are talking medical stuff. Chens.
Yeah, I don't know. He's got like a clicking in his ear, so he's been walking, but I don't know. He would love to not push a stroller. We would love I mean, you were talking about your friend Adam and I don't even know him, and we were talking about giving our kids to him.
It sounds like it'd be more work to run a mile while pushing a stroller. Is that not true? Ye find out. It's your responsibility to find out.