Pay Bill In Full Right Now, Score A Hospital Discount

Phil Villarreal, a familiar face to Consumerist readers, recently welcomed a new baby into his family. Almost as exciting to him as the creation of new life and the addition to his adorable brood was the opportunity to play hardball with the hospital regarding the bill. He had to pay a substantial part of it, see, but had a proposition for the hospital. If he paid it all right that very moment in full, he knew that he would get a discount. Only navigating the hospital’s administrative structure stood in his way.

He blogged of his victory, but unfortunately included no baby pictures:

It sucks to get a colossal hospital bill, but it’s almost worth the pain (almost) for the chance to take advantage of the secret-handshake discount program operated by seemingly all medical billing offices. All you have to do is ask for a discount in exchange for paying the remaining amount in full upfront, and your bill will be magically shrink. Hospitals and doctors do this to grab your cash while they can out of fear that you’ll ignore the bill and stiff them.

But the enemy is doing what it can to make things tougher on patients looking to slash their medical bills.

My son, Zack, was born three weeks ago, and the hospital sent me a bill yesterday. I found it odd that the bill’s contact number had an (800) prefix, but still thought I wouldn’t have too much trouble getting a discount like I did three years ago when Emma was born.

How wrong I was.

Not only did the first guy I spoke to turn me down, but so did his supervisor. They insisted the hospital didn’t offer such a discount and never had. After I presented evidence to the contrary the supervisor admitted her operation was nothing more than a call center contracted out by the hospital. She recommended I call the mothership.

Once I did that — having to look up the number myself, because the call center didn’t have it and couldn’t or wouldn’t transfer me — I got a 20 percent discount nice and easy. It’s sad that those who don’t have the perseverance to play billing office whack-a-mole will have to pay full price.

The lesson here, folks, is to never take “no” from an agency that lacks the power to make things right for you.

The inherent flaw in this plan, of course, is that anyone who desperately needs that discount certainly doesn’t have the cash on hand to pay the bill right now, and using a credit card kind of defeats the point.

UPDATE: Phil wanted to clarify to readers that he does indeed have insurance: it’s the pesky deductible and coinsurance that he was paying.

Just wanted to say that I have insurance and was just negotiating the portion billed to me I owed to meet my deductible and pay co-insurance. Both insured and uninsured patients can get the prepayment discount.


Edit Your Comment

  1. Evil_Otto would rather pay taxes than make someone else rich says:

    He won’t go away!

    • ahecht says:

      If you’ve ever had trouble negotiating a discount with an outsourced call center, how did you deal with it?

  2. Hi_Hello says:


    20% is a huge chunk.

  3. JJFIII says:

    Or a civilized country could have health coverage for it’s citizens so instead of dealing with billing issues, he could have spent time with his new born son.

    • Laura Northrup says:

      Aaaahhhhh! Socialism!

      • ferozadh says:

        There’s a voiceover scene at the end of Good Bye Lenin that perfectly summarizes what socialism is in general and within the context of East Germany.

      • bassbeast says:

        Aaaahhhhh! Canada! Loved that we were in a semi-private room (since one was available) and walked out with nothing more than a new kid. No bills.

  4. Loias supports harsher punishments against corporations says:

    Why? WHY did they hang that poor doll?!?

  5. mypcrepairguy says:

    Huh, I thought most hospitals do this.
    The CCMH here in WV does this, pay the presented bill within 20 days and get 20% off. Dr’s bills and misc 3rd part bills not included. Its a nice option and one that I take advantage of consistently. Only drawback is its hard to verify that the insurance has been properly billed as that can take up to 45days in some instances.

  6. elephant says:

    My hospital does a discount for any bill over $250 – so I purposely wait until I have enough charges to exceed $250 and then pay online for the discount – I guess the difference is that the hospital actively promotes this discount instead of making it secret….

    PS – congrats Phil!

  7. kiltman says:

    Is this for the whole bill? Does he have health insurance and was this his copay? Just looking for a little more info.

  8. Abradax says:

    Oh the ironing…

    An article that would be completely approriate for Consumerist, with Phil involved but it was written by someone else :)

    But seriously, 20% is a huge chunk of change, nice job.

  9. Jacob says:

    I’ve always wondered what conditions have to be met in order for the hospital to offer this sort of discount. Is it just for people who don’t have insurance?

    I’m on a high-deductible plan, which means if I have a big hospital bill, I have to pony up quite a bit. (No worries though because the amount of savings I get from the lower premiums totally covers the high deductible). But before I get my chance to pay up, they first send the bill to my insurance provider who usually slices some of the costs off of things.

    So can I still call the hospital to negotiate if they’ve first billed my insurance company who made them slice off some of the cost already?

    • Abradax says:

      If you are paying cash, Always see if you can get the same price they have negotiated with insurance companies.

      I did when I had surgery, and saved about 6 grand.

      • catastrophegirl chooses not to fly says:

        or see if you can get better. my roommate has catastrophic coverage only. she just had a visit with her primary care physician plus labwork. we asked about the billing difference if she had insurance
        my roommate paid $123 for the visit and labwork
        they would have billed an insurance company $125 for the visit alone, i don’t recall what extra the labwork would have been to the insurer.
        the system is very broken

    • Freshmaker says:

      It’s for the amount you’d pay after the insurance has covered their chunk. Helped a ton a couple of years ago when my son was born two months premature (which meant lots of NICU time). Insurance covered a ridiculous amount, and I was able to get 20 percent off by paying the rest in full. He actually was transferred to a second hospital due to complications, and they offered the same deal when that bill came due.

    • grumpygirl says:


  10. jeepguy57 says:

    “He had to pay a substantial part of it, see, but had a proposition for the hospital. If he paid it all right that very moment in full, he knew that he would get a discount.”

    Sounds like he has some type of insurance. I have a health savings plan so we are usually on the hook for a good chunk of the cost before we hit our annual deductible. Considering we are expecting a baby next January, we will be nowhere near that deductible. Maybe I’ll give this a shot, after Aetna knocks the $50k down to $12k (which is what happened last time my wife gave birth).

  11. kranky says:

    I had some outpatient surgery a few months ago and the hospital called me a week before the surgery, told me what my out-of-pocket cost would be after insurance, and offered me a 20% discount if I would pay it before the surgery. That was nice.

  12. Turks says:

    It’s not just big amounts, either. The hospitals in my neck of the woods will give you a pay-in-full discount of around 20% on any bill over $200. And that’s just for calling the line to make a payment, not even jumping through hoops.

  13. Not Given says:

    A local hospital gives a 15% discount for paying within so many days of getting the bill. Another will give you 20% off the deductible for paying upfront, when checking in the day before the admission. I asked about a discount when checking into a third hospital and was told it was insurance fraud. How can it be?

    • Geekybiker says:

      If they bill you and the carrier at different rates I could see it. In effect they’d be billing part of your deductible to the insurance. Or I’m sure that’s how the insurance would see it. However its probably a matter of how they do books too. If its billed as $1000 and they write off $200 it might be different than just billing $800. Just a guess.

      • Not Given says:

        I don’t see how it’s costing the insurance company anything. The insurance pays the same amount either way. I’m just getting $50 off or whatever on my part of the bill to save them the trouble of possibly having to chase me down or turn me over to collections. The discount comes out of the hospital’s pocket.

  14. PragmaticGuy says:

    Years ago my wife was n for an operation and I ended up owing $600. Although it didn’t say on the bill about any discounts for payment in full when I called to make the payment via credit card I was offered 10% off right away. So I saved $60 as a matter of course. This seems to be SOP.

  15. impatientgirl says:

    I had a minor outpatient surgery two years ago. When I called the hospital the week before to confirm insurance they said if we paid in full in advance they’d knock off 20%. It was a nice surprise.

  16. aerodawg says:

    “Hospitals and doctors do this to grab your cash while they can out of fear that you’ll ignore the bill and stiff them.”

    Well duh! Everything in the world works like this. It’s called risk pricing. If you finance a $(%&#$ TV it costs more than if you fork over $100 bills. The risk that you won’t pay up is factored into the price for extended payments.

  17. StatusfriedCrustomer says:

    //She recommended I call the mothership.//
    Wasn’t mothership provided automatically when your wife gave birth?

  18. km9v says:

    I did that for a procedure back in May. Saved me a lot. However, w/ the way hospital operate these days, you get bills from 10 different sources; Dr., anesthesiologists, radiologists, the list goes on & on. No discount from them.

    • PercussionQueen7 says:

      In a recent hospital stay for my brother, we got bills from people who had never even introduced themselves to us. How the heck are we supposed to know if you saw him if you don’t even tell us your name!

  19. BrettB says:

    Isn’t this illegal?

    I thought insurance companies considered this fraud because it amounts to overbilling the insurance company to reduce the cost to the participant against the rules set out by the plan.

    ie. Insurance bills $2000 and under the terms the participant agreed to, the participant pays their $1000 deductible and $200 for the 20% coinsurance. The insurance company pays $800.

    If the hospital discounts what they bill the participant by 20% ($240), it seems the insurance company would insist on only disbursing $480 to the hospital instead of $800. And your share would then be $1120 instead of $800.

    Does the hospital eat the $320 the insurance company shouldn’t pay AND the $320 your $800/”20% discount” doesn’t cover out of the $1120?

  20. Bender6829 says:

    When my son was born, nearly 30 years ago, we did not have maternity care in our group plan (I believe it is now compulsory for insurance companies to include it). We kept sending the hospital $5 a week. They called us and told us we must pay it in full or be turned over to a collection agency (they flat out rejected my offer of returning the baby to them).

    Fast forward about a month or so and the collection agency contacts me. I tell them I simply do not have the money, and that I will send them $5 a week. The gentleman then tells me that he is willing to forgive the debt for $.50 on the dollar, no strings attached, and no hit on my credit.

    I borrowed the money from my employer and paid off the debt. My employer took weekly deductions from my check (a little more than $5 a week of course) and the rest is history.

  21. benk016 says:

    I recently had a sleep study done at the local hospital. When I checked in they told me how much my co-insurance would cost, and that if I paid it right then they’d take 20% off. Didn’t ask for it, its just policy if you can pay it then you get the discount. She even said if I couldn’t pay it all then, but make 2 payments they’d do 20% off.

  22. frodolives35 says:

    I did this with my daughters braces about 10 years ago. Upon getting the estimate I negotiated a 20 percent discount for a cash payment at time of service including adjustments for 2 years. I saved $1600 dollars on an $8000 bill. I then put $5000 in my flex account ( an interest free loan from my self paid over the next year) used that in addition to cash and saved another $900 in taxes. A little forethought and time planning got me almost a 30%% discount in total.

  23. oneandone says:

    Congrats, Phil & family. I just did a similar thing, on a smaller scale, with an upcoming dental appointment for wisdom teeth extraction. With sedation & 4 extractions, my share after insurance was slightly over $1,100; I got a 10% discount by speaking with the office billing manager and offering to pay my part in full the day of the appointment. They didn’t offer the discount (I had to ask if they had any available), but I think they were willing to negotiate since there are so many dentists in the area. IMO its easier to switch dentists (especially for planned, minor surgery) than doctors or hospitals.

    I wouldn’t have thought to ask except for Consumerist – never knew discounts might be an option!

  24. Milquetoast says:

    I had a similar situation come up before shoulder surgery last year. It wasn’t a discount on the entire cost of the procedure — instead, they attempted to play “Let’s Make a Deal” with a product I would need for post-surgery care (Cryo Cuff). They explained that if I knew my insurance wouldn’t cover it, I could pay for it up front with a 40% discount. If, however, I chose to submit it to insurance and they denied coverage, I would be responsible for 100% of their price (couple hundred bucks). I took my chances and had them submit it to insurance; after some wrangling and complaining, it was eventually covered.