Tips For Managing Your Medical Bills When You Have a Chronic Illness | Ep. 242

Intro/Outro: You know what it is. That’s right. It’s time to talk money with your money nerd and financial coach. Now tighten those purse strings and open those ears. It’s the Money Talk with Tiff podcast.

Tiffany Grant: Hey everyone. I am ex. Cited because today I have Barbie Engel on the line. Now Barbie, she specializes in medical bills, but not just any medical bills.

She specializes in chronic diseases. So I wanted to have her on the line because she actually hit me with a stat before we got on the call and I said, whoa, one in three people have chronic diseases. So this affects a lot of the population, and it’s important to make sure that we’re not. Overpaying for these services that we need.

So, hey Barbie, how are you today?

Barby Ingle: Hey Tiffany, I’m so excited to be here and share with you in the audience, and you are absolutely right. This affects you or somebody you know. So listen up, this is gonna be good.

Tiffany Grant: Wow. Wow. All right, so let’s start off, cuz I always love starting with baselines, just basic knowledge and education.

What exactly is a chronic disease? Um, like, you know, just give us some examples of what it could be. Cuz maybe someone in the audience might have a chronic disease and they don’t even realize it.

Barby Ingle: Sure. So typically we think of a chronic disease as something that lasts longer than six months, but typically the rest of a person’s natural life.

And it can be anything from, uh, alcoholism, arachnoiditis, uh, polio, which we don’t hear a lot about, but that’s still out there. Mytosis. Um, things that, that you have heard of. Fibromyalgia or epilepsy, things that last a long time, that take a lot of. Of attention from our life. And, and for me, having a chronic illness is like getting a certain number of energy.

Pennies every day. You know, you go to work and you, you have, uh, this paycheck that comes in and with people when it comes to health, they don’t think of. What, what’s my paycheck gonna be? When you have a chronic illness, you get 12 pennies a day and you have to learn how to spend them, and that’s all you’re going to get.

And, and so I want people to be prepared and ready to go when, when they’re trying to help somebody with a chronic illness or they themself are living. To and through a chronic illness. Gotcha. So

Tiffany Grant: thinking through the definition you just gave, would that also include like asthma and diabetes and depression?

Barby Ingle: Absolutely, it can affect you physically, mentally, spiritually. Uh, chronic diseases can attack multiple systems of your life. So not just your finances, but your, your physical wellbeing, your mental wellbeing, your spiritual wellbeing. It can affect every single aspect. So it’s definitely something that you need to stay on top of When.

Getting your life organized and trying to live your best life despite facing these challenges.

Tiffany Grant: Ah, okay. So now that I understand that, I’m like, oh, I have chronic diseases and illnesses cuz I have asthma. Yes, I have depression and anxiety. And so I’m like, okay, so. Teach me what I need to know, so I’m not overpay for these services.

So let’s hop into that Barbie. What are some things with people like myself now? Um, yes, have chronic illnesses. What are some things that we should be thinking about or looking at when it comes to our medical care?

Barby Ingle: When it comes to medical care, one of the hardest challenges when it’s chronic is keeping that care ongoing and being able to afford it in our lives without putting a burden on our families.

And the people around us that love us and are, and are helping us. So I would say if you, I’m gonna start off with the people who are underinsured or don’t have insurance cuz they don’t know that they can do these things. But first is you can negotiate if you ha if you need an appointment, you can call and say, what is your cash price?

Can the, the, the medical provider. Send me to a nurse practitioner or somebody that is overseen by the medical provider, by the doctor that costs less to see, but I still have resources and access to that doctor. So that can save you money right off the bat by calling and negotiating and not just, you know, relying on, okay.

Their price is $150 for 15 minutes and I. I can’t afford that. What can you afford and can you get access to a provider that can have access to a doctor or can you get direct access to the doctor for less? Amount, and then same thing happens with when you need blood testing. If you need x-rays, labs, MRIs, CAT scans, whatever it is, like with asthma, you probably have had to have x-rays on your lungs and possibly further scans like CAT scans and MRIs.

You can negotiate those prices with the companies who do those services and you can call around and get the best price. Every place has a different price. So most people don’t know that and they just. Call and say, this is what it is, and then they end up paying extra money on their prices. Same thing happens with pharmaceutical companies and uh, the pharmacies that we go to, the end user goes to, to pick up those medications that we need.

There’s all kinds of coupons. Discount programs, when you have a chronic illness, you’re typically on for, we’ll use asthma as a, in an example. I also have, uh, lung challenges that I am faced with and I have inhalers and things that I have to use a nebulizer, and these costs a lot of money, but there’s.

Things that you can do by searching online, by going directly to the manufacturer. Go online, find out what medical options that you have, and then go to the manufacturer of those items and say, Hey, I’m low income, or I’m underinsured, or I’m not insured, and what is available for me so that I can get a discount or a coupon.

We use them in the grocery store. Why not use them with our medical care as well?

Tiffany Grant: Hmm. So that’s interesting. Okay, so I have so many questions already. All right, so we said, um, getting with providers that may be a little least expensive, so like nurse practitioners, um, asking if there’s a cash price if you’re not using in insurance and negotiating pricing, and then going directly to the manufacturer for your prescriptions.

Now I wanna stay on the negotiate pricing thing because how do we even. Do that. Like how do we, how do we open up that conversation with the doctor? Like, okay, look, I can’t afford this. You know? Cuz a lot of people are ashamed to say, I can’t afford this. So what? How can we open that conversation up? Well,

Barby Ingle: first thing, let go of the guilt.

Take that guilt. I, I will physically, before I make a, a stressful phone call to, to ask for a discount, I will take the, um, my hand and put it across my chest and. As if I’m grabbing all of the invisible guilt or stress or anxiety, and I will throw it away from my body and say, this is not part of me. I don’t want it be gone, and it doesn’t go away forever, but it will help you get through that moment.

Take a deep breath and, and have a plan when you call. Know what you can pay and give them the suggestion. Look, you charge $150, but you’re one of the best for this condition disease. Whatever I’m facing, and I really wanna get in and see you, I can afford $30. Can you please, will, will the provider accept the $30 and or do you have a way that I can see somebody in your practice to to get a consultation that can then go to the provider?

To that doctor and get more information. Let me know what’s coming down the pipeline or what I need to save up for, or what kind of plan we can be, uh, using so that I can maintain my care over time.

Tiffany Grant: Hmm. That’s great. That’s great cuz I know a lot of people face anxiety and I love your strategy of just physically acting like you’re taking that and just throwing it to the side so that way you can have the conversation.

I think that’s super helpful, not only with negotiating medical bills, but any type of bill. Um, absolutely. You know, as I think through any

Barby Ingle: stress. Any stressful situation, but it, it definitely is, is it’s a way to tell your brain, I am taking this and setting it aside. I know it’s there, but I’m setting it aside.

I’m getting it off of me and I’m going to accomplish this. Gotcha,

Tiffany Grant: gotcha. And when you say go directly to the manufacturer, cuz just the other day. I was watching tv and of course they have all these prescription drug commercials and stuff that come on. Mm-hmm. And I’m like, why do they advertise to us when we can’t just go to the store and get this stuff?

Like this is stuff that has to be prescribed. So now that you say when you go directly to the manufacturer, you might can get a discount. Now it’s starting to click for me. Like, okay. That’s why they want their name to be known so people can come directly to them. Am Am I off? On that or no, you are

Barby Ingle: absolutely right.

And they actually have special programs set up and not that many people know about ’em or use them so. It, it definitely will help if you, even if you don’t call the manufacturer, you can, uh, go on their website and look at the special programs and they have them for each different medication. So, so you can say, oh, I have asthma and I want this.

Particular medication. I want medication a go to that doc, go to that pharmaceutical company and look up what programs they have. Because oftentimes it will be less than what c v s, Walgreens or any other staple pharmacy that’s at the, you know, end of our streets is selling. You can get those coupons or get enrolled in those programs where your doctor’s involved in the process, but you’re going directly through the manufacturer to get that reduced price for whatever situation you’re in.

Tiffany Grant: Ah, yeah. Cuz I had no idea. So I. Pharmaceutical companies have programs that you can enroll in and your doctor will be a part of it. And are these like research programs or like,

Barby Ingle: not necessarily. And, and I have done research projects and that is one way you can get some reduced, uh, medical care is, Joining a research project, but there’s a whole, that’s a whole nother conversation for a different day, uh, of what to look for, for, for those clinical trials.

But you can do it just as a, a chronic patient who needs a particular medication or wants to try a particular medication and, and they have programs for that. That are reduced in price that are separate from the pharmacy, where they can se either send it to your location, your home, your house, wherever you, wherever you are, or they can arrange it so that you do pick it up at a pharmacy, but it has a different price than what the pharmacy would charge.

Tiffany Grant: Wow. Okay. Because I had no idea that exists. And when you said program, I’m automatically thinking, are these like research programs? Because you know, some people, they’re adverse to those. They’re like, well, I don’t want them researching on me. You know, that type of thing. Well,

Barby Ingle: there’s good reason. There’s good reason there’s, there’s a right way and a wrong way to do clinical trials, as I said.

But this is outside of a clinical trial. This is something that is available to us as consumers that most of us don’t take advantage of. So

Tiffany Grant: cool. So cool. So what other things, um, should, can we do to negotiate those, um, medical bills, um, or get them down to be a little more affordable? I know we hit on, uh, people with no insurance or underinsured, but what about people with insurance?

Well,

Barby Ingle: people with insurance should always pay attention to the medical billing. Eight outta 10 bills has a mistake according to jco, so you definitely wanna check your medical bills as they arrive, and don’t pay your medical bill until your explanation of benefits has arrived because. Your insurance company will negotiate pricing for you.

And even if that’s wrong, you can go back and negotiate with your insurance company and say, whoa, wait. This actually helped me. It’s gonna lower my future costs. You should pay more now so that you don’t have to pay more later and negotiate with your insurance, but also let them do their job. We’re paying our insurance companies to negotiate for us in good faith, so, If your medical bills are correct, your date of birth is correct.

Your name is spelled correctly. Your data service is correct, your c p t codes, which I know you’ve covered on a different uh, episode, and people should go back and listen to that one as well cuz there’s great tips in there. Make sure that everything’s accurate because if it’s not accurate, the insurance company will not cover it how they are.

Uh, Contracted with you to cover that expense. And then if again, for me, I’ve had a bill that was over a hundred thousand dollars for a medical procedure and I contacted my insurance who originally said they wouldn’t pay it. And I said, okay, you’re not gonna pay any of it, but can you help me negotiate it down?

And they said, sure. They said Sure, and helped me negotiate it down to the point where they got my medical records and said, wow, this is gonna save us hundreds of thousands, if not millions of dollars on this person’s care over her lifetime, and went back and retro activated, paid that fee back, and I got a check back for my insurance company for the money that I paid through the hospital.

Wow.

Tiffany Grant: Awesome. So I didn’t even think about that. Um, and I’m glad that you gave your personal example. Thank you. Because I’m like, wow. So even if you get a bill, and even if the insurance says that they’re not gonna pay it, you can still ask them, well, can you just help me negotiate this down?

Barby Ingle: Yep, absolutely.

And there’s also with, when it comes to hospitals, there’s also a form called a, it’s a, a charity form. And you’re basically asking for charity. You have to set your pride aside. Um, and, and you just the, after your insurance pays, or if you have no insurance, you can use it either way. Don’t feel like just cuz you have insurance, that that’s where you’re stuck.

You can negotiate and I’ve done it and I’ve helped other people do it. You can negotiate with that charity form, fill that, it’s a usually a one page form you attach your, your, uh, banking statement or, or a couple of other things that they’ll ask for. And, um, from the last few months and the, and you send it back in and typically they will wipe out the entire portion you owe, or a majority of that portion that you owe.

And I’ve helped people, including myself, save. Tens of thousands of dollars just by asking to be a charity case. Yes.

Tiffany Grant: And I’m glad you mentioned that cuz I have personal experience with that too. Um, I had to go to the hospital for one thing or another, I can’t remember cause this was years ago. But, um, I didn’t have it, like when the bill started coming in, I was like, oh my gosh, I don’t have this.

So I was just on the website like, what can I do to not have to pay this? And I came across, you know, the financial assistance. And I filled it out. It was very easy to fill out and they wiped it completely clean, and I was like, whoa. Now I will say though, although they wiped their portion out, I think another thing people don’t realize is that everybody bill separately too.

Yes. So the hospital’s billing, the doctors are billing, the labs are bill billing, right? Mm-hmm.

Barby Ingle: Absolutely. They all bill separately, so you have to do it with each of them. Usually the hospital bill is the, the largest, but even with those medical providers, the surgeon, the radiologist, the, the. Physical therapist that comes and visits you in the hospital or breathing help, all of that is billed separate.

So you have to do this over and over and over again for one visit to the hospital if, if you need, however, it is definitely worth it to ask for reduced pricing. I’ve had, I’ve said, look, this is the amount of money I have and I have all of these bills. If you don’t take a negotiated amount, which I would make an offer, again, be specific in, in what you can do.

Then you will not receive anything because my money is going to get spread through all of these, these medical bills, and you will end up with nothing. And, uh, typically they will negotiate with you, if not write the whole amount off, because they can write it off of their taxes. Mm. As a discount given to the patient.

So it’s definitely, and most people will not ask for a discount or even a, a charity case situation, so when you do ask, you’re one of a few that’s asking, and they’re better able to do that. But unless you ask, you will not get the help. Oh my

Tiffany Grant: gosh. That is, that is gems right there. Cuz I didn’t even realize that that is a tax deduction for these hospitals and, and doctors.

Yes. And businesses. So that’s even more, um, bargaining power for you because Absolutely. Yeah. Cuz they, they’re looking at their bottom line and what they’re gonna have to pay in taxes. And you’re like, Hey, look, you know, I can save you some tax money here if you help me. Help me help you.

Barby Ingle: Exactly.

Absolutely. And even if there’s something that is, is going to help your, your life, like a tool like microbiome testing or pharmacogenomics testing. You can go to those companies that they don’t it, it will help your health, but they don’t necessarily take insurance. Right? And you can go and say, Hey, I would like to take your test.

I cannot afford it. But if you do this, I can do some social media for you. Or I can do a make a graphic for you. Or I can write a poem about your. Your company and submit it to the local newspaper or something crafty and creative, where you’re bartering for that treatment or exchange in some way that, that you have a talent in.

Tiffany Grant: Oh, that’s a good idea too. I didn’t even think about that part. Um, in order for negotiating, um, and just bartering services or things like that, I didn’t even know that they would be receptive to that.

Barby Ingle: Absolutely. My, my a family member, I was gonna say who, a family member of mine does that with his, with his dentist for his, for him and his whole family.

He doesn’t have dental insurance and he’s an animator and he actually will create an animations for the dentist’s office that they can use in like a 32nd commercial or that type of thing, or, or a video that runs in their office. So if you have a talent or skill, You can also use that to negotiate. That is

Tiffany Grant: so cool.

Well you have dropped so many gems today. Um, and I’m already over here like trying to brainstorm cuz like my son, he has um, braces or he had braces. Now he’s in the kind of maintenance phase and I just had to get new retainers and I’m like, dang. If I would’ve thought about that, I could have said, Hey, I could do some social media management.

For y’all Absolutely. In exchange for these retainers. Uh, so now you have my brain definitely going on going forward, like if insurance doesn’t cover something, what I can offer in exchange or negotiate down in exchange or what have you. And so I certainly appreciate all these different points that you hit on from.

You know, getting the nurse practitioners to asking for the cash price to negotiate pricing, to get the financial assistance go directly to the manufacturers. We’ve covered a lot. Um, so if people were more interested in learning more about you or more about this great information that you shared on the podcast today, how would they find

Barby Ingle: you?

They can find me at my website, barbie ingle.com, Barbie with a y, Ingle with an I, and uh, they can also go to international pain.org, which is, uh, the website for International Pain Foundation, which I’m the immediate pest president. And, uh, there’s a lot more resources and information on that website as well.

Awesome.

Tiffany Grant: Awesome. Well, thank you so much for coming on the show today. We appreciate all the gems that you dropped and it sounds like I’ll probably have to have you on again cause I’m sure the audience gained super value out of this. So I appreciate you and I hope you have a wonderful rest

Barby Ingle: of your day.

Thank you so much, Tiffany. So glad to be here and share with you and your audience. Bye.

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