Detailed Answer
1. Review Your Insurance Benefits
Start by obtaining your insurance summary of benefits and coverage (SBC). Note your deductible, co-payments, coinsurance and annual out-of-pocket maximums. If you qualify for TennCare or Medicaid, explore eligibility criteria and covered services under Tenn. Code Ann. § 71-5-108 (charity care eligibility).
2. Request Cost Estimates and Good Faith Estimates
Federal law requires a Good Faith Estimate for uninsured or self-pay patients. Contact each provider for an itemized estimate before scheduling treatment. Compare facility fees, professional fees and ancillary service costs. Always request written estimates and keep copies.
3. Negotiate Self-Pay Rates and Payment Plans
Many providers offer discounted self-pay rates—often 20–40% off billed charges. Ask for a discounted flat rate or sliding-scale fee. If the total exceeds your means, request a payment plan with no interest or minimal fees. Get the agreement in writing and note payment due dates.
4. Apply for Financial Assistance or Charity Care
Hospitals and some clinics maintain charity care or financial assistance programs. Under Tenn. Code Ann. § 71-5-108, nonprofit hospitals must provide care at reduced cost based on income. Contact the hospital’s patient financial services or social work department to apply. Submit required income and asset documentation promptly.
5. Seek Community Health Clinics and Sliding-Scale Providers
Federally Qualified Health Centers (FQHCs) and free clinics offer primary care services on a sliding scale. Use the Health Resources & Services Administration “Find a Health Center” tool or call the Tennessee Primary Care Association at 615-460-8880 to locate low-cost clinics near you.
6. Document All Communications and Bills
Maintain a dedicated folder (physical or digital) for every document: estimates, bills, EOBs (Explanation of Benefits), payment receipts and correspondence. Record date, time, name of the person you spoke with and a short summary. For medical records, Tennessee law requires hospitals to retain records for at least 10 years under Tenn. Code Ann. § 68-11-202 (medical records retention) and grants patients access rights under Tenn. Code Ann. § 63-2-101 (patient access to records).
Helpful Hints
- Preserve all email and voicemail confirmations related to cost discussions.
- Use spreadsheets or budgeting apps to track expenses and payments.
- Ask for itemized bills that break down facility, physician, lab and pharmacy charges.
- Check charity care deadlines—some programs require submission within 60 days of billing.
- Consult nonprofit consumer advocacy groups in Tennessee for mediation services.
Disclaimer: This article is for informational purposes only and does not constitute legal or medical advice. Always consult a qualified attorney or medical professional for guidance specific to your situation.