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GREENSBORO, NC -- Medical bills are the leading cause of personal bankruptcy. Nerd Wallet Health estimates medical debt drives 60% of bankruptcy. Overall, one in three American adults struggle to pay their medical bills--even if they have insurance.

You certainly can be put on a payment plan that fits your budget-- just work with the billing department. But there are ways to lower your bill too.

First, the Do It Yourself option. Look over the itemized list or bill for errors. Nerd Wallet estimates 50% of medical bills have errors like an extra day charge or a drug that was only given once a day, but it shows up three times a day

Next, find the fair price for the treatment, procedure or hospitalization you had. It takes some digging, but there are at least three on-line sites you can check: ClearHealthCosts, NerdWalletHealth, HealthCareBlueBook.

"A fair price is hard to come by in our medical billing system, but in recent years there has been more transparency on price," says Christina Lamontagne. "Patients can look up the cost of common treatments or hospitalizations and know if the price they were billed is fair. Another way to do this is to look at what medicare reimburses for procedures. And this would not be uncommon to find your procedure was 2 or 3 times what medicare charges. You then have a powerful tool to go back to the hospital and say 'the government thinks the price of this is X why am I being charged three times X?' "

Christina says be ready to negotiate your bill: have your insurance card and plan, an estimate of benefits statement and you definitely want the itemized list or bill in front of you too.

"Many hospitals and doctors will respond to negotiations. They want to get paid ultimately for services rendered and payment can be couched in terms of what is fair to pay."

Bill negotiations can take weeks or months. So hang in there. If do-it-yourself isn't for you and your bill is big, like in the thousands, Christina says hire a professional.

"A patient advocate charges sometimes about $50 and hour. So to save $5,000 it may cost $200 or $300, but that math can make sense if you're saving several thousand dollars in the long run."

As with hiring anyone-- check the patient advocate out too. And know the terms of service and estimated costs BEFORE you give any money.

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