How do I negotiate a medical bill down before it goes to collections?

Act fast and be organized. First, request an itemized bill and check every line for errors, duplicate charges, or services you never received, which are extremely common. Then ask about the hospital's financial assistance or charity care policy; nonprofit hospitals are required to have one, and you may qualify even with a solid income. Ask for the cash or prompt-pay discount and compare your charges to fair prices on tools like Healthcare Bluebook or the hospital's posted price list. Offer a lump-sum settlement for less than the balance, or request an interest-free payment plan. Get any agreement in writing before you pay. Under new federal rules, most medical debt is being removed from credit reports, but negotiating still saves you money.