#Less Payments

[xtruss]

How To Not Pay Your Medical Bills! Actually, That’s Easy. This Is How I Paid A Lot Less.

— By Joel Stein | February 20, 2025 | Wall Street Journal (WSJ)

Illustration: Ryan Johnson

As you probably recall, I had a mole removed about a year ago. As fresh as this is in all of our memories, a year is a fair bit of time, so I was surprised to get a bill in the mail for $604.80 from a company called DermTech. Apparently, much like wedding gifts, you have a year to send someone a medical bill.

And like a wedding gift, this bill included a friendly note: “Thank you for selecting DermTech for your healthcare needs.” This wasn’t exactly true since, before this bill arrived, I had never heard of DermTech. There was no point in my mole removal process where I said, “Hey doc, if you wind up putting a small sticker on my back to test this mole for basal cell carcinoma, make sure that sticker is from DermTech and not those clowns at DermaSensor or Fujirebio.”

Had this bill been for anything besides health care, I would have been far more surprised. If a restaurant supply company mailed me an invoice, explaining that they had encountered some extra expenses for a burger I ate at a restaurant a year ago, and now I owed them $604.80, I’d be confused. Especially if that restaurant didn’t have prices on its menu.

Luckily, I’d been through this unexpected, unexplained medical bill situation before, due to the fact that I’m an American. So I knew that I did not need to review the specifics. Such as the $1,485 original charge, which my insurance company had paid/adjusted by $880.20, thereby reducing the cost of the testing sticker to $604.80.

I knew that these were completely made-up numbers. My high school friend is the vice president of data analytics at a huge hospital. She’s assured me that she does not make up numbers. She determines prices using data and analytics and vice presidency. Yet, by the time bills go through insurance companies or government agencies and get to patients, they are indeed totally made up.

The American healthcare system is not the only marketplace with made-up numbers. There are also Middle Eastern bazaars, used car lots and Pentagon budgets. And wherever there are made-up numbers, you can bargain.

I knew I could do well in a negotiation because DermTech, despite advancing sticker technology more than anyone since the engineers at Scratch and Sniff, is desperate. When you Google “DermTech,” the first result in the “People also ask” section is “Whatever happened to DermTech?” The answer Google provides is “DermTech has filed for Chapter 11 bankruptcy protection and laid off 20% of its staff.” When a company can’t make money on $1,485 stickers, there are definitely holes on the business side you can exploit.

I also had leverage because I knew that a huge portion of people don’t pay their medical bills, causing companies such as DermTech to sell these bills to collection agencies for pennies on the dollar. Plus, a 2023 law prevents medical debts of less than $500 from even showing up on your credit reports.

I called the number on the bill. I used a friendly voice to tell the friendly woman on the phone that I’d like to pay my bill right now, but I’d like to pay a lot less. I did not tell the woman that the bill was unfair or that I didn’t have the money or that a year is a long time to wait to charge someone for a sticker. I simply offered to pay less.

She immediately offered me a “20% prompt payment discount.” Which would reduce my $604.80 bill to $947.84. This seemed like the kind of faulty math that would explain DermTech’s Chapter 11 problems.

Then the friendly woman typed furiously and discovered that another DermTech bill was coming in a few weeks for about $580. This was for a second sticker I’d also used a year ago, one that was apparently about $24.80 crappier than the first sticker.

I told her I’d pay both bills right now for a much bigger discount than 20%. She offered me 50% off. I offered her $200 for both stickers. She said she’d check with the manager and get back to me. I had the feeling I was going to drive out of there with a brand new 1964 Coupe DeVille. She called back and said DermTech would accept $300 for the entire $1,184.80 bill.

Was I happy about paying $300 for stickers from a year ago that I never asked for? Extremely. Because there’s nothing more exciting than getting a great deal. It felt even better than finding out I didn’t have skin cancer.

A couple of weeks later, I called DermTech to tell them I was writing about my experience and wanted to find out if I could have done even better than $300. Loren Clarke, the company’s chief medical officer called me right back. He said the new, leaner, privately owned DermTech couldn’t legally talk about the large, bankrupt DermTech, even though they had the same staff and used the same stickers. I promised never to talk about old DermTech, even at home with my child.

Clarke was more upset about my bill than I was, and not because I had screwed him out of $884.80. “The billing team doesn’t want to take people’s money. They want the patients’ insurance to pay for it. I’m glad they were willing to work with you so easily,” he said. His challenge is that if insurance companies find out DermTech is cutting patients’ bills, they’ll claim they violated their contract and stop paying them. They’ll start to wonder if that sticker is as expensive as they claim.

The $1,184.80 wasn’t for the stickers, Clarke explained. It was for the four lab technicians who spent two days removing skin cells from stickers, extracting the RNA, converting it to DNA, amplifying the results by polymerase chain reaction and going to a therapist about being unable to explain what they do for a living without boring everyone. And the sticker technology was much cheaper, more accurate, and less painful than the usual practice, a biopsy. Much like it is easier to use a sticker than to scratch and sniff an actual skunk.

The DermTech billing department was indeed empowered to “find whatever they can to work with you.” But my negotiating technique, Clarke said, wasn’t perfect. “If you had called and were irate, they can sometimes reverse the claim and write it off. If someone is really upset with us, we want to take care of that.”

Clarke suggests that patients save their angry calls for the huge corporations in no danger of filing for Chapter 11, the ones who don’t even provide medical services: health insurance companies. I told him that while I was tempted by the prospect of spending three hours being transferred around Blue Shield and then ignored, it didn’t sound nearly as satisfying as screaming at his billing department.

Now that I know all of this, at my checkup next year, I’m going to ask for a whole lot of stickers.

— Joel Stein, A Former Columnist for Time, Writes a Substack Called “The End of My Career” and is the Author of “In Defense of Elitism.”

[hamletthedane]

Middle Earth map mural is complete! Definitely the coolest thing in my house right now.

…and it only took ten paint pens and three seasons of the West Wing to finish 😅

(“But what about the resale value??” my relative asked me when I started this project. Look, I do not make an ungodly mortgage payment every month just to treat my house like a rental. That’s what they invented primer and paint for :))

Before/afters under the cut:

[kirby-the-gorb]

[blackbatest]

Talia, pushing Jason into the Lazarus Pit: I can fix him (Bruce) by fixing him (Jason)

[moodstabilizr]

i lost my id and debit card a week ago so i’ve just been carrying around a empty wallet with a picture of pedro pascal in it

[starryeyed-seer]

Grietje spent most of her childhood as a street urchin, which always surprises people

The gang was THE CRAB-BADGERS. A small gang which had territory along the river, and a hideout beneath Hood's Bridge. "Hideout" is a strong word— behind a section of crumbling wall, they've built a den in an old section of London underworks. The wall can be "sealed" behind them to hide from the constables. Their hideout has three "rooms", and the kids sleep in a big pile in the largest, huddling for warmth.

They're called the Crab-Badgers because FIRST CRAB you as you cross the bridge (harass you for money, food, and surround you until your back is to the railing). If you don't give them anything, they BADGER you (throw you over the bridge into the river, at which point other members steal from you while dragging you out)

Crab-badgers also enjoy mudlarking, and tend to develop surprisingly robust immune systems.

[starlos-soulmate]

$13.50/hr to stand around advertising macaroons when I had a job two years prior doing a similar thing for $17/hr. Standing around doing nothing. $13.50/hr.

Oh if I visit her this weekend bc I didn't get another job offer I'm asking to raise the price. I didn't severely damage my leg last year for a buck more because the starting pay is $13.50. Yes I'll get the money for the next two semesters but good. Heavens.

[queenofnots]

Welp took out my first and hopefully final personal loan to pay off my credit card. Don't go into debt folks. 🙃

[juniepops]

also i HATE having to put my legal name on forms especially ones that give me an option to put my chosen name on there. why do you even need my legal name then. i don't think you're even going to do anything that would require it

[daintydoilypon]

Gonna be kinda all over until the end of the month. Silo put in his two week after a lot of abuse from his superior, like utter misandry and discrimination due to his ADHD. I don't use buzz words lightly, this woman deserves it.

Though this is better overall for his mental health, and when he does get another job, it's a guaranteed 20k at minimum increase, he doesn't have another job lined up. Due to his mental health, I did involve his family and his parents are not gonna charge us rent next month, so we're good for now. However, if it takes longer than that, OOF.

I may advertise my commissions and adjust the prices soon, to kinda make a cushion, but I ain't gonna die if I don't get any.

((I'll reply to the things I was tagged in tomorrow, it's quite hectic atm ahhhh))

[arolesbianism]

Hiiii besties I um. Rly want money. Would anyone want a tweened icon like these for like $20? I'm usually pretty fast with them so it shouldn't take longer than like a few days max

[eyepatchdate]

my parents paid off one of my loans yayyyyyyyyyyyyyyy

[dreamlogic]

in boring adult annoyances, i recently converted my checking account to a different type of checking account with the same credit union. i've done this a couple times over the years cuz it's the same checking account my dad helped me set up when i was 13 and this CU is still my primary financial institution. asked the banker

"will my account number remain the same?"

"yes, we're just converting it to a different type of the same account!"

"so my direct deposit and autopays won't be impacted?"

"correct!"

"and i can still use the same debit card i've been using for the last ~6 years!"

"absolutely!"

"great, let's do it."

fast forward to this week, when three of my autopay bills bounced, my debit card isn't working, and a closer look at my account number shows a 1-digit change at the end. go back to the same branch like "hey no offense but what the fuck??"

different banker takes a look at my accounts, makes a Face, and politely casually asks "so where did you go to make the switch? :)"

"here, this branch. that person over there was actually the one who helped me."

The Face intensifies. ".....Ah. I See. well, it looks like the way the changes were made may have Disrupted some things. you're gonna need a new debit card, etc, i'll get that printed for you ASAP."

[5 minutes later the banker who fucked up the first transaction sheepishly approaches me to hand over my new debit card & apologize profusely.]

[kedreeva]

How did you get into keeping peafowl? They're one of those animals that I'd love to keep but have unfortunately made peace with the fact I probably won't have time and space to care for them in the future.

I loved them, and I was an asshole about it.

I lived with my mom in the suburbs, and purchased hatching eggs from eBay (don't do that), and a styrofoam incubator (don't do that), and hatched them in my closet (definitely don't do that) and brooded them in my bedroom (don't do that). A friend of my mom had recently got a farm, and agreed to keep them in a pen at her place until I bought a house, at which point I went out, got a stable full time job, started putting away money for a down payment, and seeing a real estate agent to look at hobby farms. About a year later, I found one that fit my criteria (house I didn't have to repair too much stuff in, acreage, barn), got a mortgage, and started building pens with my family.

This is, I feel I should not have to say, NOT the way to go about getting into peafowl. But I did turn my life around for them, so I can't complain about the end result.

That being said... I wouldn't give up entirely if I were you, if they are what you want in life, but I would just bear in mind that the road to them may be harder than you want to endure depending on your starting point. If you can acquire a dwelling space where they're allowed (it doesn't need to be "livestock" area, since some places consider poultry to be different than livestock, and peafowl fall under poultry), and you're willing to build them a pen, their care isn't particularly intense or anything. The space to keep them is the major hurdle.

[oktobearfest]

the Miniso Chopper plush I ordered from Indonesia arrived last night!! Bigger than I expected and he can't hold his head up on his own but he's perfect

[craneboys]

how it feels to spend 40 dollars on doordash