Call the hospital, get the billing department ask if you can talk to someone about reducing the bill.

I had a similar situation once, said my chest hurt and everyone freaked out and I ended up with a 5k ER bill. With no actual answer to why my chest hurt, and was still hurting.

I talked to the hospital they set up an appointment with a woman, I showed bank statements, income, insurance information. Ultimately, because I had very little income or money at the time. They just forgave the entire amount. No more bill.

Definitely worth a shot.

Ask for an itemized bill.

Man, every time I read anything about the US healthcare system it gets more dystopian - I'm sorry you are having to deal with this nonsense

Most (all?) health insurance companies in USA have clauses in their agreements with in-network providers (ie doctors, hospitals, pharmacists) to permit a covered patient to first receive the Explanation Of Benefits (EOB) document from the insurance company first, before having to pay a provider. In fact, waiting for the EOB is highly advisable, because paying a provider's bill in-full and then later having to obtain a refund because the insurer paid out is akin to pulling teeth (that is, painful and difficult).

The EOB also shows which claims the provider actually filed with the insurance company, which if full-and-complete means you should not expect to make any further payments for services received.

To be clear, the EOB also includes any amount which the covered patient is known to have paid at the time of service. For example, most in-network doctor's offices will charge the insurance policy's copay on-the-spot before seeing the doctor, since this is a known, fixed amount and insurance will pay the doctor some sort of negotiated remainder.

You should verify the EOB reflects any copays you've already paid, and that the costs have accrued toward whichever deductible applies to you -- more than one deductible can be at play.

To answer your question directly, I would not start any negotiation until you have the EOB in hand, because otherwise you are negotiating blind: you won't know which claims have been filed, and you won't know how much insurance has agreed to already pay.

There were some good tips in this podcast episode: https://www.npr.org/2023/07/28/1190725808/tackle-your-medical-debt-with-life-kit

They often have a cash price that's cheaper, but if you ask for that they won't bill your insurance and you'll never meet your deductible.

American Healthcare