r/HospitalBills • u/cr1merobot • 12d ago

Negotiating with a hospital for immunotherapy

I am looking for advice preferably from people who have worked within hospital systems especially in the billing department.

I have POTS and I have tried a number of medications while working with a POTS specialist and none of them have worked. The POTS doctor was reluctant to suggest a potentially beneficial treatment (VIG immunotherapy) due to the cost. In his experience regardless of the impact that POTS is having on my functioning, my insurance company (BCBS carefirst) is almost certainly not going to pay for the treatment.

Whats worse is, according to the doctor the infusions are 14,000 USD per month for a year. Now i can technically afford it but I would hugely prefer not to pay 168k in a year to not feel bad anymore. I am currently waiting for one more week for a follow up from my doctor to get a referral for the treatment itself, at which time I will take the referral to an infusion center/hospital that can perform it.

now my question is this: Is there a way to leverage my ability to pay cash for this treatment into negotiating power with the hospital/infusion centers billing department? I would imagine instead of waiting months to get compensated by insurance or receiving partial payment, they would rather receiving cash for the service or even prepayment for a number of services at a discount.

Is this possible?

TL;DR: How do I get a discount on much needed immunotherapy? only suckers pay retail

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u/cr1merobot 12d ago

where did you get your medical degree genius. read the studies.

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u/Mymarathon 11d ago

Guidelines: Current expert consensus (e.g., Dysautonomia International, Heart Rhythm Society) does not recommend IVIG as routine therapy. It may be considered in rare cases where there’s strong evidence of autoimmune involvement and other treatments have failed.

Risks: IVIG is expensive, requires infusions, and can cause side effects like headaches, blood clots, kidney strain, or aseptic meningitis.

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u/cr1merobot 11d ago edited 11d ago

I have a co-occurring autoimmune disorder (celiac) as well as elevated IGE and IGA levels with no other explanation. As I explained in my post I have failed 4 medications over the last 6 months.

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u/No-Zookeepergame-301 11d ago

Your elevated ige and IGA levels are likely related to celiac, that's completely unrelated to POTS, which is not autoimmune mediated