Negotiating with a hospital for immunotherapy

[u/cr1merobot]

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

[u/FoldNaive5660]

You’re absolutely right to explore this — and yes, cash can definitely give you leverage, especially when you’re looking at $168K out of pocket.

Hospitals and infusion centers routinely discount for self-pay patients — sometimes 40–70% off. Insurance companies negotiate deep discounts, so if you’re offering cash (especially upfront), they know it’s a sure thing and often faster than waiting for insurance reimbursement.

Here’s how to approach it:

• Wait until you have the referral, then call the infusion center’s billing department directly and ask:“What is the self-pay or cash-pay rate for this treatment? And is there a discount if I pay upfront for multiple sessions?”Don’t use the word “retail” — they won’t like that — but talk like someone ready to make a deal.
• You can also ask to speak to someone in financial counseling or billing escalation, not just front desk.
• If the hospital gives you pushback, look into independent infusion centers — they often have more flexibility on pricing.

Also — you might want to check out MediLoop — they help people negotiate high-cost treatments and navigate insurance or billing issues. You upload your estimate or bill, and they can help challenge the pricing or get it reduced.

You’re smart to question the “retail” cost — it’s almost never what people actually pay. Keep pushing.