For patients with hospital bills · Billing department calls
You have the itemized bill. Rehearse what happens when they say “that’s our standard rate.”
The Medicare comparison is printed. You still don’t know what you’ll say when billing puts you on hold and comes back with a number.
The ER bill arrived: $14,200 for a two-night stay. You pulled the itemized statement, looked up CPT codes on Turquoise Health, and found Medicare pays roughly $3,800 for the same services. You’re ready to call billing. What you can’t picture is citing those benchmarks and then sitting on hold while a rep says “chargemaster rates are non-negotiable” and offers a 10% self-pay discount if you set up a payment plan today. Kommi puts you in that call first — with a billing rep who pushes back the way real hospital billing departments do — so your first real conversation isn’t your first take.
The itemized bill isn’t the hard part.
Every medical-bill blog has the same playbook: request an itemized statement, compare charges to Medicare rates, ask for financial assistance under IRS 501(r), escalate to a supervisor. You have the CPT codes highlighted. What you don’t have is muscle memory for when billing says “I can offer 15% off if you pay today” and you have to decide in real time whether to accept, ask for a supervisor, or hold your anchor without sounding hostile.
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What’s at stake
Accepting chargemaster rates on a $14,200 bill when Medicare pays $3,800 costs $10,400 you may not owe. One soft conversation on the phone can lock in the full balance before you finish negotiating.
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Why you procrastinate
You dread being put on hold, talked down to, or rushed into a payment plan. You keep rereading the dispute letter but skip the part where a rep says “that’s all I’m authorized to offer.”
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What scripts can’t do
Negotiation scripts give you opening lines. They can’t simulate billing going quiet after you cite Medicare, then pivoting to “would you like to set up monthly payments?” before you’ve finished your ask.
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What advocates cost
Patient advocates charge $150–$400/hr or 25–35% of savings. You need to know whether you can hold the line credibly yourself before you hand over a third of what you save.
Sample roleplay · 3 minutes
“Our chargemaster rate is the standard charge. I can offer 15% if you pay today.”
You’re Jamie. You’ve reviewed the itemized bill. Now you’re on the phone with hospital billing.
You (Jamie)
“I’m calling about account 8847291 for my ER visit on March 12. I’ve reviewed the itemized bill and compared the charges to Medicare reimbursement rates for CPT 99285 and the facility fees. The total of $14,200 is roughly 3.7 times what Medicare pays for the same services in this area. I’d like to discuss adjusting the balance to a fair market rate.”
Billing representative
“I understand your concern. Our chargemaster rates are the standard charges for all patients. We don’t apply Medicare rates to self-pay accounts. What I can do today is offer a 15% self-pay discount — that brings your balance to $12,070 — if you’re ready to set up a payment plan or pay in full. Would you like me to process that?”
Your move
- → Decline the payment plan until the balance is adjusted — plans often lock in the full amount
- → Ask for a supervisor or patient financial counselor with authority to adjust chargemaster rates
- → Request the financial assistance application (501(r)) and ask collections be paused while you apply
Each choice changes how billing responds. The conversation gets bureaucratic and uncomfortable. You practice holding your Medicare anchor without sounding adversarial — or catching yourself when you’re about to accept 15% off because the rep made it sound like a favor.
Then the coach reads you back to yourself.
Not a patient-rights checklist. Not a list of billing codes. One observation about what you did, one adjustment for next time, one sentence you can carry into the billing call.
Sample coach debrief
“You opened with the account number and cited specific CPT codes with Medicare benchmarks — strong, data-driven start. When billing offered 15% off for immediate payment, you said ‘that helps, let me think about the payment plan’ before asking for a supervisor. That signals you’d accept $12,070 before finishing the negotiation.
Try next time: Pause after the discount offer. Say: ‘I appreciate that, but 15% off chargemaster still leaves the bill at roughly double Medicare rates. I’d like to speak with someone who can adjust the underlying charges — or send me the financial assistance application while we discuss this.’
Carry into the call: ‘I’m not disputing that I received care — I’m asking the balance reflect what insurers and Medicare actually pay for these same services. What would it take to adjust account 8847291 to that range, and can you send me confirmation in writing before I agree to any plan?’”
Questions before you call billing
- Is this for insured patients or self-pay only?
- Both. Insured patients often negotiate the patient-responsibility portion after a high deductible or out-of-network surprise. Self-pay patients anchor to Medicare or commercial negotiated rates. Kommi rehearses the live phone conversation — where you cite benchmarks and respond to pushback in real time.
- I already have scripts from a medical-bill blog. Why practice?
- Scripts tell you what to say on the first call. They don’t prepare you for billing offering a token discount, rushing you into a payment plan, or saying “that’s all I’m authorized to offer.” Kommi is where you hear yourself respond under pressure — and fix the fold before it costs you thousands.
- What if they say chargemaster rates are non-negotiable?
- That’s one of the most common paths in the roleplay. You practice asking for a supervisor, requesting financial assistance paperwork, and refusing to commit to a payment plan until the balance is adjusted — without escalating into anger that gets you nowhere.
- Is $11.99/mo worth it for one hospital bill?
- Saving $5,000 on a single bill pays for decades of Kommi. Patient advocates charge hundreds per hour or a cut of your savings. You also get unlimited sessions across every scenario we ship: salary talks, rent negotiations, manager feedback, and other hard conversations.
$11.99 a month.
A coach with a calendar runs two hundred dollars an hour. Kommi runs roughly forty cents a day — and is awake when you can't sleep, which is when most of these conversations are actually being rehearsed anyway.
We don't have a free tier, a team plan, or a premium upsell. One price, no pricing page riddle. If we add tiers later, we'll do it because users asked — not because a growth deck did.
About forty cents a day.
- Two free sessions before billing starts
- Then $11.99 a month — about forty cents a day
- Unlimited sessions — any conversation you can describe
- A coaching read after every session, and your progress over time
- Cancel in two taps; 7-day refund if you change your mind
One conversation you’d have talked yourself out of is worth years of this. Or just sleep better on Wednesday. Either way.
Run your first rehearsal — free →US only at launch. We'll get to the rest of the world.
The conversation is on Thursday. Begin tonight.
Three minutes. Two free. 7-day money back after that.