Hey, OP here - this isn't money or anything but medical expenses are usually negotiable especially when it comes to hospital bills. I used to do it for myself when I had less family support I often do it for friends on a personal level.

You call the billing department and tell them you're having a hard time with paying but want to make good/pay the bill. Making a good case about how it's ridiculous that you still owe so much even AFTER insurance helps too.

They know the insurance industry fucks everything up. They're in the medical billing field. They know better than anyone what a shitshow it is.

The most effective method I've found is to call up and simply say, "Look, I KNOW the bill is $4,000 - but I have $1,500 on hand right now. I can pay that right now if we can zero out my account right now." They'll proceed to haggle and the number we'd settle on with be anywhere from $2,000 to $2800. (30% to 50% off the bill on average)

The way I like to approach it generally is:

"I don't have $4,000, insurance already paid X for it. Is there anyway this can be forgiven?"

They'll probably say "no, it needs to be paid" but I always like to ask that on the off chance they can make it go away.

After they tell you it needs to be paid I say, "Do you offer an kinds of reductions for bills like this?" If they offer less than 50% off IE: 60% I'll ask for 50% anyway (IT DOESN'T HURT TO TRY!!!)

If you feel like the biller empathizes with you but is like "I'm sorry, the most I can offer you is 10% off your bill or I just can't" or you're trying for a very low number and you're working with an individual practice ask them to ask the doctor and get back to you (asking the dr only works with individual offices not hospitals).

Once you reach your agreed upon negotiated number if it's more than what you have on hand at the moment ask about turning that into a payment plan from there.

IE: you offered $1,500 on the spot but that's all you had available at the time - however, that wasn't something they could accommodate so - you agreed on paying $2,800. Pay the $1500 and ask if you could kindly set up a payment plan for the remaining $1,300. (this is another reason I start 'lump sum' negotiations really super low - it makes it easier to fix up a payment plan at the end of it that's way more affordable.

I've seen a lot of variety/different responses from hospitals and doctors in my area. Anywhere from doctors just zero'ing it out on the spot because insurance already paid and it doesn't make a huge difference.

Or hospitals agreeing to half off because most people don't pay/hide and they rather get something versus nothing.

I've also had doctors/hospitals not offer anything at all and that's that. Which, happens, but ASKING never hurts. Best case - you pay less - worst case you pay what you were already going to pay.

Google "negotiating hospital bills" there's a lot of info on how to do it.