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Why disputing a medical bill may help cut your costs

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Consumers may feel their medical bills are unyielding, inflexible, set in stone. But that’s not always true: A new study shows patients can often reap financial benefits by disputing charges that seem erroneous or by negotiating for financial relief.

Of consumers who don’t reach out to question a medical bill, 86% said it’s because they didn’t think it would make a difference — but “the experiences of those who did reach out provide evidence to the contrary,” according to a new University of Southern California study.

About 26% of people who called because they disagreed with a charge or couldn’t afford to pay it got their medical bill corrected after the outreach, according to the study, published in August. Roughly 15% got a price reduction, 8% got financial assistance and 7% saw their bills canceled outright.

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“Of the people who did reach out, most of them got some recourse through self-advocacy,” said report-co-author Erin Duffy, a research scientist at the USC Schaeffer Center for Health Policy and Economics.

Researchers polled 1,135 U.S. adults from Aug. 14 to Oct. 14, 2023.

About 1 out of 5 respondents reported receiving a medical bill with which they disagreed or could not afford within the prior 12 months. About 62% of them contacted the billing office to address the concern.

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“If you can’t afford to pay something, or [if a bill] doesn’t seem right or match what your care experience was, you should call and ask questions about that,” Duffy said.

Savings can extend into the hundreds or even thousands of dollars, depending on factors like a patient’s health insurance and the type of medical visit or procedure, said Carolyn McClanahan, a physician and certified financial planner based in Jacksonville, Florida.

Bills ‘go all over the place’

A 2023 Consumer Financial Protection Bureau analysis of medical bills for adults age 65 and older found that patients “face a complex billing system with a high likelihood of errors and inaccurate bills.” Often, inaccurate bills result from erroneous insurance claims and occur more frequently among consumers with multiple sources of insurance, the CFPB said.

Common errors included missing or invalid claim data, authorization and pre-certification issues, missing medical documentation, incorrect billing codes and untimely filing of claims, the report found. Such mistakes contributed to the “rejection of claims that would otherwise be paid,” it said.

“[Bills] go all over the place,” said McClanahan, the founder of Life Planning Partners and a member of CNBC’s Advisor Council. “And there’s no transparency or rhyme or reason for how [providers] decide to charge.”

Doing nothing and avoiding payment of medical bills is likely not a good course of action: It could have negative financial consequences, such as late fees and interest, debt collection, lawsuits, garnishments and lower credit scores, according to a separate CFPB resource.

“If something seems egregious, question it,” McClanahan said.

How to manage medical bills

If something seems egregious, question it.

Carolyn McClanahan

physician and certified financial planner based in Jacksonville, Florida

The phone number for your medical provider’s accounting or billing office will be on your billing statement, the CFPB said.

Here are three other questions to consider asking about your itemized bill, according to the regulator:

  • Do charges reflect the services you received?
  • If you have insurance, do the bills reflect the payment by your insurance and reflect what the provider understood would be covered?
  • Do any of the charges indicate a service was “out-of-network” when it wasn’t?

When calling a provider about a medical bill, keep a journal about the communication, McClanahan said. Write people’s names and what was discussed, and get a commitment of when you’ll hear back.

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How to optimize your holiday travel budget on ‘Travel Tuesday’

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Is 'Travel Tuesday' a gimmick or a chance to save on your next trip?

If you still haven’t booked your holiday travel plans, take note: Prices tend to rise the closer you get to the days you’re looking to travel

To afford holiday trips, about 50% of respondents are cutting back on other expenses while 49% are picking up discounts and deals, according to the 2024 Holiday Travel Outlook by Hopper, a travel site.

Some last-minute holiday travelers are leaning into so-called “Travel Tuesday” — or the Tuesday after Cyber Monday and Black Friday — which falls on Dec. 3 this year.

Search interest for Travel Tuesday rose more than 500% from 2021 to 2023, according to a recent report by McKinsey and Company.

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There’s a reason why shoppers are searching for the term.

Last year, 83% more deals were offered on Travel Tuesday versus Cyber Monday and 92% more than Black Friday, according to Hopper data.

Yet, there may be some limitations on the deals available, experts say.

“The challenge for a lot of people is, ‘Do I wait?'” said Sally French, a travel expert at NerdWallet. 

For travelers who are set on specific days and places to visit, the answer might be “no.”

“While airlines and online travel agencies are going to offer flight deals on Travel Tuesday, there is no reason to wait,” said Phil Dengler, co-founder of The Vacationer, a travel platform.

How much you benefit from potential discounts on Travel Tuesday will depend on your flexibility, experts say. 

“If you have zero flexibility,” said Hayley Berg, economist at Hopper, then “if you see a good deal before Travel Deal Tuesday, feel free to book it.” 

How Travel Tuesday works

People wait in line for security checkpoints ahead of the Thanksgiving holiday at O’Hare International Airport in Chicago, Illinois, U.S. November 22, 2023. 

Vincent Alban | Reuters

Similar to Black Friday and Cyber Monday sales, Travel Tuesday deals sometimes begin to roll out before the day itself, said Dengler. They might even stretch into the day after. 

Nonetheless, you will typically need to book the flight, hotel stay or cruise trip by the end of the day in order to reap the benefits, he said. 

As you shop, make sure to read the fine print in case discounts only apply for certain routes and days, Dengler explained. 

Retailers often have a limited stock for Black Friday and Cyber Monday doorbusters. With Travel Tuesday, there may be a limited number of airline seats or hotel rooms, NerdWallet’s French said.

“They’re not going to fly two planes on the same route at the same time,” she said.

‘Be ready’ to book

Travel Tuesday might be better suited for deciding when and where you’ll go for an upcoming vacation in 2025, versus a very specific itinerary home over the holidays.

If you are not flexible on the days and destinations you plan to travel to and you find a flight available at a price you’re comfortable with, “book that trip right now,” French said. 

“If you wait until Travel Tuesday, then that deal could be gone,” she said. “You don’t want to wait for Travel Tuesday for it to be sold out.”

In some cases, it doesn’t hurt to book ahead and keep browsing for potential price drops, experts say.

You typically have 24 hours from booking to cancel for a full refund as long, as it’s seven days before a flight’s scheduled departure time, Dengler said. Plus, some airlines don’t have change fees for non-basic economy fares, he said.

If those terms are in your favor, “if you see a better deal on Travel Tuesday, simply cancel your current bookings and book the Travel Tuesday offer,” Dengler said.

On the flip side, if you’re less tied to specific dates and places, but have a general sense of where and when you want to travel, then holding off until discount days may be worthwhile.

“We tend to see the deals do get better and better the closer we are to actual Black Friday or actual Travel Tuesday,” French said.

The biggest takeaway for travelers is to start thinking about what you might want to book, Berg said. 

“I really encourage travelers to do that exploration now so that on Travel Deal Tuesday, they can be ready to actually book,” she said.

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How to leverage the 0% capital gains bracket as bitcoin surges

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Crypto investors could face higher taxes amid the surging price of bitcoin. But if you’re in the 0% capital gains bracket, you can reduce future taxes with a lesser-known strategy, experts say. 

The tactic, known as tax-gain harvesting, is selling profitable crypto in a lower-income year. You can leverage the 0% long-term capital gains rate — meaning you won’t owe taxes on gains — as long as earnings are below a certain threshold. The 0% bracket applies to assets owned for more than one year.

“That’s a very effective strategy if you’re in that bracket,” said Andrew Gordon, a tax attorney, certified public accountant and president of Gordon Law Group.

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The income limits for 0% capital gains may be higher than you expect, Gordon said.

For 2024, you qualify for the 0% rate with taxable income of $47,025 or less for single filers and $94,050 or less for married couples filing jointly. The brackets are higher for 2025.

You calculate taxable income by subtracting the greater of the standard or itemized deductions from your adjusted gross income. Your taxable income would include profits from a crypto sale.

For example, if a married couple earns $125,000 together in 2024, their taxable income may fall below $94,050 after they subtract the $29,200 standard deduction for married couples filing jointly.

Use the 0% bracket to reset your basis

You can also use the 0% capital gains bracket to reset your “basis,” or the original purchase price of crypto, according to Matt Metras, an enrolled agent and owner of MDM Financial Services in Rochester, New York.

If you’re in the 0% bracket, you can sell profitable crypto to harvest gains without triggering taxes. Then, you can repurchase the same asset to maintain your exposure.

However, experts suggest running a tax projection to see how increased income could impact your situation, such as phaseouts for tax breaks.

The price of bitcoin was hovering around $90,000, up more than 100% year-to-date, as of the afternoon on Nov. 18. The value briefly hit a record of $93,000 last week in a post-election rally.

It’s obviously hard to predict future price increases. However, some investors expect a boost under President-elect Donald Trump, who promised pro-crypto policies on the campaign trail.

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Number of older adults who lost $100,000 to fraud tripled since 2020: FTC

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Karl-Josef Hildenbrand/Picture Alliance via Getty Images

The number of older Americans who report losing more than $100,000 to fraud in a given year has more than tripled since 2020, according to the Federal Trade Commission, a trend that experts say represents a grave and growing threat to older adults’ financial security.

In 2023, about 4,600 adults age 60 and older reported being defrauded of a six-figure sum, according to a report the FTC issued in October. That’s up from about 1,300 in 2020.

Such thefts can be especially devastating to older adults, who have less opportunity to earn back what they’ve lost, greatly impacting their quality of life in old age, experts said.

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“It’s life altering,” said John Breyault, vice president of public policy, telecommunications and fraud at the National Consumers League, a consumer advocacy group.

Aside from the financial blow, victims also bear the emotional “trauma of knowing they have to live rest of their life in poverty,” Breyault said.

Common scams targeting older Americans

Consumers overall lost $10 billion to scams in 2023, a record high, according to the FTC.

The figure is also $1 billion more than the fraud loss reported in 2022, despite the number of fraud reports being roughly the same, at about 2.6 million, the FTC said.

“Scammers are really getting more sophisticated, better at what they do and the technology they’re using seems to allow them to target victims with ever more precision,” Breyault said.

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Adults age 60 and older reported losing more than $1.9 billion to fraud last year, up from $1.6 billion in 2022, the FTC said.

The true scope of losses by older adults was likely significantly higher — around $62 billion in 2023 — after accounting for underreporting, the FTC said. Many Americans may not report these crimes to the police or other sources partly due to embarrassment about having been duped or because they assumed nothing could be done, according to a 2023 Gallup News poll.

Older adults were 60% more likely than younger ones to report losses exceeding $100,000 last year, according to the FTC. Criminals commonly stole such vast sums from older adults via romance scams, investment frauds and imposter scams, the FTC said.

Imposter scams often involved fraudsters impersonating friends and family or agents from technology firms like Microsoft, sweepstakes and lottery companies like Publishers Clearing House, institutions like banks and government agencies like the Social Security Administration, the FTC said.

The Federal Bureau of Investigation has also detailed a stark increase in internet crime defrauding older Americans in recent years. The average victim in that age group lost more than $34,000 in 2023, the FBI reported.

Investment scams, especially those involving fake cryptocurrency investment opportunities, accounted for the largest reported losses among all older adults in 2023: $538 million, up 34% from 2022, the FTC said.

3 common red flags of a scam

“We’d all like to believe we could spot an online scam a mile away,” the National Council of Aging wrote this year. “But the truth is that con artists and cybercriminals are getting craftier and more sophisticated by the day.”

That said, would-be victims can protect themselves by recognizing three common tactics used by scammers, Breyault said:

1. Sense of urgency

Criminals often try to create a “heightened state of emotional urgency,” Breyault said.

This psychological tactic pushes victims to act impulsively, rushing them into making decisions or providing sensitive information without thinking, according to NCOA.

“Fraudsters may say an offer is good for a limited time only, a product is about to run out, or that you must make a payment immediately to prevent negative consequences,” NCOA said.

2. Social isolation

Scammers try to prevent consumers from talking to a third party. For example, they might say, “Don’t tell anyone about this. Don’t go to the cops. This is an investment no one knows about so don’t tell anyone about this. It’s our little secret,” Breyault said.

“If you’re unsure about the person you’re talking to or what you’re being told, ask a friend or family member for advice before taking any further steps,” NCOA said. “Sending a quick screenshot of a text, or simply walking through the scenario with someone you trust, can often help you see things more clearly.”

3. Unusual ways to pay

Criminals often ask victims to make a payment by buying gift cards, sending a wire transfer, going to a bitcoin ATM, or sending money through a peer-to-peer transaction on a platform like Zelle or Venmo, for example, Breyault said.

Consumers generally don’t have recourse to be refunded money in such circumstances, he said.

While there are “legitimate” uses for such payment methods, they often appear “unusual” in the context of a fraud: For example, why would a loved one who claims to need cash ask you to send money via a bitcoin ATM? Breyault said.

“When you do buy products online, make sure you only use a payment option that offers reimbursement for authorized payments (such as most major credit cards),” NCOA wrote. “Using a form of direct payment, such as a payment app, is essentially the same as sending cash. You may not be able to receive a refund.”

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