How do I negotiate a lower medical bill payment?

Well, did you know that insurance companies do NOT pay the full amount that is billed? LOL So that $1300 would probably be $650 or a bit higher if your insurance company were billed! If you have a LUMP sum (do not bother if you can only make payments) of 50% of that bill or a bit more, call up the hospital and approach them with your offer. They may say no at first, and you will have to wait it out until either they or the collection agency they employ accepts what you want to pay.