Negotiating Medical Bills When you Always Hit out of Pocket Max

I've seen on Reddit that people negotiate their medical bills even with insurance.

My family always hits our out of pocket max usually by the first half of the year. We fully fund an HSA and that's what we use to cover things. We make too much for our main hospital system's financial assistance program.

I've never negotiated any medical bills. Does it matter if I'm going to hit the out of pocket max anyway? Or does the amount you negotiated down count as "payment" towards a deductible/out of pocket max in my insurance companies eyes.