Get help stopping hospital bill debt collectors.
Dealing with hospital debt can be one of the most stressful experiences anyone faces after getting medical care. The bills arrive when people are still recovering and collectors often follow soon after. But hospital debt is not like other debt as there are unique patient protections, payment plans, and charity programs that can stop those calls and even reduce/eliminate what you owe. Learn how to get help in dealing with debt collectors when it comes to what is owned to a hospital.
Know your rights before paying anything
Hospitals and the debt collectors they hire are required to follow rules that go far beyond what ordinary collection agencies must do. As an example, every nonprofit hospital in the United States must offer financial assistance, sometimes called charity care, and post its policies online. As of course it is best to prepare in advance, and even get free care, before getting treatment and going into debt for medical care at a hospital.
- This is required under IRS section 501(r). Hospitals that ignore this rule risk losing their tax-exempt status, so it is taken seriously. Patients can also report a hospital to the Department of Health and Human Services (HHS) if they are denied charity care or are not told about it. Complaints can be filed directly at https://www.hhs.gov/ocr/complaints/index.html.
- That means if a debt collector is calling you, you have the right to ask the hospital for a copy of its financial-assistance policy. If you qualify, that policy can stop all collection activity while your application is reviewed. In some cases, bills can be reduced by 50% or more, and low-income patients often receive full forgiveness.
Asking up front will help stop future collection calls. Stop by the billing office of the hospital, even before you are admitted if possible, and ask for their discount or charity program information. If your income is within about 300% of the federal poverty level, you may qualify for free or heavily discounted care.
Hospitals are also facing greater oversight from both HHS, Consumer Financial Protection Bureau credit reporting programs, and state regulators. Many states have added their own laws requiring hospitals to screen every patient for financial assistance before sending a bill to collections. If a hospital fails to do so, you can challenge the debt on that basis alone.
The Centers for Medicare & Medicaid Services (CMS) created a resource explaining patient billing rights at https://www.cms.gov/medical-bill-rights. Even small mistakes matter. A $20 missed copay can end up with a collection agency. Always pay by card or check so you can prove payment later, and keep receipts for at least six months.
Check for billing errors from the hospital and unfair charges that may have created the debt
Hospital billing errors remain widespread. Studies continue to show that most medical bills contain at least one mistake. Before paying a single dollar, ask for an itemized bill from the hospital and compare it with your insurance statement. Look for duplicate tests, canceled services, or out-of-network fees that should not have been charged. Hospitals, and any debt collectors involved in the process, must pause collections while you dispute a bill in writing. You can also visit https://www.cms.gov/nosurprises/consumers to learn how the No Surprises Act protects you from unexpected out-of-network bills.
If you find an error or overcharge, send a written dispute to the hospital’s billing department and keep copies of all correspondence. This creates a paper trail that stops collection efforts while the issue is under review. If you have an appeal pending with Medicare, Medicaid, or your insurer, the hospital generally cannot send your account to collections until that process is completed. Read more on how to detect billing errors.
For people without insurance, hospitals must still offer a “good-faith estimate” of the total cost before treatment when possible. If your final bill is more than $400 higher than the estimate, you can dispute it under the federal patient-provider dispute process.
The 150-day rule and how to use it
Hospitals are not allowed to report or refer your bill to a collection agency right away. In most cases, they must wait at least 120 to 150 days after the first bill before taking any debt collection action. If you file a dispute or an application for charity care within that time, the waiting period pauses. This gives patients valuable time to organize paperwork, gather income documents, and apply for help.
Many people do not realize that even partial payments can keep your account from being reported. If you stay in contact with the hospital and make good faith payments, it shows cooperation and usually prevents collection activity.
Hospitals also are not to commence any type of lawsuit or civil action against the patient for nonpayment of a bill until at least 150 days from the initial service date. However, put another way, this means that the clock start the moment hospitalization occurs, and not when you are discharged.
Payment plans from a hospital and zero-interest options
Almost every hospital in the country now offers interest-free payment plans for uninsured or low-income patients. Some hospitals even partner with nonprofit financing programs, such as BNPL (Buy Now Pay Later companies) that break bills into manageable monthly payments. You have to ask, but most billing offices are authorized to set up plans on the spot. If you qualify for charity care or a discount program, hospitals cannot legally charge interest or late fees on your balance.
You also can’t be charged fees or interest either if you are part of any extended payment plan negotiated by you to settle an outstanding hospital debt. Almost all hospitals offer these types of payment plans to low income households or those on Medicaid.
You need to ask for this though, and provide details on why you are struggling to pay the bill in the first place. If you know you will have trouble paying a large bill, contact the hospital before the account is transferred to a collector. Once an account goes to collections, your flexibility drops and fees can rise quickly. Applying for charity care or a discount plan early can stop that from happening.
They should not go after your home or wages. While there may be a few exceptions, the hospital can’t use either liens or wage garnishment as a way to collect an unpaid bill. This much different than other businesses. The limited exception can be if the debt collector is the designated collection agency for the hospital. In this case, they may be able to do this, with a few restrictions of course.
Getting outside help in dealing with hospital debt
If the bills or collection notices are overwhelming, a medical billing advocate can often save you hundreds or even thousands of dollars. Most of the services are free - they only get paid if they save you money. Advocates specialize in finding coding errors, negotiating discounts, and ensuring hospitals comply with charity-care rules. The National Association of Healthcare Advocacy has listings at https://www.nahac.com.
Patients can also seek assistance from nonprofit credit counselors or legal-aid attorneys. These professionals can help negotiate lower payments, stop harassing calls, or even challenge the debt’s validity under the Fair Debt Collection Practices Act.
If all else fails, speak to an attorney to deal with your case on a contingency basis. This means they will not charge for any legal advice they give on how to prevent the hospital debt collection agency from contacting you. Many attorneys will decide to take a case against a hospital for the publicity in itself, as it gives PR to their firm. Free and low-cost legal services by state are listed on NHPB too.
What to remember when it comes to unpaid hospital debt
The key to stopping hospital debt collectors is to act quickly and stay organized. Always ask about financial assistance before or soon after receiving care. Keep every receipt and letter, dispute errors in writing, and never ignore bills even if you cannot pay them right away. The current system finally gives patients real leverage when it comes to both avoiding debt or paying it off. You have options ranging from charity care, federal billing rules, and credit-report reforms all work together to protect you. Hospitals are now required to help before they collect, and that means you have more options than ever to regain control and move forward.
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