Need to dispute a medical bill in collections that you do or do not actually owe? I'm sharing the 6 tools you can use in your fight.
For the first 7 months of this year, I was in a battle with medical collections for a medical bill.
Not just any medical bill – one that was totally erroneous.
I guess it didn’t start out that way, but it progressed to me cringing at thinking about going to the mail box (so I would only check it once a week), and delaying doctor checkups for myself (a losing proposition at best).
And the kicker is, the medical bill I was battling? Was for a preventative care appointment for my son. You know, the type of appointment that’s 100% covered under any insurance plan.
See why I said it was totally erroneous?
Psst: Want to get the exact medical bill resolution letter that got us out of $1,097 in medical debt, after battling for 7 months? Click the image for how to dispute a medical bill sample letter.
If you’re dealing with a medical bill that is completely wrong – either incorrect charges, or something like ours where we should not have received one in the first place – then I’ve got you covered.
On top of how to dispute a medical bill sample letter, I’ve listed these tools from what you should start with (least aggressive) all the way up to the “big gun” tools that you can use to aid you in your fight.
Pssst: you definitely want to read this article I wrote on how to deal with debt collectors.
But first, let's discuss a few key pieces of information for you to know about a medical bill in collections.
How Long Can a Medical Bill Be in Collections?
Do medical bills ever go away, and how long can a medical bill be in collections? Both good questions.
There is a medical bill collections statute of limitations. Medical bills are a written contract, and you can find out your own state's statute of limitations on that kind of debt here.
Do Medical Bills Affect Your Credit?
Yes, medical bills in collections will very likely affect your credit.
According to Experian, one of the big three credit rating bureaus,
“Experian no longer displays medical collections on a credit report until they are 180 days past due. This grace period gives individuals with medical debt six months to resolve any insurance or billing issues and to make payment arrangements if necessary before the past due balance is reported…”
That buys you a little time.
You should know that hospitals and medical providers ARE able to reverse their reporting of your delinquency to the credit bureaus.
So, the best thing you can do (and especially within that first 180 days to avoid having anything on your credit report) is to call the medical provider and work with them on a payment plan, or on fixing any errors they made (like the situation we dealt with).
How to Negotiate Medical Bills in Collections
Did you know that even if you are making small payments under some sort of agreement with a doctor or hospital office, they may still send your bill to collections?
Frustrating, I know.
Heck, we almost got sent to collections for a bill we didn't even owe!
But let's assume that you actually owe the bill, and you'd like to know how to negotiate medical bills in collections.
Let me give you a few tips (here's a whole article I wrote dedicated to dealing with debt collectors you'll want to read):
- Get Your Debt Validated: Any debt collector who calls you needs to validate your debt. According to the Fair Debt Collection Practices Act, within 5 days of contacting you the third party collector is required to provide you with a validation notice stating the alleged amount of debt, the original creditor, and the process for disputing the debt, but they often fail to do so. Making them do this will buy you some time.
- Offer to Settle in Cash for a Discount: Cash is King. If you can send them a money order for 50% of what you owe…would they accept that? Would they accept 30%? Get everything they agree to in writing. otherwise, they might accept what you give, then sell your bill down to the line to another collection agency.
- You Can Sue Them: You can sue for up to $1,000 penalty + reasonable attorney's fees + court costs + actual damages if a collection agency is in violation of any of the information in that article linked to above.
Check out this article for several more ways to negotiating medical bills.
Let's talk now about the 6 tools you have at your disposal when dealing with medical bill collections.
Tool #1: Politeness with a Hint of Charm
No, not kidding. And yes, I realize how hard it is to be extremely polite and diplomatic when you’re an angry victim.
I have found – through dealing with a ton of customer service issues over the years (including how the heck to get through to a live person) – that being polite gets you Fievel-Goes-West far.
In my experience, it’s the reason why a rep might personally follow up with you on an issue, or might stick their neck out for you, or might give you a nugget of information no one else shared that will blow your case wide open.
It’s a tool, use it wisely.
Tool #2: Billing Department Manager
If you are getting nowhere with the employees from the billing department, then you should next ask to speak with their manager. This is common practice in customer service, and works in insurance/doctor’s offices as well.
You’ll likely be put on hold while the situation is explained to the manager, and you may even need to wait for someone to give you a call back.
Did you get through to the manager? Be sure to ask for her/his name, phone number, and to follow-up with you on any actions they said they will take on your behalf during the phone conversation.
Tool #3: Your Company's Employee Assistance Program (EAP)
I had no idea, until recently, that your employer's Employee Assistance Program (EAP) can help by acting on your behalf to dispute medical charges.
Of course, this depends on what your employer's EAP offers (if you have one — but many companies offer these), so be sure to check with your benefits package and give them a call to discuss the issue.
Tool #4: Patient Liaison Officer
Did that manager not give you a satisfactory outcome…or did they give you the runaround?
Your next best bet is a Patient Liaison Officer. This is someone who goes above even the manager in the billing department (could be called something different within the clinic/hospital/etc. that you’re dealing with).
No one bothered to tell me one existed when I was in my 7-months long battle. So, if nothing else, ask someone you speak with in the billing department if someone exists within their organization to help facilitate issues on your behalf (hint: they’ll be more apt to tell you if you used Tool #1 when dealing with them).
You can also, of course, google it as well.
Once I found out this position existed, I immediately sat down and wrote them a letter (there was no phone number or email available for them). I followed their instructions exactly, including the information they asked for.
Then I sent my letter off. Luckily for us (didn’t feel so lucky after 7 months), within 6 days they cleared us of the debt we owed.
Hint: Get the exact letter, plus a breakdown of why it worked, that I sent into the Patient Liaison Officer to clear our account of $1,097. You could say it’s the $1,097 Medical Bill Resolution Letter. You could also use the government’s complaint letter wizard to help you fill out everything as efficiently as possible.
Tool #5: Better Business Bureau
The Better Business Bureau (BBB) exists to help consumers solve problems in the marketplace when their complaints aren’t being answered.
So why not use them for healthcare/insurance issues as well? That is, if you can’t solve the issue within the organization itself.
You can bet I was very close to submitting a complaint with the BBB. In fact, if my letter to the Patient Liaison Officer had not worked, that’s exactly what I would have spent my time doing.
The BBB attempts to close all complaints (i.e. deal with them) within 30 business days. Not bad!
Their process looks something like this:
- Submit your complaint to the BBB.
- The BBB forwards your complaint materials to the company within 2 business days.
- Receives a response from the company, or if not, the BBB resubmits the request.
- You’re notified of any results, whether the company responds or doesn’t.
Tool #6: Insurance Commissioner for Your State
Still not receiving help or a suitable answer to your complaint? If you’re here, then you’ve exhausted all other possibilities.
It’s time to take it to the top. That is, if the problem rests with your insurance company.
For us? The problem was actually with the doctor’s billing strategies. So, contacting the insurance commissioner of Texas would not have helped.
If your problem deals with your insurance company, then know that there is an insurance commissioner in each state to help with bad insurance issues you’re dealing with and who may be able to help you.
Find your Insurance Commissioner, by state and contact them with the details of your case.
- How your insurance claim was handled
- How your insurance policy is laid out
- If you think your insurance company is breaking the law or has broken the law
Hint: Again, my $1,097 Medical Bill Resolution Letter will help you in your communications with the Insurance Commissioner’s office.
One final piece of advice that I personally experienced: you will likely keep talking to new people each time you call into your doctor’s billing department and/or your insurance company. This can be extremely frustrating, as you have to re-explain the situation + hope that the last five people included good notes within their computer system.
So it’s super important that you keep records of your conversations, the names of people that you talk with, and what they said they would do for you. Be your own advocate!