A Step-by-Step Guide to Finding Unpaid Medical Bills

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From above composition of stack of USA dollar bills placed near medical protective masks produced in China illustrating concept of medical expenses and deficit during COVID 19
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Finding unpaid medical bills can be a daunting task, but with the right approach, you can uncover hidden debts and take control of your finances. You can start by checking your credit reports, as 70% of medical bills are not reported to the credit bureaus.

Most medical providers will send you a bill within 30 days of treatment, so keep an eye on your mail for any unexpected invoices. If you're unsure about any charges, don't hesitate to contact your provider's billing department.

Check your Explanation of Benefits (EOB) statements from your insurance company, as these documents often highlight any unpaid medical bills. You can request a copy of your EOB statements from your insurance provider if you need them.

Verifying and Understanding Medical Bills

You can request an itemized bill from your healthcare provider to break down the charges, which can be found in the "Requesting Medical Records" section. This can help you identify any errors or discrepancies.

Man Sitting on Sofa and Reading Unpaid Bills
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Medical bills can be confusing, but knowing what to look for can make a big difference. A typical medical bill includes a diagnosis code, procedure code, and charge for each service provided.

Be sure to review your bill carefully, as errors can occur. According to the "Common Reasons for Unpaid Medical Bills" section, incorrect patient information is a common reason for unpaid bills.

You can also use a medical bill navigator or a patient advocate to help you understand your bill and identify any errors. Some organizations, like the Patient Advocate Foundation, offer free or low-cost services to help patients navigate the healthcare system.

A medical bill may include charges for services you didn't receive or procedures you didn't undergo. This can be due to coding errors or incorrect billing information.

Look for any red flags, such as unusually high charges or unfamiliar services. If you notice anything suspicious, contact your healthcare provider or a patient advocate for assistance.

Managing Unpaid Medical Bills

A Person Looking at a Medical Test Result
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Most hospitals and medical providers will work with you to find a payment plan that fits your budget, so don't be afraid to ask.

A payment plan can break up the total amount you owe into more manageable, regular payments, or even forgive the debt altogether. This is especially true for nonprofit hospitals, which are required to give financial assistance to eligible patients who cannot afford payment.

You can also try negotiating a payment plan with the doctor, hospital, or bill collector, and ask for the lowest rate they charge insurance companies to be applied to what you owe. Many medical providers will accept a no-interest payment plan, which can help you avoid adding interest to your debt.

If you're unable to negotiate a repayment plan, a collection suit is always possible, but filing for bankruptcy can short circuit the whole process and discharge or greatly reduce medical debt. However, before considering medical bankruptcy, discuss the situation with a nonprofit credit counseling agency to explore options like consolidating medical bills.

Common Errors

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Almost half of all medical bills contain at least one error, according to Caitlin Donovan, a healthcare policy expert at the Patient Advocate Foundation. This can lead to unnecessary debt collection efforts.

Mistakes on medical bills are common, affecting 1 in 7 adult Americans, according to the Consumer Financial Protection Bureau. This can be due to high deductibles, copays, and confusing insurance coverage.

Debt collectors can continue to press for payment on debts even after being informed that a bill was paid. This is a dubious practice that can cause unnecessary stress and financial burden.

Many collection efforts come from companies that break the law by trying to collect on an amount greater than the original bill. This can be a serious issue that requires attention from authorities.

Medical debt poses a unique problem for consumers due to high deductibles, copays, and confusing insurance coverage. This can lead to people winding up in collections and affecting their credit reports and scores.

Additional reading: High Debt to Income Ratio

Payment Plan

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You can try negotiating a payment plan with your hospital or medical provider. Many medical providers, including physicians, dentists, and hospitals, can work out a no- or low-interest payment plan for your medical bills.

To set up a payment plan, you can ask the hospital or medical provider if they will work with you to find a payment plan that works. Most hospitals will accept a payment plan, and some even have a program called "charity care" that provides free or discounted healthcare to those in need.

You can also try contacting a patient advocate or a nonprofit credit counseling agency for help negotiating a payment plan. They can help you review your medical bills and insurance coverage, and work with the hospital or medical provider to find a payment plan that works for you.

Some hospitals will accept credit card payments, but this should be used with caution. Using a credit card can lead to interest being added to what you owe, which can easily exceed 20% annually on the balance. A payment plan with a hospital usually has no interest.

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If you're unable to negotiate a payment plan with the hospital or medical provider, you may want to consider hiring a medical bill advocate. They can help you negotiate your medical debt and spot potential errors or overcharging on your medical bills.

You should also be aware that filing for bankruptcy can be a last resort for dealing with medical debt. However, before considering bankruptcy, you should discuss the situation with a nonprofit credit counseling agency to go over options such as consolidating medical bills and determine whether bankruptcy makes sense.

Remember to always keep track of your payments and any communication with the hospital or medical provider. You can also try sending a partial payment each month to see if the provider will accept it and hold on to the debt until it is repaid.

When to Delay Debt Payments

If you're struggling to pay your medical bills, it's essential to prioritize your debt payments. Sometimes, it's better to delay paying your medical debt if you have other priority bills to pay, such as rent or utilities, as these are more likely to be reported to credit bureaus sooner.

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Unpaid medical bills less than $500 won't be included in credit reports starting in the first half of 2023, making them less of a priority for people struggling to make ends meet.

Nonprofit hospitals often have programs to help people cover medical bills, but they may not tell you about them. If you're un- or underinsured, consider applying for these programs, such as through Dollar For, which has helped patients get over $15 million in medical bills forgiven.

If you're being sued over a medical bill, don't pay it until the suit has been settled. If you win, the financial reward may be enough to cover your medical bill.

For another approach, see: Are Debt Reduction Companies Legitimate

Know Your Hospital Status

You might be surprised to learn that your hospital status can affect the amount you pay for medical care, especially if you're on Medicare.

A concept called "observation status" can impact your costs.

If you're admitted to a hospital, you might assume you're a regular patient, or an "inpatient", but observation status can change that.

The phone number for the Minnesota Department of Health, which can provide more information on hospital status, is (651) 296-3353 for the Twin Cities area.

Dealing with Debt Collectors

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If you can't afford to pay the entire bill at once, try negotiating a payment plan with the hospital or clinic.

A debt collector can contact you, and you have certain rights under the federal Fair Debt Collection Practices Act.

If a debt collector sends you a collection notice, you have 30 days to send a letter asking them to substantiate the debt if you don't believe you owe it.

Debt collectors must stop contacting you unless and until they can substantiate the debt.

Notify debt collectors that you've applied for assistance and ask them to pause collections while your application is being completed.

A fresh viewpoint: Payment Collection Agency

Dealing with Debt Collectors

You have the right to request that a debt collector substantiate the debt if you don't believe you owe it. If a debt collector sends you a collection notice, you have 30 days under federal law to send a letter asking them to substantiate the debt.

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Debt collectors can contact you in various ways, including letters, phone calls, emails, and text messages. They may remind you that failure to pay will severely ding your credit rating, making it hard to obtain loans in the future.

You can try to negotiate a payment plan with the hospital or clinic if you can't afford to pay the entire bill at once. This can be a good option to consider before the debt is turned over to a collection agency.

Debt collectors should honor your request to pause collections while you apply for assistance. It's essential to let them know you have applied for help and ask them to stop contacting you until the application is completed.

Collections can lead to a civil lawsuit demanding payment if you're unable to negotiate with the collection agency. Nonpayment will also be reported to the credit bureaus, which can negatively impact your credit rating.

Bill Advocate

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Hiring a medical bill advocate can be a game-changer in dealing with debt collectors. A medical bill advocate is an expert in medical billing who knows how to read health care bills and understand common costs for procedures.

They can spot potential errors or overcharging and help you reduce the amount you owe. Be careful when selecting a billing advocate because there are also predators out there who call themselves advocates but in reality steal your money or identity.

Make sure you know who you are talking to and how they work before sharing any of your information. Some medical bill advocates can charge as low as $100 per hour, but also as high as $400. They also will often charge 20% to 30% of whatever savings they might realize for you.

The Claims.org website can help find an advocate in your area. A patient advocate, a type of medical bill advocate, can be found through online search or by calling the hospital and asking for information about their policy.

Payment and Financial Assistance

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Many people struggle to pay their medical bills, but there are options available to help. In Minnesota, hospitals are required to work with patients to reach a reasonable payment plan if they express an inability to pay their entire bill at once.

You can ask your hospital or clinic if they offer a financial assistance program to help with your medical bills. These programs vary from hospital to hospital and may have names like "charity care" or "financial assistance." Some hospitals will even offer discounts or free care to those who qualify.

If you're unable to pay your medical bills, consider applying for a medical loan or credit card. However, be sure to shop around and compare rates, fees, and repayment terms before making a decision.

There are also public programs and private organizations that can help you tackle your medical bills. The USA.gov website offers information on medical and healthcare benefits, and the State Health Insurance Assistance Program (SHIP) can help you navigate Medicare.

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You can also search online for financial assistance programs or contact your health provider or medical bill advocate for additional resources. Some hospitals have patient advocates who can help you find assistance.

To qualify for help via a financial assistance program, you must meet certain criteria, which vary by state or hospital. Applications can be obtained from the hospital or a state agency and must be completed honestly and accurately.

Here are some examples of financial assistance programs:

  • Nationwide Children's Hospital requires patients to use all other available resources before qualifying for financial assistance.
  • The OhioHealth Financial Assistance Program offers eligibility after application to those with family income at or below 400% of the federal poverty line.
  • The University of Washington Medicine Assistance Form asks if you have applied for Medicaid.

Remember, it's essential to review and understand your medical bills and insurance coverage before seeking help. You can also consider negotiating your bill with the doctor, hospital, or bill collector.

To negotiate your bill, ask what the lowest rate the provider charges insurance companies and try to get that rate applied to what you owe. You can also ask if the collector will accept a no-interest payment plan or look into medical financing.

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If you're unable to pay your medical bills, don't be afraid to ask for help. There are many resources available to assist you, and working out a payment plan with your hospital or healthcare provider can be a game-changer in helping pay the bills.

Here are some options to consider:

  • Payment plans with hospitals or healthcare providers
  • Financial assistance programs
  • Medical loans or credit cards
  • Public programs and private organizations
  • Non-profit hospitals with charity care or financial assistance policies

Remember to always review and understand your medical bills and insurance coverage before seeking help.

Seeking Help and Support

You're not alone in struggling with unpaid medical bills. There are public programs and private organizations that may be able to help you tackle your medical bills if you aren’t able to do it on your own.

Some organizations to look into that may help with medical costs include USA.gov for medical and health care benefits, State Health Insurance Assistance Program (SHIP) for help navigating Medicare, and NeedyMeds for help finding prescription assistance programs and drug coupons.

To qualify for help via a financial assistance program, you must meet certain criteria, which vary by state or hospital.

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Here are some key things to keep in mind when applying for financial assistance:

  • You may need to provide documents such as tax statements, pay stubs, an employment letter, and proof of unemployment benefits.
  • Applications can be obtained from the hospital or agency you apply to, and must be completed honestly and accurately.
  • It's a good idea to ask your health provider or medical bill advocate for additional resources for paying your medical bills.

Some examples of financial assistance programs include Nationwide Children’s Hospital, which requires patients to use all other available resources before qualifying for financial assistance, and the OhioHealth Financial Assistance Program, which offers eligibility after application to those with family income at or below 400% of the federal poverty line.

Insurance and Billing

If you're trying to find unpaid medical bills, understanding insurance and billing terms is essential.

A co-insurance level of 20 percent means you pay 20 percent of the clinic costs, while the insurance company pays 80 percent.

You'll need to pay a fixed amount, known as a co-pay, for each office visit, which can be as low as $20.

The total dollar amount you must reach before your insurance company pays is called the deductible, which can be as high as $3,000 per year.

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You'll receive an Explanation of Benefits Form (EOB) from your insurance company that explains what payments were made to your doctor or hospital and what unpaid amounts you owe.

The Provider Allowed Amount is the discounted amount your insurance company will allow your clinic or hospital to charge, which is determined by contracts between the two parties.

Minnesota Specific Information

If you're a Minnesota resident, it's essential to know that the state has a law requiring hospitals and healthcare providers to report outstanding medical bills to credit bureaus.

Minnesota has a statute of limitations of 6 years for medical debt, which means you have up to 6 years to pursue collection from a hospital or healthcare provider.

The Minnesota Department of Health requires hospitals and healthcare providers to provide patients with a written notice of their outstanding medical bills.

In Minnesota, you can also file a complaint with the Minnesota Department of Health if you believe a hospital or healthcare provider has incorrectly reported your medical debt to credit bureaus.

The Minnesota Attorney General's office can also provide guidance on how to navigate the process of finding and addressing unpaid medical bills in the state.

Unpaid Bills Consequences

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The Federal Reserve estimates that more than half the accounts sent to collection agencies involve medical debt.

You could eventually face a civil lawsuit demanding payment if you're unable to negotiate with the collection agency.

Collections lead to letters, phone calls, emails, and text messages demanding payment.

Nonpayment will be reported to the credit bureaus, severely damaging your credit rating and making it hard to obtain loans in the future.

Yes, ongoing medical debt can turn your financial life into a nightmare.

You'll be reminded that failure to pay will have serious consequences, but collection agencies can't threaten you with arrest or call at inconvenient times.

Mistakes on your medical bills are quite common, including double billing for a procedure, service, or supply.

If this caught your attention, see: Payment Posting in Medical Billing

Colleen Pouros

Senior Copy Editor

Colleen Pouros is a seasoned copy editor with a keen eye for detail and a passion for precision. With a career spanning over two decades, she has honed her skills in refining complex concepts and presenting them in a clear, concise manner. Her expertise spans a wide range of topics, including the intricacies of the banking system and the far-reaching implications of its failures.

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