Know your rights and protections when it comes to medical bills and collections

Are you aware there are more than $88 billion of outstanding medical bills currently in collections—affecting one in five Americans?  Medical bills can be very confusing and overwhelming and often come at a time when you may already be in distress.  You might feel like you’re navigating a winding maze of information to understand what you truly owe, to whom, and by when.  Help is available.

“Everyone needs to check their medical bill for accuracy.  During this time, one could find themselves caught between their medical providers and their insurance company, which can be a confusing and unclear space.  They may find it hard to understand the cost of the different services received along with what is or is not covered by the insurance.  The problem can become compounded if one is receiving care from numerous providers,” says Amanda Kostman, Human Development and Relationships Extension Educator, UW-Madison: Division of Extension in Walworth County.

Some tips when you are checking your medical bill for accuracy:

  • Make sure the date of service and treatment is accurate.
  • Verify your name, billing address and insurance information are correct.

If your bill is hard to understand, contact your provider who will be able to provide you with a plain-language explanation for items on your medical bill.  If your bills are turned over to a bill collector, you can have them verify the debt as well as provide you with information about the collector and the bill that is being collected.

There are protections under the No Surprises Act that went into effect January 1, 2022, wherein you should never get unexpected bills for emergency services received from a health care provider or facility that you did not know was out-of-network until you were billed.  If a person does not have health insurance or if you choose to pay without using your health insurance, your provider must give you a “good faith” estimate on how much the care will cost, before you receive care.  Afterward, if the billed amount is $400 or more than the estimate, you may be able to dispute the charges through the patient-provider dispute resolution process.  If you have any questions about the No Surprises Act or believe the act is not being followed, you can contact the Center for Medicare & Medicaid Services No Surprises Help Desk at 1-800-985-3059 from 8:00 am to 8:00 pm (ET), seven days a week to submit a question or a complaint.

Before your bill ever reaches collections, there are opportunities available regarding financial assistance program options along with setting up a payment plan.   One financial assistance option is if you find yourself not being able to afford the bill, talk with your medical care provider.  Nonprofit hospitals are required by law to offer financial assistance programs and many other providers are willing to work out payment arrangements.  Contact your medical provider’s social worker or your local social services to see if there may be more help available to you.

“If you are unable to avoid your medical bill going to collections, make sure to avoid scammers.  A reminder – never pay a person or a service to remove the medical bill from your credit report or to protect you from unexpected, out-of-network medical costs.  Stay clear of individuals who want to charge you upfront fees to resolve your debt or credit situation. You can check your credit report once a year for FREE from the Equifax, Experian, and TransUnion credit bureaus. To access your free credit reports, go to https://www.annualcreditreport.com/index.action,” says Kostman.

Medical billing, collections, and credit reporting can hurt people when they are already struggling with a health crisis.  The Consumer Financial Protection Bureau is on your side to make sure you are treated fairly.  For more information visit https://www.consumerfinance.gov/rules-policy/medical-debt/.

Check out our free online Money Matters financial modules at https://fyi.extension.wisc.edu/moneymatters/ where you can learn about your financial strengths, gain new money management skills and build the knowledge you can share with others–your kids, your spouse, friends, co-workers, and more.  Money Matters topics include: Your Financial Strengths, Making a Spending Plan, When You Can’t Pay Your Bills, Explore Credit Scores and Credit Reports, Staying Organized, Money and Relationships, Credit Unions, Banks, and Other Financial Institutions, Managing Student Loans, Health Insurance Options for WI Residents, How Health Insurance Works, How to Save Money Using Health Insurance, Retirement Planning Basics, and Saving Money.

If you have any questions please contact your local educator by calling Amanda Kostman at 262-741-4961 or emailing at amanda.kostman@wisc.edu.

Video from the Consumer Financial Protection Bureau on the impact of medical debt: https://youtu.be/t2Rjdl7m1vw

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