How to fight a Doctor/Hospital bill.



The #1 reason that people file for bankruptcy or get foreclosed on their house is getting hit with a huge, unexpected Hospital or Doctors' bill. This can happen for several reasons: When it comes to medical costs, you have virtually no say in what hospitals and doctors will charge.   It's not like going into a store where you can choose to buy a toaster oven from Neiman Marcus or from Wal-Mart.   Hospitals and doctors charge whatever they want and rarely if ever explain what the costs are ahead of time.   Especially if it's an emergency or necessary procedure.

What you may not know, however, is that the amount that the hospital will bill you is often many times higher than what they would charge an insurance company, Medicaid or Medicare.   You would think that if a person could not afford any or better insurance, the hospital would bill less not more, but the exact opposite is true.   For example, a CT scan might normally cost about $900.00 and an insurance company may pay less than half of that.   But if you're in a hospital and get a CAT scan and you're uninsured, the hospital may charge you $4,000.00 to $5,000.00 for the CAT scan.   Sound like a ripoff?   But what can you do?

What to do when you first receive a Bill:

When you receive that first jaw-dropping, heart attack provoking bill from the hospital or doctor, you can do the following: You can use this Hospital sample letter or Doctor sample letter to dispute the charges enclosing a copy of the bill that they sent you.   The reason this is so important is it stops the hospital, doctor and subsequent collection agencies who may buy the debt from claiming what is called an "account stated."   An account stated means that you were provided with one or more bills and did not dispute them.   It is one of those very rare times in law that silence is deemed to be consent.   In other words if you do not dispute it, a court may automatically hold for the doctor or hospital based solely on the fact that you did not dispute it.

The second important reason for disputing it is that if the hospital, doctor or subsequent collection agency threatens or attempts to report it to a credit agency, it must be noted as having been disputed.   After you have received these types of bills for a while, you might want to check your free credit report to see if there is any mention of the bill on your credit report.   If it does not state that the bill is disputed, you should write a letter to all three credit reporting agencies explaining that that is a disputed charge and include copies of your letters disputing the charges.

Thirdly, it lets the hospital know that they are not going to get a quick judgment against you and may have to disclose information which is very sensitive to them.

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What to do when you get a collection call or letter:

Collection agencies want you to believe that they, and not you, are holding all the cards.   They want you to believe that you MUST talk to them, and MUST accept what they say you owe.   This is not true!  You are protected by Federal and State law and NYC Regulations.   The following is a list of what you may do when you receive a call or letter from a debt collector:
  1. If you receive a call from a debt collector, first make sure that they clearly tell you their name, the name of their company, their consumer affairs license number and their address before you have any conversation with them.   If they try to cut you off or ask you questions before giving you this information, tell them that you will not speak to them until you are given that information.   If they do not give you that information tell them not to call you again and hang up.
  2. If it is the first call from a collection agency and they have not yet mailed you anything, insist that they mail you a notice BEFORE you speak with them.
  3. NEVER give out your social security number, date of birth, work or cell phone number, names of person in your home, credit card information, checking or other banking information over the phone to a debt collector.
  4. Always send a Demand for Verification the first time you receive a call and the first time you receive a letter from a debt collector.   This letter also demands that they not call you anywhere.   Collection agencies can sometimes be aggressive and may often break the laws that protect you from them.   If this letter is sent within 30 days of you receiving a letter from a debt collector, they can not take any further action against you, including calling you, until they have verified the debt. This may seem like an easy thing for them to do, but quite often it is not. The nature of the collection industry is that collection agencies may buy blocks of debt without knowing if the debt is good or not.
  5. Keep a notebook of all calls and letter that you receive from (and send to) the creditor and collection agencies.   You may be able to sue the creditor and/or collection agency for up to $1,000.00 for EACH violation of the laws.   If you receive ANY phone call from the collection agency after sending the above letter, they may be held in violation of the Federal Debt Collections Practices Act.   You can sue them in small claims court, civil court or supreme court depending on how many violations or you can readily find attorneys willing to take these suits against debt collectors.
  6. If the debt collector does send you written verification of the bill, make sure that it is from the creditor and not just the debt collector.   Also insist that they send the additional information that you have requested.
  7. You can try to work out a payment arrangement with the debt collection agency if you choose.   Again this is best done in writing rather than over the phone.   If you do not wish to try to work out a payment or a chat with the debt collection agency you can send them a final do not contact me a letter which will end all communication except for the one additional contact to tell you what they can or will do.


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What to do if the billing department won't negotiate your bill:

All hospitals in the State of the New York are "not-for-profit" by law.   They have come under scrutiny in the last several years for price gouging especially against uninsured patients.   There are politicians who believe (rightfully so) that not-for-profit hospitals should not seek to take advantage of uninsured consumers by essentially engaging in price gouging and often financially wiping people out because they needed life-saving medical care.   By sending a letter disputing the charges and explaining to them how you intend to attack their bill, you are letting the hospital know that your bill is going to be included in this hotbed political issue.

If you continue to receive bills and the hospital is unwilling to negotiate, it is a good idea to write to the Head of the Hospital and notify your NYS Assemblyperson and Senator about your situation.   Hospital price-gouging is a political issue around the country.   By involving your local politicians, everyone who uses these forms can help to get your state legislature to enact and enforce fair consumer protection for Hospital patients.

If you are uninsured, you can use these sample letters to the heads of the Bronx Hospitals with cc's to the NYS Senate and Assemblypersons representing the Bronx.   Use these links to find out who your NYS State Senator is or to find out who your NYS Assembly person is.   You can check off their names at the end of the following letters.   Make sure to include the bills you are disputing as well as your letters and correspondence back and forth with the hospital, doctor or collection agencies.