How to cope with old medical debt

REUTERS/Alexander Reshetnikov

REUTERS/Alexander Reshetnikov

Published Oct 5, 2018


My kids got a great report from the dentist at their last checkup. From the receptionist? Not so much.

When I went to make an appointment for their next cleaning in six months, she shocked me by saying I owed nearly $3,000 in charges dating back to 2014.

“We have a payment plan,” she said, trying to be helpful.

I needed information instead, and immediately concluded that plunking down my credit card was the wrong way to go.

Old medical bills plague many Americans, harming their credit scores and holding them hostage to collection agencies. They make up more than half of all collections items noted on credit reports, said Chi Chi Wu, an attorney with the National Consumer Law Center.

When confronted with a doubtful bill, there are ways to prevent it from putting a dent in your finances. Here are initial steps to take:

Check the bill

Contact the insurance company first to make sure the charges are legit. Ask for a supervisor to escalate your case.

If that fails, ask your employer’s human resources department to step in. If that is not an option, search for independent medical billing advocates near you or nationwide services like Some charge flat fees, but most work on contingency for a percentage of the amount they save you.

Sunni Patterson, co-founder of Medical Bill & Claim Resolution, an nationwide advocacy company based in Illinois, said it sometimes works best when one of her advocates is on a three-way call with the patient and the insurance company.

Keep negotiating

In my case, the dentist had no record of being paid for a slew of cavity fillings in 2014. As is pretty standard, I had signed an agreement that I was legally responsible for those bills.

When I tried to negotiate with the dentist’s office, it would not budge on the balance due.

But I kept calling back to talk to billing to keep the dialogue going.

“Providers are a bit more sensitive to not losing you as a customer and maintaining their reputations,” said Wu.

And they can negotiate if they want to, said Adria Gross, chief executive of MedWise Insurance Advocacy, based in Monroe, New York. She has negotiated medical bills down from $1 million. One bill of $257,000 ended up being only $7,000 by the end.

What works best is evidence. I spent a couple of hours on the phone with Aetna, and they found receipts that showed the dentist had cashed checks for a large part of the balance. Negotiating leverage achieved.

Check your credit report

Often a debt collector will not call or send notices. You only find out about old debt because you are buying a car or house. It is called “debt parking,” or, more politely, “passive collecting.”

One way to combat this: Check your credit report every year, which is free (, said Greg McBride, chief financial analyst for

The stakes can be high - even a paid collection stays on your credit report for up to seven years, although it will have a diminished effect on your credit score over time.

A new law prevents medical debt from landing on your credit report for 180 days, giving you time to sort it out. New credit score models do not even count medical collections, said McBride, but they are not yet in wide use.

Negotiate some more

To dispute an old bill in collection, pursue multiple avenues at once, said Gerri Detweiler, education director for

First file a dispute with the three main credit bureaus - TransUnion, Equifax and Experian. Next, go to the collections agent. If you can work out a payment, ask the agent to recall the notice (and get this in writing) before you pay so that it is wiped from your credit history.

“Technically, their agreements say no pay-for-removal deals, but it is worth making part of the conversation,” said Detweiler.

Finally, go to the government to lodge a complaint - either your state’s attorney general or insurance commissioner, or to the federal Consumer Finance Protection Bureau (

MedWise’s Gross had a client who used the strategy of getting a member of Congress involved. The client faced a hospital bill of $50,000, of which only $50 was initially covered by insurance. The approach drew attention and the bill was ultimately reduced to nothing.


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