By Mylika Scatliffe,
AFRO Women’s Health Writer,
mscatliffe@afro.com
Medical debt is a looming crisis for millions of families. While Congress has passed the No Surprises Act to protect Americans from certain unexpected medical bills, including unexpected bills for emergency services from out of network providers, there are steps consumers can take to manage and perhaps reduce or eliminate medical debt.
Medical debt is the leading cause of bankruptcy in the United States. According to the Consumer Financial Protection Bureau, nearly 20 percent of U.S households have some form of past due medical invoice.
“It’s often the $300 medical bill that drives people into bankruptcy, not necessarily bills from a catastrophic accident or health event, “ said Mark Fuller, strategic business consultant and managing member of Manager of Wealth LLC.
Late fees, penalties and collections can cause a modest medical bill to become unmanageable quite quickly if the recipient is unprepared to make an immediate payment. Medical bills can have a snowball effect on the personal finances when the choice has to be made between paying rent or buying food or medication and paying a past due bill.
Mounting medical debt can be daunting, causing additional stress for an individual already dealing with a medical crisis or that of a family member for whom they are financially responsible. Knowing the rules that pertain to credit reporting and navigating medical debt is an excellent way to minimize negative effects on creditworthiness.
Berneta Haynes is a staff attorney at the National Consumer Law Center (NCLC), where she focuses on medical debt and leads the medical debt team. She recently authored NCLC’s “The Racial Health and Wealth Gap: Impact of Medical Debt on Black Families.” She previously served as director at Georgia Watch, a state-based consumer advocacy organization in Atlanta, where she was instrumental in the passage of crucial medical billing legislation and authored the Georgia Consumer Guide for Medical Bills and Debt.
Haynes told the AFRO how she once worked with a woman who received over $30,000 in medical bills after she suffered a stroke. After paying approximately $2000 toward the debt she went to the financial assistance checklist in the guide and was able to get the remaining $29,000 of the debt canceled.
“As soon as you receive a medical bill, request an itemized bill from the provider and review it with careful attention to detail. Billing errors frequently contribute to the total that is included in the bottom line of what you are being invoiced,” said Haynes.
The explanation of benefits, or EOB , provided to you by your insurance company is also a valuable piece of information.
“Always hold onto your EOB from your insurance company and compare it to your bill. Make sure you actually received all the services for which you’ve been charged,” continued Haynes.
There are steps you can take to ensure you are being fairly charged for medical services, and/or your bill is not correct.
Experts say that consumers should request an itemized bill.
“The benefit of an itemized bill is being able to note and challenge discrepancies,” said Rahwa Yehdego, policy research associate at Georgia Watch.
There are also steps you can take if you notice inaccuracies on paperwork related to a debt. Yehdego says an appeal should be made to adress inaccuracies.
“Patients frequently receive upcharges for medical services, and you can begin with an internal appeal with the provider,” Yehdego said. If an internal appeal is not successful, an external appeal with a local insurance commissioner should be filed.
If reviewing the bill and making an appeal does not work individuals can check to see if they qualify for financial assistance, particularly if your bill is from a hospital. It is a federal requirement that all nonprofit hospitals have a financial assistance policy that is easily accessible and widely publicized to the public.
“It’s important to know that these options exist. If people are unaware financial assistance exists, they often feel like they don’t have much agency in that situation to advocate for themselves,” said Yehdego. “This is especially true when you’re in the midst of a crisis and just focused on getting through the medical emergency and thinking ‘let me worry about that bill when it comes in the mail in a few months.”
Haynes also wants patients to be reminded that there is the option to negotiate your medical bill.
“The provider may be willing to accept a lower amount to settle the bill,” said Haynes.
If you decide on a payment plan with a provider, it is imperative to get the terms of the agreed plan in writing and to be sure to set it up with payments you can afford.
If you are sued over an outstanding medical debt, you can make an argument that the bill is not reasonable and try to fight it.
“If you raise the argument in a lawsuit that the amount billed is not reasonable, the hospital or health care provider may opt to settle with you for less rather than try and prove the charges are reasonable,” said Haynes. “It’s important to try and fight a medical bill if you’re sued because the type of judgements these bill collectors can receive can wreak havoc in the patient’s life. We’re talking about things like liens on homes, wage garnishment, property seizure, etc.”
Fuller wants patients to understand the consumer law and make sure it works toward their advantage. He agrees asking for an itemized bill is a crucial first step and most medical bills are negotiable.
“The United States is the only industrialized nation with no universal health care…that provides services up front and tells patients later how much they will be charged,” said Fuller.
Even when a medical debt is sent to collections, Fuller says there are steps you can take to resolve the financial problems at hand.
“You never borrowed any money from them or got any services from them, so they have no legal right to collect anything from you,” said Fuller. She advises consumers to remember the following tips and options, if contacted by a collection agency regarding outstanding medical debt:
- Do not strike a deal with a collection agency.
- If a collection agency attempts to collect a debt, the response should be to request– in writing– the original contract between the consumer and collection agency with an original signature. If they are unable to provide that information, request they stop contacting you and not report to any agency that they are owed money by you.
- Collection agencies are playing the law of percentages knowing that a small percentage of people will not pay because they are savvy about consumer law and that some people will not pay because they simply are unable.
- The final percentage of people will fall into the trap where they enter into agreement with the collection agency, at which point the consumer has now entered into contract with that collection agency and now owes them a debt.
“We can be victimized by what we don’t know,” Fuller concluded. “We have to become savvy and not be a victim of acquiescence to an unfair system.”