With out-of-pocket health care costs on the rise, it’s easy to suddenly and unexpectedly wind up with a big bill you can’t afford. When you’re overwhelmed by all those dollar signs — perhaps on top of coping with a challenging medical diagnosis — it can be hard to know what to do, especially if the bill is sent to a debt collector.

Here are some tips from billing specialists, patient advocates, and the Consumer Financial Protection Bureau:

Don’t ignore mistakes

Challenging medical bills can be a hassle, but it’s much better to deal with the problem before it is handed off to a debt collector. Contact the provider and your insurance company. You have a right to appeal charges that you believe are incorrect or that you believe your insurer did not cover correctly.

Are you eligible for charity care?

If the bill is correct but you feel unable to pay it, try to work with the provider to come to terms you can manage. Nonprofit hospitals are required to have charity-care policies that give discounts to people based on income and most bills tell people that these policies exist. However, discounts are not always automatically applied, and many patients don’t think to ask or assume they won’t be eligible.


Many providers will allow patients to pay off debt in monthly installments. Make sure any payment plan you agree to is an amount you will be able to afford. Some people may be able to negotiate a lower rate on their bill if they can pay the full, lower amount right away.

Keep diligent records

Hold onto bills and records of payment, and if you get a discount, make sure you have it in writing. This will be helpful should the provider or a debt collector later attempt to collect on a bill you’ve already paid.

Don’t panic

Health care providers are required to notify patients of when their unpaid accounts will be sent to a debt collector. Once it is transferred to a debt collector, people often feel rushed to settle the bill to avoid damaging their credit. But there’s still time to resolve the issue before it appears on your credit report. Credit bureaus must wait six months before recording medical debts on credit reports.

Ask for debt verification

If you receive a notice from a debt collector, request verification of the debt they are seeking to collect. This must be done in writing within 30 days of receiving a notice. The Consumer Financial Protection Bureau has sample letters on its website. Debt collectors are required to provide proof of the debt they want to collect — but only if you ask — and are not allowed to continue trying to collect the debt until they have provided proof.

Dispute the debt

If you don’t believe you owe all or part of the debt, you can file a dispute to the collector. This also must be done within 30 days of receiving the notice, in writing, and the Consumer Financial Protection Bureau has sample letters you can use. Once you dispute a debt, the debt collector cannot continue to try collecting the debt until the dispute is resolved.

Ask them to stop calling

If you request in writing that a debt collector stop trying to contact you, they are legally required to oblige. However, if your debt is valid, they may still pursue collection through other means, such as a lawsuit, and may still report your delinquent account to credit agencies.

File a complaint

If you’re having difficulty resolving a dispute with a debt collector, file a complaint with the Consumer Financial Protection Bureau.