Managing Your Health Care

Medical Billing

Medical billing is often confusing. Hospitals and clinics generally bill directly to health insurers or HMOs, and certain billing codes are used to identify certain treatments or types of service. In addition, patients are sometimes asked to pay a portion of a bill through a co-pay or all of a bill if they don’t have health coverage or if the type of service is not covered under their particular health plan.

If you believe a health care provider is mistakenly attempting to collect charges, you may want to consider the following information.

Sometimes a provider may use a collection agency or lawyer to collect bills that are not paid. If you would like to make a complaint about a provider involved in questionable billing practices, you may contact the Attorney General’s Office. The Attorney General’s Office publishes a free brochure called The Credit Handbook that discusses your collection law rights and how to dispute a debt. We also publish a flyer called Medical Billing Pointers. In addition, the Minnesota Department of Commerce regulates and accepts complaints concerning such activity, and can be reached by phone at (651) 539-1500.

Charging the Uninsured a Fairer Price and Changing Collection Practices

Although health plans, employers, and the government are able to negotiate steep discounts for health care charges, many hospitals and other providers have charged the uninsured their “sticker” or “list” prices, which are much higher. Most Minnesota hospitals signed agreements with the Minnesota Attorney General’s Office to offer uninsured patients a fairer price for hospital services and improve the debt collection practices that currently exist in the hospital industry.

The agreements will help those patients who do not have health insurance in the following way:

The agreements also establish standards that hospitals and certain clinics will follow when attempting to collect medical debt from patients.

As of the publication of this brochure, most Minnesota hospitals had signed agreements with the Minnesota Attorney General. If you are unsure about whether your hospital is covered by such an agreement, please contact us.

A Note about Collection Practices

The federal Fair Debt Collections Practices Act (FDCPA) establishes a standard procedure for “third-party” debt collection and provides consumers with certain protections. Within five days after the debt collector’s initial contact with you, the collector must send you a statement of the total amount owed to the creditor. In that written correspondence, the collector must also inform you what action you can take if you want to dispute owing the money. If you send a letter within thirty days disputing that you owe the money, the debt collector cannot make further collection efforts until you receive proof of the debt. The debt collector cannot collect for any debt that cannot be verified. The FDCPA also restricts debt collectors from trying to collect any debt in dispute.