The Provider is Still Billing

after my Letter of Dispute

One of the most frustrating situations you may encounter is that a provider continues to try to collect on a medical bill despite that it received, but has not responded to, your Letter of Dispute.  After all, your Letter of Dispute clearly informs the provider of the questions and concerns you have about the medical bill, and that you need those addressed to resolve your dispute.  Is it fair, and can a provider really continue to try to collect on a medical bill that the patient has formally disputed?


Let’s address the “can they really do that” question first.  As surprising as it may seem, in most cases it is not illegal for a provider to continue to try to collect on a medical bill that the patient has formally disputed.  It is up to the provider and patient to resolve any dispute, and the laws do not necessarily govern collection efforts during the dispute.  Even in cases in which a medical bill dispute is related to the federal No Surprises Act or other laws that expressly prohibit billing patients in certain situations, it may be difficult to get a provider to comply fully with such prohibitions. 

Now for the question “is it fair?”. If you have formally and thoughtfully informed a provider of the questions and concerns about a medical bill in a Letter of Dispute, then it probably isn’t fair for the provider to continue to try to collect on a medical bill without earnestly responding to your letter. If you think it isn’t fair then it is up to you to stand up for yourself, and not let a bullying tactic like ongoing billing interfere with your medical bill dispute.

 

 

Understanding the Provider Still Trying to Collect

Keep the following in mind if a provider is disregarding your Letter of Dispute.

 

1.  Rely on Your Letter of Dispute.

Regardless of whether the provider responds to, or acknowledges your Letter of Dispute, the Letter of Dispute is a keystone to challenging a medical bill.

  • It gives formal notice to the provider that you are disputing the medical bill. 
  • It outlines questions and concerns about the medical bill for the provider to address to resolve the dispute.
  • It is a written record of your dispute, concerns and arguments over what obligation, if any, you have to pay the medical bill.

 

2.  Ignoring a Letter of Dispute may be a deliberate tactic.

Many providers, especially large health systems and collections agencies, use automated systems and impersonal processes designed to bill and collect from patients, with limited consideration to halt or pause such efforts when the patient raises a concern. The provider may continue to pursue collection after the bill is disputed because its customer service hand doesn’t know what its bill collection hand is doing.  Alternatively, the provider may intentionally continue to pursue collection because it thinks there is a chance the patient will pay the bill out of frustration or fear, and the provider prioritizes bringing money in through collections over giving time and attention to a patient’s challenge to a medical bill. 

 

3.  Patience and perseverance can be your best defense

You are following a plan to challenge your medical bill. A key in that plan is for your Letter of Dispute to put the provider on notice that you require thoughtful responses to questions and concerns about the bill to resolve the dispute. 

 

You are challenging a medical bill because you think it may be incorrect, or there are other reasons you do not owe it as billed. You want to be treated fairly. Seeking fairness in medical billing can mean standing up to unfair medical bills, and not giving in to continued collection efforts even after your challenge in underway and the provider has your Letter of Dispute.

 

Don’t let a provider’s disregard of your Letter of Dispute be a reason for you to abandon your plan to challenge the medical bill.

 

4.  Stick with the plan

Important to your plan is to require the provider respond to your Letter of Dispute so you can understand if the medical bill is fair, complies with requirements such as the federal No Surprises Act, and accurately reflects what you really owe. If the provider ignores your Letter of Dispute and continues to try to collect on the medical bill then stick to the plan.

 

Sticking to the plan means informing the provider or collections agent every time it tries to collect that you have sent a formal Letter of Dispute on the medical bill, that any payment is contingent on resolving that dispute, and that the dispute can only be resolved by the provider responding to the letter of dispute. Simply put, the provider should not expect any payment from you until the provider addresses your Letter of Dispute. 

 

 

Respond with your Letter of Dispute – Again and Again

The most effective way to respond to phone calls, letters and other attempts to collect on a disputed medical bill is to refer the provider or collections agency back to your Letter of Dispute. Patient Fairness offers tools to make responding easier for customers.

 

Customers can use templates for spoken and written responses to these collection efforts. The response includes that:

 

  1. The customer has formally contested the medical bill via a Letter of Dispute;
  2. The provider has not responded satisfactorily or at all to the Letter of Dispute;
  3. The provider must respond satisfactorily to resolve the dispute; and
  4. The customer will not pay the bill until the dispute is resolved.
  5. The customer requests that the collector cease contacting him or her about the debt. (optional)

 

Patient Fairness offers tools and templates for customers to respond collection attempts when a provider hasn’t responded to a Letter of Dispute.

 

You can use these messages, and the related tools and scripts, as a broken record. Repeat these same points each time you respond to collections efforts while your Letter of Dispute is unaddressed. These messages are reinforced by sharing a copy of the Letter of Dispute with your response if the collections associate says he or she is not aware that you have disputed the bill. The point of this is to clearly and consistently (over and over again, if necessary) to emphasize that you are standing by your Letter of Dispute, and you require the provider to respond to your Letter of Dispute for you to consider paying anything on the medical claim. Without such response to the Letter of Dispute, you do not know what, if anything, you owe.

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