Credit Reporting and Medical Debt Collection

Author: Christina Bach, MBE, LCSW, OSW-C
Last Reviewed: March 07, 2024

In 2015, credit bureaus in the United States made some changes to the way in which medical debt is included in your credit report, as well as how long it can stay on your report. The biggest change is that credit reporters will now allow a 180-day waiting period BEFORE medical debt can be included in your credit report. This allows time for medical claims to be processed appropriately by the insurance (and sometimes to go through appeals) before it is labeled as an unpaid debt. The other major change enacted is if that debt is settled in that 180 day period, by either an insurance company or an individual, it must be removed from your credit report by the credit reporting companies.

The No Suprises Act (NSA) became active January 1, 2022. The NSA protects you from receiving a "surprise" bill for receiving medical care at an out-of-network provider or facility without prior authorization. It also prohibits out of network cost-sharing (coinsurance) for ALL services you receive in an emergency room and out-of-network charged for care you receive by an out-of-network provider at an in-network facility. If you receive a "surprise bill," you should appeal it with your health insurance plan. For more help, you can contact the No Suprises Help Desk, 1-800-985-3059. The NSA should help to decrease medical debt for many individuals who, for no fault of their own, received out-of-network care without be informed. It is always a good practice to understand your own insurance provider networks and to ask questions about providers and networks before receiving care. As part of the NSA, more changes were made to the way medical debt shows up on your credit report. Credit reporting companies cannot collect or report on any "invalid" medical debt. So any debt incurred as a result of surprise bills for services provided in an emergency by out-of-network providers can no longer be reported.

The credit reporting companies also began to take things off of credits reports including all paid debts and those less than one year old. They are also working to remove any debt that is less that $500 from credit reports. All of these changes benefit consumers and cancer patients.

While your healthcare provider/hospital itself may not report your medical debt to credit bureaus, once your debt is “sold” to a collection agency, it likely WILL be reported and show up on your credit report. Those credit scores impact many things, including your ability to secure loans (think house or car), lower interest rates on those loans, credits cards, and can even impact your ability to secure employment! This debt can remain on your credit report for many years.

Be aware, bill collectors may call and/or contact you by mail. Under the Federal Fair Debt Collection Practices Act, debtors should not be contacted before 8:00 am or after 9:00 pm. The collector may not tell anyone other than the debtor, and their attorney, that the debtor owes them money. The collector may not use threats, use profane or obscene language, make false statements or repeatedly use the telephone to annoy someone. If the collector is told in writing to stop contacting the debtor, it should stop (but the debt will continue).

As a cancer patient, it is essential that you keep on top of your medical bills. Don’t just put them in a box and hope they will take care of themselves. They will not. Here are some helpful tips for staying on top of your medical claims and bills:

  • Formulate a record-keeping system that works FOR YOU. This may be a file box where you keep paper copies or an Excel spreadsheet.
  • Open and examine EVERY bill/statement you receive related to your healthcare.
  • Match the bills from the provider with the explanation of benefits forms (EOBs) you receive from your insurance companies. Be sure the information on these two forms about how your claim was paid is equal.
  • Report discrepancies to your insurance company immediately.
  • Report discrepancies to patient account/billing at your health care provider immediately.
  • Keep a detailed record of everyone you talk to about your bill: name, phone number, id number, date and time you called, and what was discussed.
  • Know your insurance coverage: what is your deductible, your copay, your coinsurance, your out-of-pocket maximum?
  • Ask for help! Oncology social workers and financial navigators/counselors can help you understand your bills and advocate for coverage.
  • Appoint a family member or friend to be your medical bill review partner. Two sets of eyes reviewing bills and EOBs are better than one.
  • If you don’t agree with a denial of service, appeal the decision. Your provider’s office will need to partner with you in this appeal process.
  • Check your credit! It's important to know if a medical debt is on your credit report. You are entitled to a FREE credit report once a year from each of the 3 credit bureaus, so get one from each spaced out over the year. Access your FREE credit report here.

The financial impact of cancer care and treatment is often overlooked by medical teams. Your credit report can have long-range and wide-sweeping impacts on your life after cancer. Being on top of your out of pocket medical costs, where to get help, and how your medical-related debt impacts your credit score is a key component of survivorship. It’s important to speak up if you are struggling with these issues and ask for help.

What about the No Surprises Act? How does that impact medical debt?

The No Suprises Act (NSA) became active January 1, 2022. The NSA protects you from receiving a "surprise" bill for receiving medical care at an out-of-network provider or facility without prior authorization. It also prohibits out of network cost-sharing (coinsurance) for ALL services you receive in an emergency room and out-of-network charged for care you receive by an out-of-network provider at an in-network facility. If you receive a "surprise bill," you should appeal it with your health insurance plan. For more help, you can contact the No Suprises Help Desk, 1-800-985-3059. The NSA should help to decrease medical debt for many individuals who, for no fault of their own, received out-of-network care without be informed. It is always a good practice to understand your own insurance provider networks and to ask questions about providers and networks before receiving care.

Resources for More Information

Fair Credit Report Act

http://www.consumer.ftc.gov/sites/default/files/articles/pdf/pdf-0111-fair-credit-reporting-act.pdf

Consumer Financial Protection Bureau (CFPB)

http://files.consumerfinance.gov/f/201412_cfpb_reports_consumer-credit-medical-and-non-medical-collections.pdf

Ask the CFPB

https://www.consumerfinance.gov/ask-cfpb/

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