How to Check if I Have Medical Debt

Medical debt refers to money owed for healthcare services, including bills from hospitals, doctors, or pharmacies. This debt arises from unpaid balances, out-of-pocket expenses not fully covered by insurance, or high-cost procedures. Proactively checking for medical debt is important as it can accumulate from various sources and may not always be apparent. Understanding outstanding balances helps manage financial health.

Accessing Your Medical Billing Records

Obtaining and reviewing your Explanation of Benefits (EOB) statements from your health insurance provider is a primary method for checking for potential medical debt. An EOB is a document from your insurance company detailing how your medical claims were processed, outlining services received, costs billed, the amount insurance covered, and any remaining amount you owe. Compare each EOB to the actual bill received from your healthcare provider to ensure the charges align.

Direct medical bills from healthcare providers, such as hospitals, doctors, or laboratories, are another source to review for outstanding balances. These bills include the provider’s name and address, statement date, and a breakdown of services or supplies. Verify that the dates of service and the services listed on the bill correspond to the care you received. The bill will also show total charges, any insurance payments, and the balance you still owe, which might include deductibles or coinsurance.

Contacting the billing departments of healthcare providers directly can help clarify any potential debt. Call the billing office of any provider you recently visited to inquire about outstanding balances. Be prepared to provide personal information, such as your name and patient identification number, to help them locate your records. Request an itemized statement that details every service, supply, and medication, along with associated billing codes and costs.

Reviewing Your Credit Reports for Medical Debt

Credit reports offer a distinct avenue for identifying medical debt, especially if it has been sent to collections. Individuals are legally entitled to a free copy of their credit report every 12 months from each of the three major nationwide consumer credit reporting companies: Equifax, Experian, and TransUnion. These reports can be accessed through AnnualCreditReport.com or by calling a toll-free number. Free weekly reports are also available.

When reviewing your credit report, look for specific entries that indicate medical debt. This debt typically appears as “collection accounts” and may list the original healthcare provider’s name or the name of a collection agency. Most healthcare providers do not directly report to credit bureaus; instead, medical debt usually appears on a credit report only after it has been sold to a collection agency.

Recent changes in medical debt reporting rules offer consumers additional protections. Paid medical collection debt is no longer included on consumer credit reports. The grace period before unpaid medical collection debt appears on a credit report was extended from six months to one year. Medical collection debt with an initial reported balance under $500 is also excluded from credit reports. These changes aim to mitigate the negative impact of medical debt on credit scores, recognizing that such debt often arises unexpectedly.

Verifying and Understanding Identified Medical Debts

Upon identifying a potential medical debt, requesting a detailed itemized bill is an important next step to verify its accuracy. An itemized bill provides a line-by-line breakdown of every service, treatment, and medication received, along with associated costs and billing codes. This detailed statement allows for a thorough review, which is often not possible with a summary bill. Request an itemized bill by contacting the billing department of the medical facility or provider, providing your information, and specifying the dates of service.

If a collection agency contacts you about a medical debt, you have the right to request debt validation under the Fair Debt Collection Practices Act (FDCPA). Debt collectors are required to send a written debt validation notice within five days of their initial communication. This notice should include the amount owed, the name of the original creditor, and a statement that the debt is presumed valid unless disputed within 30 days. Sending a debt validation letter within this 30-day window requires the collection agency to cease collection efforts until they verify the debt.

Comparing information across various documents is a helpful step in identifying discrepancies or errors. Cross-reference your Explanation of Benefits (EOB), direct medical bills, and any information found on your credit reports. Look for inconsistencies such as duplicate charges, services billed but not received, or incorrect patient information. Common medical billing errors include:

• Incorrect procedure codes
• Mishandled payments
• Missing information
• Unbundling of services
• Upcoding for more expensive procedures

Identifying these errors can help in disputing inaccurate charges and ensuring you are only responsible for legitimate debts.