What Happens if You Don’t Pay an ER Bill?

Unpaid emergency room (ER) bills present a common financial challenge. Costs can be substantial, even with insurance, leading to financial struggles. An average ER visit can range from $1,500 to over $3,000 without insurance, with complex cases potentially exceeding $20,000. These high costs are often due to facility fees, professional fees, and extensive diagnostic testing. Understanding the progression and consequences of an unpaid ER bill is important.

Initial Stages of an Unpaid Bill

An emergency room bill enters a standard billing cycle. The hospital issues a bill detailing services and amount owed. Subsequent statements and reminder notices follow if payment is not received.

Healthcare providers undertake internal collection efforts before escalating debt externally. These efforts include phone calls, letters, and attempts to verify insurance or arrange payment. Hospitals may offer payment plans during this phase to help patients manage the debt.

A bill becomes delinquent if it remains unpaid for 60 to 120 days. This indicates the bill is overdue and requires focused attention from the billing department. Hospitals attempt to resolve the balance internally for several months before considering external collection actions.

Debt Collection and Credit Impact

If an ER bill remains unpaid after internal collection efforts, it may be transferred or sold to an external debt collection agency. A third-party debt collector acquires the right to pursue the debt, often at a discounted rate. Agencies initiate contact through letters and phone calls, adhering to the Fair Debt Collection Practices Act (FDCPA).

The impact of an unpaid medical bill on an individual’s credit report has evolved. Historically, medical debt could significantly affect credit scores, but recent changes provide more protection. As of 2023, medical debts under $500 generally do not appear on credit reports. Additionally, medical collection accounts are not reported to credit bureaus for one year after being sent to collections, providing a grace period for resolution.

If a medical bill is paid after being sent to collections, it will be removed from credit reports. However, unpaid medical collection balances exceeding $500 can still negatively impact credit scores and remain on a credit report for up to seven years. While medical debt is handled differently than other types of debt, an unresolved collection can still affect a consumer’s ability to obtain loans, rent an apartment, or even secure certain employment.

Legal Action and Its Implications

When an ER bill remains significantly unpaid and collection efforts are unsuccessful, hospitals or debt collection agencies may pursue legal action. This typically involves filing a lawsuit to obtain a judgment for the outstanding debt. The process begins with the debtor receiving a summons and complaint, which are legal documents notifying them of the lawsuit and claims.

If a judgment is granted in favor of the healthcare provider or collection agency, it allows for various enforcement actions. These include wage garnishment, where earnings are withheld by an employer and sent to the creditor. A bank account levy permits the creditor to seize funds from bank accounts. Liens on property, such as real estate, may also be placed, complicating selling or refinancing assets.

Legal actions are often considered a last resort and are dependent on the amount of debt and specific state laws. While a hospital or collection agency can sue for unpaid medical bills, they are often less likely to do so for smaller amounts compared to other creditors. If a lawsuit proceeds and a judgment is obtained, the financial consequences can be severe, including additional court fees and interest charges.

Addressing an Unpaid Emergency Room Bill

When faced with an unpaid ER bill, proactive engagement can mitigate negative consequences. Contacting the hospital’s billing department is an important first step, even if the bill has gone to collections. Many hospitals have financial counselors or patient advocates who can assist in understanding the bill and exploring options.

Patients can explore negotiating the bill amount, as hospitals may accept a lower lump-sum payment. Setting up an affordable payment plan is a common solution, allowing patients to spread out costs over time, often with little to no interest. Hospitals, particularly non-profit institutions, are often required to have financial assistance policies (“charity care” programs) that provide free or discounted care based on income and family size.

Reviewing the itemized bill for accuracy is advisable. Billing errors, such as duplicate charges or incorrect coding, can occur and should be disputed. Documenting all communications, agreements, and payments with the hospital or collection agency is important for future reference. Seeking assistance from medical billing advocates can provide expert guidance in navigating complex billing issues and negotiating on a patient’s behalf.