Another Reason to Expect Health Care Cost to Increase

Today I was informed by my collection agency that no more patient accounts would be accepted for collection with balances under $500. The reason? As a result of pressure from politicians and “consumer advocates” none of the big three credit rating agencies will ding consumer credit for unpaid bills of under $500.

Just to let you know, the vast majority of unpaid bills in my practice are under $500. This change will make most patients who rip us off virtually untouchable.

Historically, it was not practical to pursue patients with small balances in small claims court. We reported them to credit bureaus. Eventually, when the deadbeat sought a loan, he would have to pay us to clean up his credit history. Now this motivation will be a thing of the past.

People never think of the repercussions of such so-called “consumer protection” actions. Practice owners like me will be forced to make more patients pay in full up front, especially with first-time emergency patients. A greater percent of our revenues will go uncollected, forcing doctors to raise fees. As usual, responsible people will pay for letting the irresponsible people escape payment.

It is a myth that most patients are placed in collections through no fault of their own. The vast majority are NOT victims of any sort. When I review bankruptcy notices of patients, I invariably find very foolish and irresponsible borrowing for things like trucks, boats, RVs, ATVs, and other luxury items.


This new practice you are describing seems consistent with the “permissible theft” that is occurring in retail stores every day. Our degenerating society has taken individual accountability in life and thrown it out the window. Now its about entitlement…


Clark is a big fan of the new credit reporting rules. I would love to hear his response to your post.

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The narrative is that responsible people are thrown into bankruptcy by unexpected colossal medical expenses. Although doubtless this sometimes happens, people taken down this way are usually head over heels in debt for other stuff to start with.

Even if it were so, “consumer protection” laws would prohibit reporting to credit bureaus for huge sums, not small ones under $500. It is the small charges uncollected charges that really add up in a practice.

Had a patient complain about high health care costs in the USA. I ran down the list of all the ways our government raises the cost of health care by its various dictates- most notably how large health care facilities have to be over here compared to other countries, due to the Americans with Disability Act. Her eyes just glazed over, because the truth did not fit her narrative.

Every time you cripple small business by things such as making it impossible to collect legitimate charges, you increase the cost to honest consumers.

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One trip to the hospital, and being assigned a physician or service whose providers are not on your plan’s provider list and you can suddenly owe many thousands, if not hundreds of thousands of dollars.

These consumer protection laws were not designed for people who don’t pay smaller dental office (or doctor office) bills.

Most doctor offices require payment either before or after seeing the physician.


Problem here is that healthcare is a for profit business here. So of course if you focus on profit you don’t like it. Maybe you should have chosen a profession in corporate investments…You ain’t a doctor!

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Next time how about telling us how you really feel about Hanks thoughts. :laughing: :smiling_face_with_three_hearts:

I noticed you trimmed my answer so that excerpt is taken out of context. shame. Also I don’t see a Hanks anywhere in that thread.

Or maybe you were sarcastic/ironc. In that case my apologies.

Ooops! I left out an apostrophe, Hank’s might might make more sense as in Hank, short for Henrius. It’s a holdover from times Henrius posted similar thoughts to these on the late lamented legacy Clark political forum. His thoughts might be more measured here, but they touch all the wrong bases still.

If they weren’t designed for people that don’t pay smaller bills, why is reporting smaller unpaid bills no longer allowed?

You are naive if you think physicians or dentists can accurately predict 100% of the time what insurance will pay. Many times patients walk in the day after they quit their job or were fired. We call and verify coverage. Then we file the claim and find any payment disallowed. Now we cannot collect from the patient. He has just stolen services, so others must pay more for theirs.

Quite the stupid comment. Show me one country in the world where healthcare providers do not expect a profit for their labor.

Whether employed by the government or in private practice, all providers have to turn a profit, just like others workers. And it is harder to do when government makes it harder to collect legitimate bills from patients.

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Please don’t call other people stupid without investigating first (I have 3 post graduate degrees, 2 MS + 1 MPM)
NHS, England, salary through taxes, not profit. OOPS, it’s a FG Clusterfk right now.
France (my former country) Securite Sociale, and Germany (also my former country) Krankenkasse. They seem to be holding for now. But you have 2 tracks: public & private. Of course only the rich can afford the private route (although there are complimentaire de sante assurances, since I no longer live there it’s complex).
I do not argue for Med practices losing money, of course not, it would just lead for more med wasteland, hence counterproductive. But I do argue for patients getting their money’s worth. And I attest that I really, really not feel that way.
So, unlike you, I’m not calling you stupid. I’m just asking that you consider all factors in the life of your patient. Maybe a bit more empathy?

Does the SCC in your jurisdiction allow you to include labor and expense charges in your SCC complaint. This would include and hourly rate for the filing, travel time and milage and attendance labor.

Having some one on your staff who might be an account or office manager with some experience in SCC might change the dynamics.

Not exactly true…yet…
My sister was paying monthly on a medical bill and they sent the last $150 to a collections agency…that was within the last 60 days…

He didn’t say you were stupid. Just that it was a stupid comment. Which it was.

Show me one country we’re the cost of a host of healthcare and dental procedures are near the cost of the same procedures in this country. Same goes for prescription medications. Profits are expected and logical, profiteering, not so much.

On the other side of the coin, a physical therapy practice billed me erroneously for appointments that had been cancelled well in advance for valid reasons having to do with their own policies. I paid for all visits I had attended but refused to pay for the visits I had not attended. Several years later, I was sent a collection notice that included penalties. Still it amounted to just over $100. That was posted to my credit report despite my sending notice by certified mail, just as Clark suggested, to the collection agency that the debt was invalid. I have a very high credit score and figured that even if posted, the debt would expire in less than 2 years. Now I see that the posting has been dated as of 2021 on my credit report. I have disputed it but it remains on my report with only a note that I denied it was a valid debt. Despite this new law, it remains on my credit report. So, you see, this law came about to reign in the mis-practices of the credit bureaus, not to hurt practitioners. Unfortunately, practitioners are caught in the middle of the credit bureau’s mess.

The notice I got from my collection agency saying the big 3 credit agents will not report on small medical debt came to my desk 1 week ago. It was a recent change.

To be clear, we can still send patients to collections with small balances. But most collections will not take small balance accounts, as their main tool (reporting to credit ratings bureaus) has been taken away.

Our only remedy now will be collecting a number of past due accounts, and paying an attorney to go after them in small claims court. This is less efficient, so guess who will pay for our decreased collection rate.

No, the law came about to protect “victims” who would not pay their small balances. As with all other debts, creditors have always had a right to dispute what they think are unfair dings on their credit report. It is comical to see some of the excuses deadbeats post in response to being placed in collection. No deadbeat wants to suffer for not paying their bills. I am not judging your case, however.

Unpaid bills for services are unlike unpaid bills for physical items. We cannot repossess health care services.