Chi Chi Wu, a lawyer with the National Consumer Law Center, said the findings in part reflected the complexity of the health care payments system, which often involves insurers that may pay all or part of the cost of care. Consumers may not understand the details of how their health insurance works, and may think that it covers more than it actually does. Co-payments and deductibles — the amount that you pay before insurance does — can often trip people up.
“The medical and health care billing process is just really confusing and complicated,” Ms. Wu said.
The report also detailed complaints about abusive behavior by collectors, as reported by some consumers. In one instance, a consumer received a call at work, supposedly from a doctor calling about a medical emergency. But the call turned out to be from a debt collector. In another, collectors called a consumer’s relatives to demand payment.
The consumer bureau, which shares responsibility for enforcing the federal Fair Debt Collection Practices Act, which bans abusive practices, has taken several actions in recent years to rein in aggressive medical debt collection activities.
To complain about a medical debt collector, you can submit a complaint online to the consumer bureau or contact your state attorney general’s office.
A representative of ACA International, a trade group for debt collection companies, did not immediately respond to a request for comment on the report.
Here are some questions and answers about medical debt collection:
What should I do if I am called by a collector about a medical debt?
Bruce McClary, spokesman for the National Foundation for Credit Counseling, recommends that consumers first confirm who is calling — is it an affiliate of the hospital or doctor’s office where the treatment occurred, or is it an outside debt collector? If it is the original care provider, he said, “You have more negotiation options up front.” You might ask if a partial payment is acceptable, or if making affordable monthly payments is an option.
Keep detailed notes of the call, he advised, including the time of the call and what was said.
In general, you should avoid the temptation to pay off your medical debt with a credit card, he said. The card will carry double-digit interest and may end up making your debt worse, if you cannot pay it off quickly.
Ms. Wu says consumers can ask for verification that they actually owe the bill. And if the collector is calling repeatedly, you can send a letter telling them to stop. (The collector may still take further action against you in court, however.) The Consumer Financial Protection Bureau offers sample letters on its website.
Can checking my credit report help avoid problems with medical debt?
Checking your credit report at least annually can help head off possible damage to your credit report, Ms. Wu said. In some cases, in particular if the amount owed is small, medical collectors may “park” the debt on your credit report, but not make any attempt to notify you or collect it. Then, when you need to apply for a car loan or a mortgage, the debt shows up — and you may feel pressured to pay it. By checking your report, she said, you will spot any unpaid bills before they cause big problems. You can do so at no charge once a year at www.annualcreditreport.com.
Will unpaid medical bills hurt my credit score?
Credit scores summarize the information in your credit report, and the latest scoring systems from FICO, which produces the most widely used scores, play down the weight of medical debt when calculating scores. Older scoring models used in the mortgage industry, however, may still give undue weight to medical debt, Ms. Wu said, so unpaid doctor bills could hurt you when you apply for certain types of home loans.
Correction: April 12, 2017
Because of an editing error, an earlier version of this article misstated what a new report says about complaints to federal regulators about medical debt collectors. About two-thirds of those who complained said they did not owe the money, not that they did owe it.