The way that we pay for medical bills is incredibly unique. It’s not straightforward, customer-friendly, or simple. You usually have no idea what each visit will cost you until you receive a bill three months after your appointment. It’s a process seemingly unlike any other we encounter in our modern, 21st-century society.

You see, medical bill payment is a three-party process, unlike most service payment arrangements we come across. Think of it this way: You hire a landscaping company to install some new grass in your front lawn. You call and make the appointment, they show up on a Monday morning, ask you for a small deposit (like a co-pay), and then get to work. After they’re done, they head back to their office without any mention of the bill. At this point, the new grass is installed, but you still don’t know what it’s going to cost you!

When the landscaping company arrives at their office, they hand your file off to their billing specialist. The billing specialist then sends a bill out to your homeowner’s insurance provider. The insurance provider then sends you a statement explaining what they’re going to pay for (like an explanation-of-benefits). Sometime later, the landscaping company sends you a bill. You’re shocked! $3,000? But what about insurance?

The whole process can make you, the customer/patient, feel very in the dark, and over time, memories get fuzzy. Combine this with unexpectedly high bills and lost mail, and more often than we’d like to imagine, bills don’t get paid.

And the unfortunate truth is that doctors’ offices are good at treating patients, not collecting payment. So what do they do?

They farm it out to collections.

The Collections Process

Once a collection agency has received your bill, it typically does one of two things:

1. Harass you until you pay it; or

2. “Park” it on your credit report and wait. (This is generally illegal, so if it happens to you, you should seek legal counsel.)

And whether the collection agency starts harassing you for payment or simply waits until you notice, having a collections account on your credit report is definitely going to affect your credit score.

While people are accustomed to debt and poor credit history affecting their ability to get a loan for a house or a car, many people don’t realize that unpaid medical bills can also impact their ability to obtain medical care.

Your Doctor’s Ability to Dismiss You

Outside of emergencies, doctors are generally free to dismiss patients whenever they choose. While doctors can’t commit “patient abandonment" they more often than not are free to give you the boot whenever they see fit. As long as a doctor provides adequate time–usually 30 days–they are typically 100% within their rights to end their relationship with a patient. So if you don’t pay your medical bills, you may find yourself at risk of needing to find a new healthcare provider. And even if you’ve paid off a delinquent medical bill, the doctor can still usually refuse to continue treating you!

The moral of the story is, if you get behind on your bills, talk to your doctor about a payment plan. Just “not paying” is not a solution–it’s a recipe for needing to find a new doctor.

Other Doctors’ Ability to Refuse to See You

But it’s not just your current doctor that could refuse to treat you. Some doctors also perform credit checks before admitting patients. While healthcare providers technically need your authorization to check your credit, unless you have an outstanding balance or are applying for financial assistance, many patients unknowingly give consent when they fill out their new patient paperwork. Most people don’t read the “fine print,” so it’s a perfect place for doctors to sneak in a credit check authorization provision.

This means that if your medical bills get sent to collections, you could end up dismissed by your original doctor and struggling to find a new one!

To make sure that this doesn’t happen–build a strong relationship with your doctor’s office.

When it comes to medical bills, communication is vital. Healthcare offices see hundreds to thousands of patients each month, so when your account becomes delinquent, it’s no longer Sarah Murphy, the nice lady with red hair’s bill, it’s Patient #004027’s bill. Communicating with your doctor’s billing coordinator can help keep your bills out of collections.

Here's how:

First, patients should be sure to verify that their doctor has the proper mailing address. This might seem obvious, but many patients get sent to collections simply because they never received a bill. That is not a risk that any patient should be willing to take. If you move, proactively reach out and make sure that your doctor’s office has your updated address. Don’t leave your credit score and ability to obtain medical treatment in the hands of the US Postal Service.

Second, closely review the explanation of benefits that your insurance provider sends you. Make sure that the services that they billed actually were provided. Remember that even a small bill can get sent to collections, so don’t be afraid to ask for clarification if something doesn’t seem right.

Finally, if you are having a hard time paying your balance, please ask the billing department to help make accommodations. It is possible that you may qualify for financial assistance or that the doctor’s office may be able to set you up with a payment plan. They can’t, however, do any of those things if you don’t ask.

Medical bills being sent to collections can be a disaster for your life. You can get “fired” by your doctor and have a hard time getting “hired” by another. It can also harm your ability to buy a house or a car. It’s the epitome of a lose-lose situation. Fortunately, by building strong lines of communication between yourself and your doctor’s billing team, you can give yourself a much better chance to make sure that you don’t find yourself struggling to find a new doctor when you need one the most.