Some hospitals “resolve” bills in the worst possible way — by turning to collection agencies and even litigation. For the patient, it means financial worries; for hospitals, it means bad publicity and little chance of reimbursement.

Now, there are new best practices for departments to help handle medical bills.1 The guidance, created by the Healthcare Financial Management Association (HFMA) and the Association of Credit and Collection Professionals, includes a checklist of steps to take before resorting to “extraordinary” collection actions (defined by the IRS as liens, credit reporting, lawsuits, or wage garnishments).

“The economy has changed with COVID. It’s a good time to remind people about the best practices for collections,” says Richard L. Gundling, FHFMA, CMA, HFMA’s vice president of healthcare financial practices.

Many have lost their jobs and coverage. They need the expertise of patient access staff. “It’s great when revenue cycle staff are seen as an advocate for the patient. It should not be a contentious relationship,” Gundling says.

When patients first learn about a hospital bill, the reaction often is avoidance. “People may not be thinking clearly and are just reacting,” Gundling observes.

Transparency on the cost of care is the only way to avoid drastic steps like collection agencies. Providers and hospitals need to realize what third-party collection agencies are doing on their behalf. “They may think it’s just additional phone calls and letters,” Gundling says.

Hospitals that disregard unethical or illegal practices are going to face consequences. “They are the hospitals that will start sticking out like a sore thumb,” Gundling adds.


  1. Healthcare Financial Management Association. Healthcare Dollars and Sense.