Sample Letter to Collection Agency
[COLLECTION AGENCY NAME]
[COLLECTION AGENCY ADDRESS]
Re: Request for Suspension of Collection Pending Determination of Eligibility for Hospital
Dear [COLLECTION AGENCY NAME]
My hospital bill from [HOSPITAL NAME] has been sent to you for collection. I believe that I should have been offered and granted financial assistance for the medical services that I received at [HOSPITAL NAME] on [INSERT DATE(S) OF SERVICES].
California's Hospital Fair Pricing Act (CA Health & Safety Code § 127400 et seq) requires hospitals to have written financial policies and notify their patients of these policies. According to the law "Uninsured patients or patients with high medical costs who are at or below 350 percent of the federal poverty level . . . shall be eligible to apply for participation under each hospital's charity care policy or discount payment policy." CA Health & Safety Code § 127405(a).
[Select the circumstances that apply]
- I am uninsured and the hospital did not inform me that I could apply for financial assistance or seek coverage from government program as required by CA Health & Safety Code § 127410(a) and § 127420(b). I am now trying to do so.
- I have applied for financial assistance and am waiting for a decision from the hospital. CA Health & Safety Code § 127425(e) requires that you wait to collect on this bill.
- The hospital wrongfully denied me financial assistance according to the requirements of CA Health & Safety Code § 127400 et seq and I am appealing this decision [or] filing a complaint with the Department of Health Services.
- According to CA Health & Safety Code § 127425(d), you may not report me to a credit reporting agency or commence a civil action against me for 150 days after I was initially billed.
If you continue to try to collect on this bill before a determination of financial assistance is made on my account, you may be in violation of the Rosenthal Fair Debt Collection Practices Act and the federal Fair Debt Collection Practices Act. CA Civil Code § 1788 et seq. and 15 U.S.C. § 1692 et seq.
I am asking that you cease collection on this bill until [HOSPITAL NAME] makes a decision regarding my financial assistance application.
CC: [HOSPITAL NAME] (Send a copy to the hospital)