Justice in Motion: Medical Bills — Open (and read!)

Medical debt can be overwhelming. If you are (or were) uninsured or underinsured, you may be one of those people who stack unopened medical bills on the table by the front door (or in a shoe box under the bed or “file” them in the garbage can).

Stop! Open your bills! You need to understand your debts.

In my practice, consumer cases are cases my clients often get meaningful resolutions. I am in the process of wrapping up three medical debt collection cases. Each client is low-income and employed; meaning they were under threat of wage garnishment. Each had over $10,000 in medical debt from several years ago.

Their settlements: one paid just over $100; another paid just under $1,000 with a tax refund; and the last is in an affordable monthly payment plan to pay about $1,000 with no interest accrual (and if payments are made timely, the court judgment will not be entered). Some collection agencies do understand the proverbial “bird in the hand is worth two in the bush” and will agree to reasonable resolutions.

Keep in mind certain types of income, e.g., SSI, Social Security, TANF, veterans’ benefits, some pensions, etc., may be exempt from garnishment altogether. And, medical debt older than six years may be time-barred from collection IF no payments have been made and a collection case was never filed in court.

With medical debt in particular, if you were low-income at the time you received hospital-based medical services in Washington, you may be eligible (typically on a sliding scale) to have your medical debt reduced or forgiven. All primary payers, e.g., Medicaid, insurance, etc., must first be exhausted.

My colleagues in other parts of Washington sometimes encounter push back from hospitals, which is odd as charity care debt looks better on their books than bad debt. In contrast, our local hospitals, Grays Harbor Community Hospital and Summit Pacific (f.k.a. Mark Reed) have been cooperative in working with my office in processing charity care (or “Community Care” at Summit Pacific) applications.

Even if medical debt has been transferred to a collection agency; even if the case has gone to judgment and resulted in garnishment, if eligible for charity care at the time the services were provided, under the Washington Administrative Code, applications can be submitted “at any time” to see if medical debt can be reduced or forgiven. If eligible and payments have been made on the debt, some or all of the payments may even be eligible for refund.

When applying, in addition to providing information about your present income, be sure to provide verification of your income at the time of the date of service. The applications do not always ask for this, but the analysis of your eligibility is based on your income at the date of service, NOT your present income.

If you filed for income taxes, one of the easiest ways to confirm your income is an IRS transcript from http://www.irs.gov/Individuals/Get-Transcript. It’s free and they usually show up in the mail in about 7-10 days. If you were employed, but did not make enough to file, your employer should have provided a W-2. If you were unemployed, written verification can be provided by a third party, e.g., DSHS, a family member, etc.

Charity care applications often request more information than what is required. You do not need to provide multiple, overlapping, redundant proofs of income, bank statements, etc. You only need to provide the minimum required snapshot that accurately reflects what your income was for the year in which you received the medical services.

Lastly, do not wait until you get sued for medical debt. It is best to apply promptly after the medical debt has been incurred and billed. Outside medical services contractors providing services at the hospital, e.g., radiology, physician groups, specialists, etc.—though not required to do so—often honor charity care reductions. If you wait until the outside contractor refers the debt to collections, they are often unwilling to reduce or forgive the debt that late into the process.


Summit Pacific:

Billing: 1-888-292-8810


Grays Harbor Community Hospital:

Main line: (360) 532-8330

Patient last name A-L: (360) 537-6114

Patient last name M-Z: (360) 537-6150


The website is being upgraded. Charity care applications will be available online soon.

Charity care information: http://www.washingtonlawhelp.org/issues/health/getting-medical-coverage-...

General consumer debt information: http://www.washingtonlawhelp.org/issues/consumer-debt

To find out if you are eligible for Northwest Justice Project services:

For cases including youth (Individualized Education Program and school discipline issues), debt collection cases and tenant evictions, please call for a local intake appointment at (360) 533-2282 or toll free (866) 402-5293. No walk-ins, please.

For all other legal issues, please call our toll-free intake and referral hotline commonly known as “CLEAR” (Coordinated Legal Education Advice and Referral) at 1-888-201-1014, Mondays through Fridays 9:10 a.m. to 12:25 p.m. If you are a senior, 60 and over, please call 1-888-387-7111; you may be eligible regardless of income. Language interpreters are available. You can also complete an application for services at nwjustice.org/get-legal-help. Be sure to also check out our law library at: www.washingtonlawhelp.org.

Sarah Glorian is the senior attorney for the Aberdeen office of the Northwest Justice Project, a private, non-profit legal aid organization providing free representation to low-income residents in Grays Harbor and Pacific counties.


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