Consumer organizations are have been examining the billing and collection practices or non-profit and for-profit hospitals for many years.  Negative publicity of aggressive billing and collection practices has resulted in lawsuits filed in federal and state courts, congressional investigations and action taken by state legislatures and attorneys general.  All of this has focused attention narrowly on medical debt and more broadly on the issue of uncovered services.

Concerted efforts taking place at local, state and federal levels regarding hospital charity care have brought this issue to the attention of policymakers are all of these level.  Local groups (Champaign County Health Care Consumers, AMOS:A Mid-Iowa Organizing Strategy, Tenants and Workers Support Committee, etc.) collaborate with area hospitals to clarify and publicize existing policies, some states groups(UHCAN-Ohio, Health Access- CA, Health Care For All- MA) have promoted legislation or regulation to require hospitals to provide or report on the specifics of the charity care, and national groups (Consumers Union, Community Catalyst, Families USA, The Access Project) have provided input on IRS and Sen Finance Committee proposals recommending changes regarding the level of charity care provided and the reporting of it.

Medical Billing Advocates of America is committed to educating and arming the public with the knowledge they need to fight escalating healthcare costs and ensure that no one pays a dime more than they truly owe for medical care.  They strive to hold the medical billing establishment accountable for inaccurate and inflated charges. Working together, we can stop the healthcare providers and healthcare insurance industries from passing the cost of their errors on to the American public.

The Access Project has developed a Medical Debt Resolution Program which features a self-advocacy protocol for helping people to resolve their medical debt.  While the program has been highly effective at eliminating or reducing bills, the remaining bills may still outstrip household savings and be difficult to repay.

Patients are unaware of existing financial assistance programs.  Providers and patients would benefit from working in partnership on billing and collecting issues.  In particular, insured patients working with provides could identify insurance company policies and practices that result in wasteful and inappropriate billing, underpayments and reduced revenues for providers.   Through collaboration, patients could face lower uncovered health care costs and providers could spend less in collection efforts; both would benefit from identifying ways to streamline insurance practices and ensuring that insurers pay for all services they are obligated to cover.

• Transparency across multiple pricing and reimbursement strategies
• Realignment of collection practices and risk in system
• Smoothing the vicissitudes
• Potential for new alliances