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Medical Collection Letter Template for United States

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Medical Collection Letter

"I need a Medical Collection Letter for outstanding charges of $3,500 from a cardiology practice in California, where the patient has not responded to previous billing attempts and insurance claims were denied in January 2025."

Document background
The Medical Collection Letter serves as a critical tool in healthcare revenue cycle management, used when standard billing efforts have been unsuccessful. This document must carefully navigate the complex intersection of healthcare privacy laws (HIPAA) and debt collection regulations (FDCPA) in the United States. The letter includes specific required disclosures, debt validation information, and payment options while maintaining patient confidentiality. It represents a formal attempt to collect payment while respecting both the healthcare provider's right to compensation and the patient's legal protections.
Suggested Sections

1. Patient Identification: Patient name, account number, and other relevant identifiers (while maintaining HIPAA compliance)

2. Debt Information: Amount owed, service dates, and original creditor information

3. FDCPA Disclosure: Required legal notice about debt collection rights

4. Validation Notice: Statement about right to dispute debt within 30 days

5. Payment Instructions: How and where to make payment

Optional Sections

1. Payment Plan Options: Details of available flexible payment arrangements, included when payment plans are available

2. Insurance Information Request: Section requesting updated insurance information when insurance status needs verification

3. Financial Assistance Notice: Information about available financial assistance programs, included when required by state law or institutional policy

Suggested Schedules

1. Itemized Statement: Detailed breakdown of charges and payments

2. Payment Slip: Detachable portion for returning with payment

3. Privacy Notice: HIPAA-required privacy practices notice

Authors

Alex Denne

Head of Growth (Open Source Law) @ ¶¶Òõ¶ÌÊÓÆµ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Clauses




















Industries

Fair Debt Collection Practices Act (FDCPA): Federal law that regulates debt collection practices, prohibits harassment and false statements, requires specific disclosures, and defines collection communication requirements

Fair Credit Reporting Act (FCRA): Federal law governing credit reporting practices, including requirements for accuracy in reporting medical debt and waiting period requirements for reporting medical debt

Health Insurance Portability and Accountability Act (HIPAA): Federal law governing privacy and security of medical information, including restrictions on sharing protected health information and requirements for maintaining patient confidentiality

Consumer Financial Protection Bureau (CFPB) Regulations: Federal regulations providing additional debt collection requirements and specific guidelines for medical debt collection

No Surprises Act: Federal law establishing requirements regarding unexpected medical bills and patient protections against certain billing practices

State Debt Collection Laws: State-specific laws that may impose additional or more stringent requirements on debt collection practices than federal regulations

State Medical Billing Regulations: State-specific rules governing medical billing practices and procedures

State Debt Validation Requirements: State-specific requirements for validating medical debts before collection

State Statute of Limitations: State-specific time limits for legally collecting medical debts

State Licensing Requirements: State-specific licensing and registration requirements for debt collectors operating within the state

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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