What to do if you get a late medical bill

Last week, I got an unpleasant surprise in the mail: an unexpected doctor’s bill for $150. It was unexpected for a pretty good reason: The insurance company it ran through hasn’t been my plan for three years. When I switched to my new coverage, I ensured everything was fully paid off—at least every bill I knew about. 

I called the insurance company to see what the issue was, and they explained to me the late medical bill was from about three years ago; it just hadn’t been processed until now. I had so many questions. How long does a medical provider have to bill you? Do you have to pay medical bills? How long do you have to pay medical bills? And how would this affect my credit?

My bill is still up in the air. But if you’ve faced this same situation—or you’ve just plain forgotten to pay a bill—here’s what you need to know about late medical bills.

How long does a medical provider or hospital have to bill you?

You might be surprised to know, as I was, that medical providers and hospitals can take a pretty hefty amount of time to send you a bill. The rules and regulations vary by state, but they are often allowed several years.

For medical providers, the law “varies from state to state,” says Adria Gross, the founder of MedWise Insurance Advocacy. “In Florida it’s five years; New York is two years; Texas is no longer than the first day of the 11th month; California is 12 months.” Gross recommends checking with your state to see what the limit is. 

With hospitals, it again varies between states. “It’s normally within three to six years,” Gross explains. “[But] even after that time, the hospital can still try to collect.”

These time frames are called medical billing time limits, which is how long it’s allowed to take to submit a claim to the payer—whether that’s you or your insurance.

Do you have to pay medical bills?

In short, yes. You are required to pay the medical bills you incur—whether that’s directly or through your insurance. Depending on your plan, you may need to pay a copay, coinsurance, or the full bill until a deductible is met. You may also have a secondary policy to cover the extra costs you’re responsible for. But, in one way or another, you will have to pay for your medical care.

You do have some options, though. Speak with your medical provider to see if you qualify for financial assistance or can offer you a payment plan. They’ll likely look at your income to make a determination, but it can help cut the cost or spread it out so it’s less of an immediate impact. In some cases, they may identify the bill was sent in error.

RELATED: How to pay for medical bills without insurance

How long do you have to pay medical bills?

The standard repayment time for a medical bill—whether you receive it on time or not—is 30 days. That being said, every provider or hospital is different, so make sure you check with them to see what the allowable payment timeframe is.

What happens if your doctor’s bill becomes overdue?

When your bill is overdue, the provider can issue late fees and interest charges for a certain period of time to encourage you to pay. If you don’t, they will often give you a last warning (and final chance to pay). Then, if you still don’t pay they have the option to turn the bill over to a debt collection agency. 

When this happens, you will likely need to work it out with the collection agency as it will be out of the provider’s hands. Just keep in mind that once that bill goes to a collection agency, it may negatively affect your credit report.

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What is a typical late fee for a medical bill?

The amount of late fees and interest on medical bills varies by the provider. If you qualify for financial assistance or arrange a payment plan, you typically aren’t required to pay anything outside the cost of the medical bill itself. But for simply a late bill, it’s up to them. Sabrina Watkins, credentialing manager at Choosing Therapy, rarely sees providers charge a late fee, but Gross has seen fees hovering around 1% to 1.5% of the total bill.

What’s the process for paying late medical bills?

Follow these steps to pay a late medical bill, whether you’ve missed the payment or gotten the bill far after the service date.

1. Check your records to see if you’ve already paid.
2. Call the provider to double check what the bill is for.
3. Follow up with the insurance company to see what they paid.
4. Ask for supporting documentation to ensure the bill is accurate.
5. Pay the bill, either in full or with a payment plan.

Essentially, you’re trying to determine whether there’s been a medical billing error, which can sometimes be the cause of an excessively delayed bill.

“Errors happen about 10% of the time,” Watkins says. “If you discover an error or believe one has occurred, you should first contact your insurance carrier and verify your benefits and ask how that claim was processed and explain your balance. If the balance is different than what the provider’s office billed, contact them and advise them of what your carrier said you owe. You should always read your policy and know exactly how your benefits are paid out and what you are expected to pay before they cover at 100%. Always read the financial policy of the provider.”

How do I get a late medical bill cleared from my credit report?

Before determining how to get a late medical bill cleared from your credit report, it’s important to understand the rules and regulations behind how those bills get on your credit report in the first place. From now until Jun. 30, 2022, a hospital must wait for six months after the service date to submit an overdue bill to credit bureaus. But lucky for us, that rule is changing. Gross says that beginning Jul. 1, 2022, that timeframe is being pushed out to 12 months. So if you’ve had an overdue bill for a year, only then can it be submitted to credit bureaus.

Of course, that will leave some lingering bills left on the old timeframe still showing up on your credit report. Plus, even if you paid off a bill, that blemish might still be affecting your credit. Gross and Watkins both say that all you have to do is call the credit bureau with proof of payment, and it’ll be removed from your report—according to an agreement between the major credit agencies in the U.S.