Challenge Medical Bills in Small Claims Court
Small claims courts have been a fixture throughout America for over seventy years.
In the state of New York, for example, there are Small Claims Courts in each of the 62 counties — including at least one in each of the five boroughs of New York City. Most other states have similar coverage.
In small claims court, there is usually a single judge with no jury and no witnesses.
The courts are typically informal – designed to make the legal process accessible and affordable. The judge usually asks the plaintiff and the defendant to simply “Tell us your story in your own words.”
These courts serve individuals and small businessmen who might otherwise be too intimidated (and too broke) to initiate a formal lawsuit. It only costs the plaintiff about 30 or 40 dollars to file a case.
In most states, the limit on disputes is ten thousand dollars. In small claims court in Texas, the limit is twenty thousand dollars.
How to challenge medical bills
There are many medical bills that could be challenged in small claims courts, such as
- Extra billing for ‘facility fees’ (i.e higher charges for outpatient care done in hospitals)
- Outlandish charges for simple diagnostic tests (i.e. $5000 for an echocardiogram)
- $14,000 for a drug infusion that costs $500 in Britain, France, or Germany
- $12,000 for the use of an “operating room” to conduct a 20 minute surgery
- $15,000 for a ‘Trauma Activation Team” to help with an ER admission
- $10,000 for an anti-venom inoculation that costs the hospital about $200.
- $10,000 for one hour in the emergency room for back pain
Before filing a medical billing claim, the patient/plaintiff must gather their evidence – usually, this will be research on what are considered fair prices. The patient should consider sending a warning letter to the entity behind the bills – saying that if the bill doesn’t get corrected the consumer will file in court.
The warning letter is an important step. If you do go to court, you want to be able to show the judge that you did everything you could to be fair and to avoid wasting the court’s time. Plus, sometimes the warning letter will be enough to bring a matter to a conclusion that’s fair for the patient. Providers may not want to pay hundreds of dollars per hour for their attorneys to defend a small claims lawsuit.
Meanwhile, all bill collections can be suspended while a patient is waiting for a hearing in small claims courts.
However, the plaintiff/patient should not expect the entire bill to be wiped away in small claims court. Sometimes the best result is that the hospital or clinic is forced to retreat to what most judges would consider “reasonable charges.”
Judges can rely on ‘market-based fair value ‘– which is the amount that the hospital actually receives in payment from the majority of insurers for the same care that has been provided to the patient in question.
Medical devices and drugs often have outrageous markups when a hospital is involved.
If constant court cases lead to the end of this practice, the nation will be better off.
But patients should remember this:
For whatever amount the judge finally approves, a money judgment from the court is created. The court becomes a judgment creditor and you are called a judgment debtor.
The judgment is generally enforceable for 20 years and accrues interest at 9 percent per year. The other side may try to enforce the money judgment via an enforcement officer, who might be a sheriffs or a local police officers. The judgment creditors will sometimes hire a collection agency to get the help of enforcement officers. Enforcement officers may garnish your wages or freeze your bank account , and seize, sell, or get a lien on property.
You can indeed challenge medical bills in Small Claims Court – but be prepared to pay something even if you win!
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