wife completely absolved herself. We were not going to send her to collections anyway, but I think this example perfectly illustrates the situation in which we often fnd ourselves.
Has this patient made an effort to pay his or her bills? How many days delinquent is the account? The key word here is “effort.” Has the patient made any effort at all? A patient who has sent in $15 each month for four months on a $300 account is going to get better consideration than someone who has paid zero per month for four months.

I was more aggressive than most billers in that I wanted all accounts paid within six months. I would usually allow “micro- payments” the frst few months if the patient would agree to a balloon payment at month six. Most billers will allow payment plans greater than six months. As a patient advocate, the longest payment terms I have ever gotten for someone was two years.

Has this patient followed an agreed upon payment plan? If you get the biller to agree to let you make payments, it is crucial that you not miss a payment. There is an “implied contract” when you enter a payment plan that the provider has waived its ability to collect the full amount due immediately as long as you make your payments on time. Once you miss a payment, this “implied contract” is breached and they can call the full amount due immediately. If you think you are going to miss a payment, I strongly recommend that you call the provider before the due date and let them know. This might be your only chance of preserving your payment plan.

Now that we understand our bills and EOBs and we know how billers think, we are almost ready to talk to them. Let’s suppose there’s a biller on the phone. After the biller has introduced himself or herself and had a chance to ask any minor questions about your insurance or identity, I usually like to open with something like this:

I was happy with the service we received at your facility. They did a good

48 // The Medical Bill Survival Guide