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Just because it's not on a report doesn't mean providers have no recourse when it comes to seeking compensation. If they so choose they can take anyone to court and obtain a legal judgement. The frequent calls and letters from collectors are no picnic either.
The biggest issue I have with paying bills on time is the stupid billing systems. Like 30% of the time I either can't find the payment option in their portal, login doesn't work, don't see any record of services (i.e. just give us money), or the total amount owed is different from the paper bill. Life is distracting, and if I can't assess what I'm paying for and get to the "Submit Payment" button in 10 mins then don't expect me to remember 8 hours later when I again have free time.
No, but most of the time it's simply not worth it for hospitals to fight. Either they'd spend more time and money on lawyers, arbitration, etc. than they'd be able to collect if they win, or the patient is poor and all but judgement-proof.
If I recall reading the updated proposal from the CFPB correctly, it's supposed to be putting a stop to the debt collectors too. The only recourse left, if I'm reading everything correctly, would be for the hospitals to sue patients directly, and that would probably only be for bills high enough to make seeking legal action worth it and if they feel the patient has the resources to pay. The latter is the most important part -- whether the bill is for $100 or eleventy billion dollars won't matter if the patient is, for example, and elderly woman on disability with no possible way to repay anything.