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Sorry in advance for the long first post. My wife has a bill from her labor & delivery in July 2013. We prepared for some expenses at the beginning of the year but did not expect complications that led to about $800 in meds and DME, and a week in the hospital for mom and baby after delivery. So after paying for the meds and DME we had a $1500 bill from the hospital. I wanted to try getting it reduced since our income is at ~150% FPL but couldn't get the paperwork figured out. Long story short, I was putting it off until we got our tax return, checking the bills for "final notice" or "past due" in case we needed to just throw it on a credit card, and I was reading the bill wrong so missed the fine print and we got a letter from the CA this week. The CA letter has our correct information and amount, plus interest. The letter reads: Your delinquent account has been assigned to USCB America to collect the balance now due. USCB is not aware of any reason for your nonpayment. If you do not dispute the amount owing, please pay the balance due. And on the back: INTEREST DISCLAIMER: In the event your account is accruing interest, be advised that because interest charges vary from day to day, the amount due on the day you pay may be greater than the total amount due referenced on the front of this notice. I tried to research what to do which is how I ended up here. I told my wife not to talk to them if they call her. The letter says the debt was assigned to the CA, not purchased by the CA, so I called the hospital billing to confirm the amount due and ask how we can pay. The hospital billing rep gave me the amount due without interest, and said we can pay them directly, but she said two things that I don't completely understand. First she said, the account is in collections, and so the CA might charge interest, even though the hospital isn't charging interest - it sounded like she was saying the CA was charging the hospital interest, but she was definitely implying that this interest was our problem, not the hospital's problem. I tried to get her to explain but all I got was that we would find out within 30 days if interest was an issue. I thought a CA can't charge interest on a debt they don't own, but if they owned the debt, 1) why would the letter say "assigned" and 2) why would the hospital still accept payment or even talk to me at all? Second thing that I didn't understand: She said when we pay the bill, the hospital will tell the CA that we paid it. That's exactly what she said, but I don't think that's what we want. It sounds like they're going to put it on the wife's credit report as a collections account. I want to just pay them off, I can put it on the credit card and worst case scenario we pay a month of interest before our tax return comes (just waiting for the W-2s, they usually come at the beginning of February from wife's employer), but only if it's going to keep the debt from going on wife's credit report. Today we pulled her reports and there are no bad marks with 2 of the agencies, we have to wait for the trans union report to come by mail because she made a mistake in the identity verification step, but she checked her credit karma account (which uses trans union) and it's not showing up there so we're assuming the account has not been reported to the CRAs. (So I don't think we can use Why Chat's HIPAA process since we have no collections account to dispute to the CRAs which is the first step.) In a perfect world here is what I would do: Send a cashier's check to the hospital with a letter insisting that they instruct the CA to nuke the account without reporting it since there is no payment due, reference applicable laws (FCRA, HIPAA, others?), and relax. Is this the right move? I'm worried that if we rush to pay the hospital they will just tell the CA to report the account as paid. And to be honest, if she has to have a bad mark on her credit either way, I would just as soon wait until we can negotiate a smaller settlement from the CA. Thanks for your advice.